HomeMy WebLinkAbout1 Legoland Dr; ; CBC2016-0038; Recycle(City of
Carlsbad
WASTE MANAGEMENT
PLAN
Development Services
Building Division
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov B-59
Owner: Contractor:
Job Address:. ______________ _ Phone Number: ________________ _
Permit#: Estimated Cost of Project: $ ____________ _
Type of Project: D New Construction D Remodel or T.I. D Residential D Commercial D Demolition
(check all that apply) D Other
Non-hazardous construction waste generated during the course of this project shall be recycled and/or salvaged for re-use at a
minimum of 50% per CALGreen Sec. 5.408.1. Failure to comply may result in a penalty fee up to $1,000. For projects which
consist of mainly equipment and/or racking, that have a combined weight of new construction disposal that does not exceed 2
lbs per square foot of building area affected by this permit, may be deemed to meet the 50% minimum requirement upon
approval of Building Department.
ALTERNATIVE FORMS OF COMPLIANCE: (If selected, do not complete Tables 1 & 2 below)
D Construction waste shall not exceed 2 lbs. per sf. of area. All receipts shall be provided to the Building Official prior to
final. (This option not applicable for most construction projects.)
Square feet of construction area X 2 lbs. = lbs. of allowable waste.
D I plan on using a WASTE MANAGEMENT roll-off bin. All receipts shall be provided to the Building Official prior to final.
Table 1 -Estimated Waste (To be filled out prior to permit issuance -refer to example on Page 2.)
MATERIALS lbs. of waste to be taken to lbs. of waste to be Waste Hauling Company or Re-Use Method LANDFILL RE-USED or RECYCLED
Asphalt/ Concrete 375 cy [10 cy per lo ad] Asphalt and Concrete will go to Brick/ Masonry Vulcan Materials Carrol Canyon
Cardboard plant. The Asphalt and Concrete will
Drywall be 100% recycled by Vulcan. All
Landscape Debris 23 loads [10 tons pE r load] other materials and debris disposal
Lumber/ Wood 3 loads [10 tons pe1 load] will be at Sycamore Landfill. The 23
Metals 1 load [10 tons per I oad] loads of green waste will be mulched
Mixed Waste 10 loads [10 tons PE r load] by the landfill.
Trash I Garbae:e I
Western Trucking & Transportation will be
Other: the hauler for demolition and soils.
TOTAL lbs: I
Estimated Percentage to be Re-Used or Recycled_ 50.3 %
I certify that the information provided herein, to the best of my knowledge, is true and correct.
Contractor or Owner (print name)
Contractor or Owner (signature) Date
Official Use Only
D Plan Approved D Plan Denied D Project Valuation Approved
Reviewed/ Approved by:, ________________ _
PaE!e 1 of 2
Table 2 -Actual Waste (To be completed after construction.)
MATERIALS lbs. of waste taken to lbs. of waste Waste Hauling Company or Re-Use Method
LANDFILL RE-USED or RECYCLED (complete only if different than Table 1)
Asphalt/ Concrete
Brick/ Masonry
Cardboard
Drywall
Landscape Debris
Lumber I Wood
Metals
Mixed Waste
Trash I Garbas:e
Other:
TOTAL lbs.:
Actual Percentage Re-Used or Recycled ______ %
Official Use Only
D 50% Goal Achieved D 50% Goal Not Achieved D Alternative Compliance Achieved Penalty Paid $ _______ _
Reviewed/ Approved by:. __________________ _
EXAMPLE: Use the following example as a guide to completing this form.
