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FORWA RD US, <br /> �+ INCORPORATED rs 4 �� `' �` r IOC <br /> 9 South Austin Road/WEIGAING LOCATION ' P O 'Box 6336 '�'� WEIGHMASTER4- 1 �" <br /> Rna,CA 95336 1 Stockton,CA 95206 `+ <br /> a 209) 982-4298/wEIGHrNG LOCATION Main Office (209) 466-4482 Ln I-DATE,IN r TIME IN <br /> Recovery (209) 982-4936 Fax (209)465-0631 4 June dQQj I I ,1+ am <br />' 003365 <br /> ADVANCED GELS ENv HUhah►ENTiL rGATEi oLlr TIME CIT <br /> 'AUL DOTSON Line _�{ � -47 air, <br />' 837 SHAW ROAD vEkdL Tx7t i' F(OLL OFF <br /> STODpr T 3N. CA 9521s REI CE °r 4aRiGtN3 <br /> Contract: 3365# � T 1 <br /> tz <br />' 00 Gross Weight S1 , 320-fists LB Inbound - SCALE TICI<ET <br /> Stcred Tate Weight 29.988„00 LB <br /> Net Weight 51 ,34o.00 LS 25.67 TN <br /> CtfY� 1 Utitli tr l3EIIFTlOISE1 a v <br /> >;xTENsrnN r S TAX ° - TOTAL <br /> 25.6 Tib 1 n STOCfb LE <br /> I <br /> I <br /> EIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmaster whose signature is <br /> 11hIs certificate who Is a recognized authority of accuracy as prescnbed 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 /> ------------- <br /> NET AMOUNT <br /> MANIFEST #220761 <br /> TtrN©FRED <br /> If CHANGE: <br /> CHECK NO <br /> DRIVER'S SIGNATURE <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 /> I Is true and accurate. <br /> DISPOSE OTHER <br /> REMARKS ❑ SOIL <br /> I ❑ CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑ NON—FRIABLE <br /> ASBESTOS <br /> SIGNATLJRE OFAUTHORIZED T ` DATE <br /> ❑WOOD <br /> I .O SPECIAL OTHER <br /> SCHEDULING MADE PRIOR TO 3 OO P M.THE DAY PRIORTO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUB•IECT <br />�TO REFU"C UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> SALES COPY MANIFEST# 22 <br /> ; r'► —_ <br />