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(J)#FORWARD <br />INCORPORATED <br />9999 South Austin Road/WEIGHING LOCATION P.O. Box 6336 <br />anteca, CA 95336 Stockton, CA 95206 <br />:ndrill: (209) 982-4298 / WEIGHING LOCATION Main Office: (2091 466-4482 <br />Kesource Recoverv:(209) 982-4936 Fax: 1209) 465-0631 <br />c:-731 1 1 <br />)::2V IN <br />STi--V-70N CA <br />OT <br />ManL!al Tare ,{ei:]h1+. <br />Y UNIT <br />`! C _ c'-' L_ E <br />3172:` LP <br />DESCRIPTION <br />2.2, ! TDNS I Cover LlaEis Il Ton <br />SI'E ' TICKET <br />GRID <br />WEIGHMASTER <br />DA--= !N <br />TIME IN <br />77 <br />I DATE OUT <br />TIME OUT <br />ROLL OFF <br />- _ <br />rEPc?c'+Cc <br />ORIGIN <br />r4—r. <br />RA.T= EXTENSION i TAX i TOTAL <br />WEIGHMASTER CERTIFICATE 'N,1S IS 7C 7i= nE'CI'-C+o. _ =--'.aE7 _Gro^ Ve c__. _ _ c ..= _ -. SE ;Ure is <br />C' _ _.'c. WhC is recaanizea _,. Tf occ.;rac" _ -?5_.,c_, <br />:Ccc ,,aminislerec Cy `.e'DI, -,,Cn of %4eC5U-= �:.. -'1e _.. _ ^:c <br />ManiT_st. #(: 61P41a <br />P. 0. #E NONE <br />T r a i ter #r` <br />Drive Safely I ! <br />DRIVER'S SIGNATURE <br />the landfill. <br />I NET AMOUNT <br />I <br />TENDERED <br />CHANGE <br />CHECK NO. <br />W recycled page <br />