MATERIALS lbs. of waste to be taken to lbs. of wc1ste to be
LANDFILL RE-USED or RECYCLED
Asphalt I Concrete 0 2000
Brick I Masonry 100 450
Cardboard 0 150
Drywall 0 50
Landscape Debris 0 i:2.0
Lumber I Wood 500 0
Metals 300 200
Mixed Waste 1-500 0
Trash I Garbage 300 0
Other: Pool C:::iul/\,[te 0 900
TOTAL lbs.: ':(J-00 3<2J-O
Percentage to be Re-Used or Recycled 59 %
Formula:
Total Re-used or Recycled X 100 = % Re-Used or Recycled
(Total Combined Waste)
Waste Hauling Company or Re-Use Method
Al;G H-CH,<.LLl/\,C::1 Go.
WM I Re-l,{selil B.vLe,i,z Ql/\,-sLte
AB.G H-C1uLLV\..v1 Go.
AB,G H-CluLLV\..C\ Go.
Mulcviecl E; R.e-us.;eol 011\,-s.;[te
wi;iste MC1V\..C1gev1tteV\..t
WM I AB,G H-C!uLLl/\,(1
WM
WM
l,{_$eli1 cis crnsvielil B,cise ol/\,-sLte
3870 X 100 = 59% Re-Used or Recycled
(2700 + 3870)
Since 59% exceeds the minimum requirement of 50%, this plan complies.
Page 2 of 2
SWL
SPECIAL INSPECTION AND
Geo TECH SeRv1ces
Serving all your special inspection needs
In the Greater L.A. Basin
2026 Andreo Avenue
Torrance, CA 90501
Office/Mobile: 310. 489.9176
Email: swlstacylenz@sbcglobal.net
Veteran Owned
REGISTERED INSPECTOR'S DAILY REPORT Job No.
1YPE OF INSPECTION
REQUIRED
0 Structural Steel Assembly
0 Fire Proofing
As halt
INSPECTtON SUMMARY• LOCATIONS OF WORK INSPECTED. TEST SAMPLES TAKEN. WORK REJECTED. JOB PROBLEMS. PRCGReS. REMARKS, ETC.
INCUJDES lNFORMA.TlONABOUT • AMOUNTS OF MATERIAL Pl.ACED OR WORK PERFORMED, NUMBER, TYPE & IOENT. NO'S
OF TEST SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.t BOLTS TORQUED! CHECKED: ETC.
QUALITY CONTROL C ~CK!O INWITHQTV
CHECKLIST ~TIMETOJO!l
TURE OF REGISTER£D1H
5"13"5 AGENCV ' SP£C1AI.TY
Cl REVIEWSI> PRE\IIOUS REPORTS
Cl OSTAIMEOAPPROPRIATI NO. OF SAMPU!S
COH11NUED ON NEXT PAGE c, PAGE
All lnapeetlou bued on I mlnl111um of, heu,a anti ova, '4 hours• 8 hour
minimum. AH 1nspacllon111 starting bafont 12:UO p.m. and nmnlng put
12;00 p.m, wfll be ch•rged • a hour minimum.
Apprond~-----------,,_, ...... _..,.. ____________ __
Pruject Suplflntlndlnt
Sl\1 1~
SPECIAL INSPECTION AND
GEO TECH SERVICES Resistance Pier Installation Log
JOB NAME:
Cylinder Effective Area
Drive Cylinder Effective Area: Red Ram -9.62 SQ. In, Grev Ram -14.18
Lifting Jack: 5.15 Sq. In.
