Laserfiche WebLink
FORWARD STE TICKET GRID <br /> INCORPORATED <br /> 9 South Austin Road/WEIGHING LOCATION P O Box 6336 WEIGHMASTER <br /> pit a, CA 95336 Stockton, CA 95206 <br /> iS 209) 982-4298/WEIGHING LOCATION Main Office (209) 466-4482 DATE IN TIME IN <br /> es Recovery (209) 982-4936 Fax (209) 465-0631 - <br /> DATE OUT TIME OUT <br /> VEHICLE ROLL OFF <br /> I t a REFERENCE _ ORIGIN <br /> QTY= UNIT DESCRIPTION RATE EXTENSION "I <br /> TAX TOTAL <br /> L� <br /> 1 <br /> EIGHMASTER CERTIFICATE THIS 15 TO CERTIFY That the following described commodity was weighed measured or counted by a weighmaster whose signature Is <br /> Uslofessons <br /> certificate who is a recogn¢ed authority of accuracy as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business <br /> Code admtntsterod by the Division of Measurement Standards of the California Department of Food and Agncuiture <br /> NET AMOUNT <br /> TENDERED <br /> CHANGE <br />' CHECK NO <br /> DRIVER'S SIGNATURE <br /> Qf <br /> iY <br /> ! CUBIC YARDS <br /> II hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing DISPOSAL METHOD (TO BE COMPLETED BY LANDFILL) <br /> Is true and accurate <br /> DISPOSE OTHER <br /> FIEMARKS ❑ SOIL <br /> I ❑CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑ NON-FRIABLE <br /> - ASBESTOS <br /> SIGNATURE OFAUTHORIZED AGENT DATE <br />' ❑ wooD <br /> aASH <br /> ❑ SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3 04 PM THE DAY PRIORTO EXPECTED ARRIVAL*ANY UNSCHEDULED LOADS ARE SUBJECT <br /> iTO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE _- <br /> SALES COPY MANIFEST# fl '"a 7 <br />