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FORWARD SITE TICKET GRID <br /> INCORPORATED <br /> 9499-%"�70tf>,5Austin ROad/WifiGHING LOCATION P O Box 6336 WEIGHMASTER�� t ��. � j; <br /> a" '95336 Stockton, CA 95206 <br /> L (20 )982-4298/WEIGHING LOCATION Main Office (209) 466-4482 DATE IN TIME IN <br /> Resource Recovery (209) 982-4936 Fax (209) 465-0631a <br /> y DATE OUT TIME OUT <br /> °..1 a} 4 fr 3�� r` tir t�' .rt K41",� r j r�i-'.� �� 1 , r "i•i .f 55 1 f 1, <br /> P t <br /> ! i r r! "' ... W 3r �.•k_..+ c_... L.t Y .. M r\ a. U 1-" <br /> 1}Tf- <br /> i Q VEHICLE ROLL OFF <br /> r <br /> —W <br /> REFERENCE ORIGIN <br /> TkAC <br /> ��i f)r' ' a r`k`� . <br /> ' +7' or <br /> .. ,.''Y ' '� 1 ' f 01yo . o" S E <br /> r [' 4 6 i t r (1'7 <br /> any- i 1��=s (,y}, 4 1 ��r .ta'�� 1_.11 �#; � u.a <br /> CITY UNIT 'tt DESCRIPTION 7n� RATE EXTENSION TAX TOTAL <br /> 1.-it�,.',1REOU`h J <br /> f <br /> NEIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the followEng described commodity was hed measured or counted by a weighmoster whose signature is <br /> in this certificate who Is a recognized authority of accuracy as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business <br /> and Professions Code administered by the Division of Measurement Standards of the California Department of Food and Agriculture <br /> NET AMOUNT <br /> TENDERED <br /> CHANGE <br /> /F CHECK NO <br /> DRIVER'S SIGNATURE <br />