SECTION LENGTH -3'
PIER# ( PIER# 1_ PIER# 3 PIER#
SECTION PSI SECTION PSI SECTION PSI SECTION
1 50D 1 ·50l) 1 l.D.an 1
2 roe 2 ~ 2 lJ ff\ 2
3 l?>Oo 3 i~ 3 '?.a-n 3
4 IYO-O 4 i '-fern 4 ( LfCI"'\ 4
5 1--1~ 5 I '4cm 5 \'-t~-o 5
6 \A'l)t) 6 i f'bt\ 6 \\>OU 6
7 7 7 7
8 8 8 8
9 9 9 9
10 10 10 10
11 11 11 11
12 12 12 12
13 13 13 13
14 14 14 14
15 15 15 15
16 16 16 16
17 17 17 17
18 18 18 18
19 19 19 19
20 20 20 20
21 21 21 21
Depth Depth Depth Depth Below Below Below Below Grade Grade Grade Grade
Total Pier Total Pier Total Pier Total Pier
Length Length Length Length
Last Pier Last Pier Last Pier Last Pier
Length Length Length Length
Total Pier Total Pier Total Pier Total Pier
Depth Depth Depth Depth
JOB NUMBER:
PIER LOG#: C OF \
DATE: '7-Z.~ Ii
Lt PIER# :"'5
PSI SECTION PSI
1.-,An 1 {p(l')
ln() 2 'iOO
( 'lL:!JT-~ 3 12.oo
i300 4 \'Soo
IL.Ion 5 ll/(}J
l'it)f\ 6 1loO
7
8
9
10
11
12
13
·~., 14
,. 15
1·e .
17
18
19
20
21
Depth
Below
Grade
Total Pier
Length
Last Pier
Length
Total Pier
Depth
r I I ~
i
. ··cAL-T #143-11. ~-_, " f;
E.P.A. ID .. NO. CAR00018792Q,
(619) 443-6193
FAX (619) 443-9364
c-1··. RINGIPAL OR OVER-
"'· LYING CARRIER
•ft "
... -·-:·· ····-~···.·.-:·::·-· ·-·······-·-···-· ----······ -·-··
"w,,,RUST & SONS
TRUCKING
15353 Old Hwy 80 • El Cajon CA 92021
!
FREIGHT BILL
ADDRESS-----------------------~~--~-----~~-
CITY
STATE _____ ~-------~'-----~--------,,---Z_IP __ ~------~-TRUCK#
UNDERLYING
.CARRIER (IF ANY)
/-;·.Sf;IIP.PER .. ,,.,
·coNSIGNER
PT. OF DESTINATION
BEG. OD,\)"1,,E_T_ER
t nu_ri l~""l'li ·l-v ~v ~ fl I
TAG NO.
TRAILER# . W:" ·. i-·:. :ff··•, . '''.'•,s,/'~;·c,~F'c~~~:SIGNEE • ,+.,;,·, ••'fy '•.-"' ~i;.
-------~--~--------~-
. -·_~,:...·.
I ENDING ODOMETER
WEIGHT
. ~ ; C
TOTAL MILES
STREET OR BOX~------------------
CITY/STATE/ZIP
I . P.O. NO.
if,.,jt~ -1.JJ o -Et..)
RATE-
/(){) I JOB NO.
LOADING . UNLOADING-• STANDBY BREAKDOWN I COMMODl~)',1-__ -... -'.,A_R_.fl_lV~_E~. ~-D~E-.P-'A-RT-~-./J.-.§-.'?-IV-E-.... -..... -.... :.-0.-Ef'-.11-RT-.-.. --; .. , '" TIME:.,. REAl30N FOR DELAY
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OF DUMP TRUCK EQUIPMENT \\ AcPpR11NGTI~E . ENDING TIM~ . 1"' 1 TOTAL ri~;,,-.• ...
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D 2 AXLE D 2 AXLE D TRANSFER ~~i;::~VING TIME ~~t~~l~IMEAT DUMP \ DEDUCTIBLETIME . _,.../ FUEL SURCHAAGE
D 3 AXLE D 3 AXLE D END DUMP SEMI \.,., .,,/
D -.., .. "'~--~~,,,.,,,
X
END UNLOADING
lAflT TRIP ..
RUNNING TIME
L\STTillP
NEHIME TOTAL CHARGES
,;-,,f\JON~NEGOTIABLE BILL)QF .. LA.DING···: ..
AND TRANSPORTATION AGREEMENT
CITY/STATE/ZIP PH.
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POINT OF DESTINATION "-"----""·-·-.. y,,_)o ··oo· C · ~(?J-6(~0 _
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,'*8"'SUPE8-10' .
