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Y +,1� "E CERTIFICATE
<br /> AISFY that the foflotfi g d ri commodity was weighed fine tired, ®rr,Yt�ho a si , attire is on.this certificate,who is,a, r
<br /> f??r,. g� recognized authrout arx ad by Chapter 7
<br /> action27f3(3)4f`f(tftsld.,r. ;„ t aStdlifomia`BuSihess and Papfessions Ivistgft'of:bileesnrerrterrt Standards of the Cal'rfomia©epartmemof E d;A'r+'' re.
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<br /> HARV,�1(WIGHIET3, 151
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<br /> WEIG5
<br /> HED AT'1463-1425 9th t. �; P O Bax 114 Mbde�ta,Calrfarnia;Y r`,• Pn`" Igm 5 14q • Fax1 i COManENTs Y"
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<br /> DI-TION
<br /> IRIVEA S LIG;# ' CAl i=�AAE� ODEL
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<br /> WEI('aHED FOR'OR ACCOUNT OFrr IEFOlMATIx You SS with
<br /> O[iTOF STATE w HAIR - ,kiT +NT �J IC#
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<br /> 17 L-' J SF E EYE HOUR A
<br /> PURCHASES FROM ORIGIN CHECK#
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<br /> SORT Y_v�S N=No _ IZ-Affil TOTAL
<br /> PAYMENT BASIS: (SW)SEGREGATED--6ASEPAYMEN�N,WEIGHT�S ) BASE P 4MENFON COUNT(G)COMMINGLED
<br /> ENT ER�PERbENTSHRINKAGEORADJUSTMENT;�MAl �+fpp4dCABL�"�UN�('P IQEr"�ONL'Y�IF?lllARRi)t�fED `
<br /> �� ,• �, INX/Q1�E ADJUSTMENT
<br /> ®PT,,'Predetermined Tare • TOTAL,
<br /> (M) Mined, (E)=Each, (ME)#,Mixed E;(0
<br /> MODESTaJUNKCa.- WEIGHMASTER a P�Y�E�T
<br /> CAS,HIR/D
<br /> BY DEPUTY iCASLjER SIG AT
<br /> SIt `,Sal®>:1 herex;< ,Tom: ...,
<br /> I, . , ui ovine t a material descn¢ad hereon,that . ave the ri ht to seii`same;that tha o `Mate 1 ,f o f an .claims that I m
<br /> w �.x .. ,. g ,.. att,X„•,. k ..,:: .Y a. a over 48 years of age,that n'a of,the-material
<br /> as the property of a public utility,t(8ns tOrtatlon vip }iunlcaiign r or political cubdrvision,That itcomains.-no hazardo s to iat s
<br /> ,._ •. _u-fia x a defir,ed,Fy.Federal or State law,and that for,payment received Tin full,:hereby
<br /> ackadwled'ged;`tselhandcorneyfide.ofsafnata ;; lsa=,urk:Com Atsoartacporan�ewithsections8
<br /> d O6(b)„(i),antl 608(c).of.the 99e,,`, Air Act,the undersigned certifies tniWall CFC refn Brants„have been
<br /> properi `euapuated from an and alI r 9-
<br /> pe y ecycl>�ble�'natena® nfamed in ti�Ts��t ; sactwn:I declare uritler penalty of erjury that the lgeegoirig`is true and,cOt€act.”
<br /> Holdaarmless Agreement: f;atsa known as oaltet,- Ik. emm a tltgltl bu er tarrriie`ss-frorri lamages,
<br /> �emands dti ”iii ^""
<br /> ty tl Yan abi1,es,including rgasonabie attorney s fees,resulting from the breach of any warranty hereunder
<br />` `and dnyertagrees to The responsible for 8agia�eslo� role�ring unio��T ':T �"
<br /> S£LL IGNA,TURE SELLER'S ADDRESS
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