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! FORWARD <br /> INCORPORATED <br /> �� C O jZ � O x � T E D SITE TICKET GRID <br /> �101 186210 D-99 <br /> 9999 South Austin Road/wEIGHING LOCATION P O Box 6336 WEIGHMASTER <br /> Manteca, CA 95336 Stockton, CA 95206 L. DOM I NGUEZ <br /> Landfill (209) 982-4198/WEIGHING LOCATION Main Office (209) 466 4482 DATE IN TIME IN <br /> Resource Recovery (209) 982 4936 Fax (209) 465-0631 05/03/00 11 :34 <br /> 9415400 DATE OUT TIME:OUT <br /> ADVANCED GEO ENVIRONMENTAL 05/03/00 11 :35 <br /> SILL LITTLE VEHICLE ROLL OFF <br /> 4005 N. WILSON WAY N 1908 <br /> STOCKTON CA 95205--2486 REFERENCE ORIGIN <br /> 45400 HAN KHAN � <br /> Scale 2 Gross Weight 75660 LS Inbound - Charge ticket <br /> Stored Tate Weight 29940 LB <br /> Net Weight 45720 LES <br /> CITY uNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 22.86 ONS Class II Soil by Ton <br /> I <br /> t ' <br /> } <br /> r <br /> � v <br /> 4 <br /> WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the foFlowing described commodity was weighed measured or counted by a weighmaster whose signature Is <br /> on this certificate who is a recognized outhordY of accuracy os prescribed by Chapter 7(comment;ng with Section 12700)of Division 5 of the California Business <br /> and Professions Code administered by the Division of Measurement Siondords of the California Department of Food and Agriculture a <br /> MANIFEST # 35862 NET AMOUNT - <br /> TRUCK # J CONRAD <br /> P.O. # NONE TENDERED <br /> Schedule 24 hours In advance directly with the landfill . CHANGE <br /> Ca,11 (209 )982-4298 to schedule. <br /> Drive Safely ' ' CHECK NO <br /> �0% recycled paper <br /> DRIVER'S SIGNATURE ' <br /> • <br />