D STRON'G ARM :
5
6 ·:-'"·.···· ..
7
8
11
12
. -"t .
15
D SUPERTAG
0 tRANSFER
. D DBL BOTTOMS
0 END DUMP . 0 FLAT B'ED
D SIDE DUMP D MIX~R : .
D TRUCK & PU,P , · ·~ 0 OTHER .
· 0 SEMl~BOTTOM . ·; ·' D WATER TRUCK·
·:-:.;
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.REPORTING TIME ENDING TIME TOTAL TIME DEDUCTIBLE TIME NE:-TTIME TOTAL TONS
1.,() 1\ I f5 ....-,
::) ) '·
STARTORMNG ARRIVAL TIMEAT END LOAD/NG RUNNING TIME
TIME LAST TRIP DUMP LAST TRIP LAST TRIP LAST TRIP
NOJ\ilNEGOTIABLE BILL~OF~LADING
re>·?'' AND TijANSROiTATIOI\I AG~EMENT PRINCIPAL . i . ··,, ... \ ·•... . . . .
CARRIER v', '<. ~ C.. t -" '-\ 4L r~
ADDRESS
CITY/STATE/ZIP
·;"l~DERLYING CARRIER
\ /ANY) . . ·
l1\DDRESS
SHIPPER
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"
PH.
PH.
DATE I /.·· A-
7/ Z}/lr· \l0i
BROKER!
TRUCK1
TRAILER I
CA1
RECEIVER
·,' '' .... •, '
ADDRESS~---"=--'" ------'----,;,,'"'":.._······ ____ _c_· -_.;· .. _-__ • ·_---• ADDRESS tJ~J-5@. lA. . ~e(y
CITY/STATE/ZIP . -~ ~ .~ < (.,, CITY/STATE/ZIP
POINT OF ORIGIN POINT OF DESTINATION
o 1 ri\,vH.EELER ·
_)!) SUPER~10
- 0 STRONG ARM ·
2
3
4
5
6
7
8
\
11 --
12 -·;,·.·'
.13 ..
14
ts
D SUPERTAG
D TRANSFER
0 DBL BOTTOMS
0 SEMl~BOTTOM
0 ENDDUMP
0 SlOE DUMP
• D TRUCI< & PUP
0 WATER TRUCK.
·~ t • .,,_: J.:' . . .~:.'-"..•'
·f ,--::;·-·· . : .. ·~-~ . :: ... (-.. '(-•
D FLATBED
D MIXER -
0 OTHER
{~fzORTING TIME ENDING TIME TOTAL TIME PEDUCTIBLJµlKilE c;" .,. 5~ . ,.,..,, '• .,/
f\lETTIME
?{\b \ 0 l-\ ~{)
.-, STAfffDR!VING ARRIVAL TIMEAT
TIME LAST TRIP DUMP LAST TRIP
END LOADING
LASTTRIP
RUNNING TIME
tASTTRIP
tS". :t',; .
TOTAL TONS
D HOURLY
RATE@
••• •" 0 ••••• ----• • •••• 0 ••• ,.-•, 0 ••• 0 •• ••• • -••-•• -• •" '~"-"• ••--~~--~-• ~--.••••• ,• -·--·---o -·-•-_ -••-• •••• •H•N•~-., ••-•-______ ,,_ •--·
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NON-NEGOTIABLE BILL-OF-LADING.'>.
AND TRANSPORTATION AGREEMENT
'pRIN.CIPAL \ / • " . . ~~1'·_. , ~
CARRl"ER . . \l,,,.,.~ $ S \·1''\ t! .Jl "" ~ i(ut,\L t ;'
,;,''
ADDRE:SS
CITY/STATE/ZIP PH.
