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I SITE . <br />I\ <br />009914 <br />SME TICKET R <br />FORWARD LANDF Y8 1 <br />9999 S AUSTIN WEiGHMASTER <br />CA CA 95336 IChristina <br />JIM THORPE OIL INC. <br />MARTIN THORPE <br />P 0 BOX 357 <br />4204145409 6) <br />SCALE IN GROSS WEIGHT 80,020 <br />'SCALE OUT TARE WEIGHT 30,440 <br />7 <br />NET TONS 24.79'" <br />NET WEIGHT 49,580 T:;BOOND <br />18.0 <br />�fD <br />TRACKING QTY <br />RATE "` <br />EXTENSION <br />TAX <br />TOTAL <br />18.0 <br />YD <br />TRACKING QTY <br />24.7 <br />TN <br />SW -BENEFICIAL REUSE STOCKTON <br />24.7 <br />TN <br />SW -BENEFICIAL REUSE STOCK <br />`�0 s <br />Id <br />a _ ^moi <br />The undersigned Individual signing this document on behalf of Customer acknowledges that he or she has read and understands the terms and conditions <br />on the reverse side and that he or she hes the authority to sign this document on behalf of the customer. <br />RS-F042UPR (07/12) SIGNATURE <br />SITE SITE., TICKET # CELL <br />FORWARD LANDFILL <br />9999 S AUSTIN RD VIEIGHMASTER <br />MAMTFrn ra OS1Zr. -_ I . . <br />CHANGE <br />CHECK# <br />009914 V HCL CONTAINER <br />JIM THORPE OIL INC. <br />MARTIN THORPE REFERENCE <br />P 0 BOX 357 INVOICE <br />4204145409 BILL OF LADING <br />817496 <br />SCALE IN GROSS WEIGHT 80,020 NET TONS 24.79 <br />SCALE OUT TARE WEIGHT 30,440 NET WEIGHT 49,580 INBOUND <br />Ow. <br />UNIT <br />!? .DESCRIPTION ="'" <br />' RATE ' <br />EXTENSION" <br />TAX <br />TOTAL'' <br />18.0 <br />YD <br />TRACKING QTY <br />24.7 <br />TN <br />SW -BENEFICIAL REUSE STOCK <br />Id <br />rn <br />The undersigned individual signing this document on behalf of Customer acknowledges that he or she has read and understands the terms and conditions <br />on the reverse side and that he or aha has the authority to sign this document on behalf of the customer. <br />RR-FO4911PR M7/191 901 mr_u •n me <br />TENDENED <br />CHANGE <br />CHECK# <br />