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<br /> THIS IS TO CERTIFY that the following desc d commodity was weighed, measured, or counted
<br /> (commencingwith Section 12700 of Division S g 4eighrpaster,whose signature is on this certificate, who is a recognized fiority of accuracy,as prescribed by Chapter 7
<br /> ) the California Business and Professions Code,adminlaferiii yf j fe Divi'sion of Measurement Standards of the California Department cod and Agriculture.
<br /> n
<br /> ESTABLISHED1 V l` I SCRA CHASER TAG S SERIES C
<br /> ALEX HARVEY H GHHIET, PRESIDT M()DEST O J NIS CO., IN 98085
<br /> JEFF HIGHIET,OPERATIONS M x AGER SCRAP IVISION DATE
<br /> RC 3288
<br /> 098085
<br /> WEIGHED AT:1403-1425 9th St, • P.0 ox 1146 Modesto,California 95353 Phone(209), 2-1435 • Fax(209)522-1891 COMMENTS
<br /> a ADDITIONAL DRIUR'S LIC# CAR MAKE&MODEL
<br /> haul r fog` io business i
<br /> INFORMATION
<br /> I HED EOR O COUNTomino ons ,O,�F4�,y� g�gq�N.�g OUT rryyF ST{P�T HAIR HT WT HI y C s!
<br /> (01
<br /> N �.
<br /> OCCUPATION µtl M SEX EYE HOUR TRAILER LIC#
<br /> iO
<br /> PURCHASED FROM PT OF ORIGIN CHECK#
<br /> driver and cash t an h
<br /> OItALI.W I H1 ttd PO LESS O7MER „ .SPECtF1ED ! PMI*,s SHI3IN `,'G i A IN t' R
<br /> Ali
<br /> G1C31TY SOf�f`,, OSS TAI RE QNB 1a PGT t�NCi IPFt1fA
<br /> a .Y' .) P ,
<br /> o` % t4
<br /> 71 % $ t
<br /> ®� Ih
<br /> 0
<br /> ®�®
<br /> % $
<br /> .i %
<br /> %
<br /> %
<br /> / tp
<br /> ar4x
<br /> SORT Y=YES N=NO T � , . .
<br /> PAYMENT BASIS:(SW)SEGREGATED•-BASE PAYMEN- oN WEIGHT,(SC)--BASE PAYMENT ON COUNT,(C)COMMINGLED
<br /> ENTER PERCENT SHRINKAGE OR ADJUSTMENT,MAY BE APPLICABLE TO UNIT PRICE ONLY,IF WARRANTED
<br /> INVOICE ADJUSTMENT
<br /> T=Predetermined Tare
<br /> (M)=Mixed, (E)=Each, (ME)=Mixed Each Christopher r TOTAL
<br /> PAYMENTL=
<br /> MODESTO JUNK CO - t�V GH $TE CASHIER/DRAWER# a t ?
<br /> BY DEPUTY CASHJER SIGNATURE 1 A �
<br /> Bill Ot 5ala: I hereby state 4hat t am the lawful own®r of the material described hereon,that I have the right to self same,that the above material is free of any opims,that I am over 18 years of age,ahat none of the material
<br /> was the property of a public utility,4ranspartatlon eo.,communications co.,or political subdivision,that it contains no hazardous material as defined by Federiii or State law,and that for payment received in full,hereby
<br /> acknowledged,I self and convey title of same to Modesto Junk Company. Also,in accordance with sections 608(b)(1)and 608(c)of the 1990 Clean Air Act,the undersigned certifies that all CFC refrigerants have been
<br /> properly evacuated from any and ail recyclable materiel cont ned in this transaction. i declare under penalty of perjury that the forgggoing Is true and correct.
<br /> Hold Harmless Agreement: I,also known as seller,Will in emnify and hold buyer harmless from damages,demands and fiabfllties,In
<br /> aneluding reasonable attorney's fees,resulting from the breach of any warranty hereunder
<br /> d driver agrees to be responsible for damage vehicle d,Ing unloading.
<br /> SELLER' GINATURE SE!!!!
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