Laserfiche WebLink
r— <br />' ��+ SITE TICKEC GRID�+� EORWARD <br /> CORPORATED <br /> 9 South Austin Road/WEIGHING LOCATION P O Box 6336 WEIGHMASTER <br /> Ent a, CA 95336 Stochton, CA 95206 <br /> a 209) 982-4298/WEIGHING LOCATION Main Office (209) 466-4482 DATE fN TIME IN <br /> fes Recovery (209) 982-4936 Fax (209) 465-0631 i _ _ <br />' s V DATE OUT TIME OUT <br /> VEHICLE ROLL OFF <br /> 1 r REFERENCE— ORIGIN <br /> L <br /> yy tt t 4 r <br /> `� <br /> QTY UNIT DESCRIPTION RATE EXTENSION 4TAX _ TOTAL <br /> �w <br /> I <br /> I <br /> EIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmasterwhose signature is <br /> his certificate who is a recognized authority of accuracy as prescribed by Chapter 7(commen=g 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 />' CHANGE <br /> CHECK NO <br /> DRIVER'S SIGNATURE <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 /> ❑ SOIL <br /> REMARKS <br /> al CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑ NON-FRIABLE <br /> SIGNATURE OF AU'rHOFf1ZED AGENT DATE ASBESTOS <br /> ❑WOOD <br /> ID ASH <br /> Q SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT <br /> I TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> SALES COPY MANIFEST# <br /> ,_ _ Z, <br />