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n � — <br /> =P R Q R � t <br /> FORWRD SITE TICKET 1 GRID � <br /> l <br /> INCORPORATED <br /> I II WEIGHMASTER <br /> "999OS6uth Austin Road/WEIGHINC LOCATION P O Sox 6336 <br /> K^ -�=r <br /> Manteca, CA 95336 Stockton, CA 95206 <br /> landfill (209) 982-4298/WEIGHING LOCATION Main OffILe (209) 466-4482 DATE INI 11 TIME IN <br /> ",Resource Recovery (209) 982-4936 Fax (209)465 0631 <br /> f <br /> l>' {, Y-fir"# s DATE OUT II TIME OUT = <br /> ^ L. it to rte(I`,` ► L+#)i I�^i 1 1 t—e _ a 3 11� . �. t �r= <br /> r y VEHICLE II ROLL OFF <br /> T F F1,r'� <br /> �;��";�# �' t ? REFERENCE 1 II ORIGIN <br /> a <br /> I-iir H{l�l� tdiS�1I <br /> UNIT DESCRIPTION RATE EXTENSION, TAX TOTAL <br /> zt <br /> K'a4ria;,�V 3 r it <br /> � I•-e <br /> 4E FIMA5TER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or Counted by�a welghmaster whose signature Is <br /> pori thss certificate who is a recognized authority of accuracy as prescribed by Chapter 7(commencing with Section 12700)of DIv sionl 5 of the California Business <br /> Qnd Professions Code administered by the D}rasion of Measurement Standards of the California Department of Food and Agriculture II ` <br /> -_ I I NET AMOUNT <br /> TENDERED <br /> I <br /> _ II CHANGE <br /> ! CHECK NO <br /> 3 <br /> DRIVER'S SIGNATURE I <br /> I <br /> t <br /> r! <br /> I I I <br /> � I - <br />