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FORWARD <br /> SlTE`A TIi sRID.. t <br /> INCORPORATED ' (� 0-0 <br /> 199 South Austin Road/WEIGHING LOCATION 'P O Box 6336 5-44 -77° WEIGHMASTER r; <br /> ISO, CA 9533f3r Stockton,CA 95206 <br />, 209) 982-4299V WEIGHING LOCATION Mam Office (209) 466-4482 ����;a� �'DATE IN--, - � TIME IN <br /> es Recovery (209)-r82-4936 Fax (209) 465-0631 3 L111a 0373 a„o 7 p ffin <br /> 003365 <br /> ADVANCED GEO ENVIRONMENTAL unEe ,_ Q � ` :c� TIME OUT <br /> r�m <br /> PAUL DOTSON <br /> 837 SHAW ROAD VEHICLE, ",�, , u ROLL©FF <br /> I r4l%l Won <br /> STOCKTONs CIS ' 5815 <br /> REFERENCE' r QRfG1N <br /> Contract: 3365# TRACY <br /> Gross Weight 77,740.00 LB Inbound - SCALE TICVET <br /> Stored Tare Weight 2Q,480.00 LS <br /> Net Weight 48,860.oO LH 84. 13 TIS <br /> OTY a ` "U rl° 7 .F31A'ffC�TlF ,4 ,�.' dry • PIATE k`?cTENSt0N ' = TAX TOTAL 1 <br /> 24. 13 Tint 16 STOCK I LE <br /> e1GHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmaster whose signature is <br /> his 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 /> Professions Code administered by the Division of Measurement Standards of the California Department of Food and Agriculture <br /> NET AMOUNT <br /> TENDERED <br /> k'1+AN IFEST x#220"',5,o <br /> CHANGE <br /> CHECK NO <br /> DRIVER'S SIGNATURE <br /> 4 <br /> CUBIC YARDS <br /> I 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 /> �e <br /> ❑SOIL <br /> EMARKS <br /> ❑CONSTRUCTION � <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑ NON-FRIABLE <br /> ASBESTOS r <br /> SIGNATURE OF AUTHORIZED AGENTJ 1_j 19WEI 1 / <br /> ❑WOOD <br /> ©ASH <br /> I ❑ SPECIAL OTHER y <br /> SCHEDULING MUST BE MADE PRIORTO 3 00 P M THE DAY PRIORTO EXPECTED ARRIVAL•ANY UNSCHEDtALED LOADS ARE SUBJECT <br /> ITO <br /> REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIESIIUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> SALES tQPY MANIFEST 0220750 <br /> 2 0 7 5 0 <br /> G V <br />