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FORWARD LANDS <br />9999 S AUSTIN <br />INTECA, CA 95336 -- <br />TOMER— <br />009914 ' <br />JIM THORPE OIL INC. <br />MARTIN THORPE <br />P 0 BOX 357 <br />4204145409 <br />'SITETICKET # <br />CELL <br />YB 1CM71 <br />RATE <br />WEIGHMASTER <br />Christina G. <br />DATE/TIME IN <br />DATE/TIME OUT <br />04-16-2014 4:11 m <br />04-16-2014 4:22 prr <br />VEHICLE <br />CONTAINER <br />THORPE 6 <br />REFERENCE <br />INVOICE <br />BILL OF LADING <br />R 17494 <br />SCALE IN GROSS WEIGHT 79,140 NET TONS 23.77 <br />SCALE OUT TARE WEIGHT 31,600 NET WEIGHT 47,540 INBOUND <br />QTY. <br />UNIT, <br />n.rvk„ <br />RATE <br />EXTENSION <br />TAX <br />TOTAL <br />18.0 <br />YD <br />TRACKING QTY <br />23.7 <br />IN <br />SW -BENEFICIAL REUSE STOCKT <br />s *, <br />s t <br />` " <br />�� <br />SAFETY \ <br />fl <br />ar { yY a 4 d <br />4 <br />The undersigned Individual signing this document on behalf of Customer acknowledges that he or she has reatl and understands the terms and Conditions <br />on the reverse side and that he or she has the authority to sign this document on behalf of the customer. <br />RS-F042UPR (07/12) SIGNATURE <br />SITE <br />FORWARD LANDFILL <br />9999 S AUSTIN RD <br />MANTECA, CA 95336 -- <br />009914 <br />JIM THORPE OIL INC. <br />MARTIN THORPE <br />P 0 BOX 357 <br />4204145409 <br />TENDERED <br />CHANGE <br />CHECK# <br />SITE I TICKET # <br />YB 1006971 <br />CELL <br />WEIGHMASTER <br />r4r <br />DATE/TIME IN <br />DATE/TIME OUT <br />VEHICLE <br />THORPE 6 <br />CONTAINER <br />REFERENCE <br />INVOICE <br />Etl 7 9 9 91NG <br />SCALE IN GROSS WEIGHT 79,140 NET TONS 23.77 ` <br />SCALE. OUT TARE WEIGHT 31,600 NET WEIGHT 47,540 INBOUND <br />- OTY. <br />UNIT <br />'RATE <br />EXTENSION <br />TAX <br />TOTAL <br />18.00 <br />23.77 <br />YD <br />TN <br />TRACKING QTY <br />SW -BENEFICIAL REUSE STOCK <br />f ti <br />v 4 <br />�� <br />y dy m 4 <br />fl <br />I oc c^^I The undersigned individual signing this document on behalf of Customer acknowledges that he r she has reatl and understands the terms and conditions <br />on the reverse aide and that he or she has the authority to sign this document on behalf of the customer. <br />�m <br />TENDERED <br />CHANGE <br />CHECK# <br />