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FORWARD <br />t 9999 S . <br />MANTECA, <br />ITOMER <br />010392 <br />JIM THORPE OIL INC. <br />MARTIN THORPE <br />P 0 BOX 357 <br />4204141109 <br />SCALE IN <br />SCALE OUT <br />95336 -- <br />GROSS WEIGHT 65,420 <br />TARE WEIGHT 35,500 <br />SITETICKET M CELL <br />YB 43 <br />WEIGHMASTER <br />IN - Victoria P. OUT Brid ette B. <br />DATE/TIME IN I DATETMEOUT <br />03-05-2014 12:59 pm 03-5-2014 1:43 pm <br />VEHICLE CONTAINER <br />THORPE 6 <br />NET TONS <br />NET WEIGHT <br />14.96 <br />29, 920 <br />INBOUND <br />OTT. <br />UNIT <br />DESCRIPTION <br />RATE <br />EXTENSION <br />TAX <br />TOTAL <br />18.0 <br />YD <br />TRACKING QTY <br />14-9E <br />TN <br />14-96 <br />TN <br />SW—CONST DEBRIS STOCKTON <br />1.0c <br />ENVIRONMENTAL FEE 1 <br />1.00 <br />ENVIRONMENTAL FEE 1 <br />1.0 <br />FUEL RECOVERY FEE <br />1.00 <br />FUEL RECOVERY FEE <br />The undersigned Individual signing this document on eha" of Customer acknowledges that he or she hes mad 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-FO42UPR (07/12) SIGNATURE <br />se1C FORWARD LANDFILL <br />9999 S AUSTIN RD <br />MANTECA, CA 95336 -- <br />010392 <br />JIM THORPE OIL INC. <br />MARTIN THORPE <br />P O BOX 357 <br />4204141109 <br />TENDERED <br />CHANGE <br />CHECK# <br />SITE TICKET# <br />Y8 998843 <br />CELL <br />WEIGHMASTER <br />o*rA R <br />DATETME IN <br />03-09-2n14 1 <br />DATETME OMIT ' <br />-2n14 1:43 pm <br />VEHICLE <br />THORPE 6 <br />CONTAINER <br />REFERENCE <br />INVOICE <br />S1LI, OE I.pyING <br />SCALE IN GROSS WEIGHT 65,420 NET TONS 14.96 <br />SCALE OUT TARE WEIGHT 35,500 NET WEIGHT 29,920 INBOUND <br />OTT. <br />UNIT <br />DESCRIPTION <br />RATE <br />EXTENSION TAX <br />TOTAL <br />18.0 <br />YD <br />TRACKING QTY <br />14-9E <br />TN <br />SW—CONST DEBRIS STOCKTON <br />1.0c <br />ENVIRONMENTAL FEE 1 <br />1.0 <br />FUEL RECOVERY FEE <br />I The undentigned 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 has the authority to sign this document on behalf of the customer. <br />RS-FO42UPR (07/121 901 <br />RIGNATURF <br />TENDERED <br />CHANGE <br />CHECK# <br />