Laserfiche WebLink
1 > <br /> +� FORWARD SITE 3 TICKET GRID <br /> Vo INCORPORATED <br /> 19 South Austin Road/WEIGHING LOCATION P O Box 6336 WEIGHMASTER <br /> t CA 95336 Stockton,CA 95206 <br /> n09) 982-4298/WEIGHING LOCATION Main Office (209) 466-4482 DATE IN TIME IN <br /> so Recovery (209) 982-4936 Fax (209) 465-0631 <br /> DATE OUT TIME OUT <br /> s «' VEHICLE - ROLL OFF <br /> REF=ERENCE ORIGIN <br /> 4 <br /> QTY , UNIT DESCRIP-PON RATE, EXTENSION t TAXe TOTAL <br />' ` 1 <br /> I <br /> IGHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmaster whose signature is <br /> his certlhcote 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 ana Agriculture <br /> NET AMOUNT <br /> wN TENDERED <br /> s <br /> CHANGE <br /> ` CHECK NO <br /> DRIVER'S SIGNATURE <br /> J, 4 <br /> - — -- - - -- — -- -- -- -- -- - ---- -- -- -Tzl-- -— - -- , - --- <br /> I * r 1 <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 /> CI CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> ISIGNATURE OF AUTHORIZED AGENT DATE ❑WOOD <br /> r <br /> ❑ASH <br /> ©SREC1AL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT <br /> To REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BF-FORE -- <br /> SALES COPY MANIFEST# i% <br />