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F ORWARD SITE <br /> INCORPORATED TICKET GRID <br /> 9 South Austin Road/WEIGHING LOCATION P O Box 6336 WE€GHMASTE:R <br /> rite a, CA 95336 Stockton, CA 95206 <br /> an 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 /> 1 _ - <br /> g <br /> TE OUT TIME OUT <br /> " 5 <br /> 1 EHICLE ROLL OFF <br /> r E I ORIGIN <br /> Z. <br /> lk <br /> k f ♦: } <br /> QTYUNIT DESCRIPTION RATE E ,i EXTENSION TAX TOTAL <br /> I 1 <br /> IGHMASTER CERTIFICATE THIS IS TO CERTIFY That the foilowing described Commodity was weighed measured cr counted by a weighmaster whose signature is <br /> is certificate who is a recognized authority of accuracy as prescribed by Chapter 7(commencing with Secfion 12700)of Division 5 of the Ca}ifornia Business <br /> Professions Code adminstered 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 SIGNATURE5EMKZGMM= 210W <br /> I 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 /> I is true and accurate. <br /> DISPOSE OTHER <br /> ❑SOIL <br /> REMARKS f <br /> I ❑ CONSTRUCTION <br /> FACILITY TICKET NUMBER r DEBRIS <br /> O AS NON-FRIABESTOS LE <br />' SIGNATURE OF,AUTH©q OAGFNT D T <br /> ❑WOOD <br /> Q ASH <br /> ' r ❑ SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3 00 P M THE DAY PRIORTO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY OEFORE <br /> SALES COPY MANIFEST <br />