DATE ~:z /) '< ·-\ ·=1. · se• ff if \ t.,_~· ,/'
A·
JOB1
BROKER1
TRUCKi
UNDERLYING CARRIER
;-·· -'\NY)_'·_·, --'----~L.4-:-P-.\\,,c.....-~~~-=-:,~µu...::J---:-------"-~~:---:-~~-----a.-TR_A_IL_E_R i
; ' .. __ JRESS . CAi
SHIPPER RECEIVER
·. . . ... -.. . ,• .. -' .. ~---: ..
ADDRESS~--,------~-~-~----~
CITY/STATE/ZIP
POINT OF ORIGIN
, ,, , , sh
. EQUIPMENT TYPE . . q $UP~RTA9,
o ·1o~WHEELER · . : p TAA.~SF!:~. .. .• g,~:°n~:
. . . . . . . ' . o·,TRUCK & PUP
CITY/STATE/ZIP
POINT OF DESTINATION
.. 0 FLATBED ..... '.c:i' MIXER. .
: O.OTHER i;J~f'ER~tO . . . , , . D DBL BOTTOMS
0 STRONG ARM::·.· ..... D :SEMl~BOTTOM . D WATERTRUCK ·
2
:_-:_-.:
4
5
6
T
8 / •. _,.,::·
10 . : -~ -.-. \ :·
11
12
13
,14
'15 · .....
REPORTING TIME . ENDING TIME TOTAL TIME bEbli¢JIBLE T!ME ; .. ' L :· tA:) i '\ :· o {;fa. . r::::5
<i,,STARTDRlVING : ARRIVAL TIME AT . END'(OAOING' ' .RUNNING TIME· .
TIMELAST.TRlP: · .. OUMP·lAST:TRIP.:.-: :_--:, ··:IASJTRIP, -: •>::. _:, ·.·. l/l~TTR/P.,, .. : ·
.RATE@
.. '.· '.
[~ii
\ ~DATE:-. r!;3/t:3/ l 7 f i::i~sro~iR < ~~· 'i: E Rf~r-1
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----l BILL ND. ]
~~---'--'---'------------'------'------'----'-,X---.I ::~,. ~ 10 z; 5 f
CITY ST ZIP PH l
••• / --...... ....., ..... _....; ..... ,.... __ ...,;~--.i....----..i...---------...-1TRUCK# ·/,/';,; ( / .. I ri~·AN~>'NG.t~:rti> f') \ , >-T-CRAA_#_IL_E_R_#+--------. ·:1
ADDRES~((Jj 1J t:~t)I (; 11(J,r l:j lrJ ,L( / ',"//,{ P,'d1? 'j'/7}
SHIPPER
CONSIGNOR
CITY/STATE/ZIP / / / i {.!1 /Jc. {)n,j
NAME AND AO DRESS OF DEBITOR IF OTHER THAN SHIPPER/CONSIGNOR POINT OF ORIGIN
POINT OF DESTINATION
EQUIPMENTTYPE D SUPER TAG D END DUMP PROD. AREA :CS)-HOURLY
E) 10-WHEELER D TRANSFER D SIDEDUMP DELIVERY ZONE 0-TONNAGE RATE@$ D SUPPER DUMP D DBL BOTIOMS D TRUCK & PUP -----------1! 0 4-AXLE O SEMI-BOTIOM O MILEAGE O -PER LOAD
'2:!
,
3
4
7
8
9
10
REPORTING TIME ENDING TIME TOTAL TIME
'\>':'! //; ~ ;· /) .; r ·u)· id· t',(, r..J t ·r .... ! -1 ·,/f,,_.,.l
START DRIVING ARRIVAL TIME AT ENO LOADING TIME LAST TRIP DUMP LAST TRIP LAST TRIP
DEDUCTIBLE TIME NET TIME , .... ,.,}., '"(
. ; ),;~~~
RUNNING TIME
LAST TRIP
EX"fRA COPY.
. -·-·-------··----··· ····---.·------·--·----····-··-·····-·-··.·°'.1
: BILL NO: '-,.
l .. \610755
ADDRESS JOB# l/0/2. !j) .
~c=1T-y_----------'---s-T--..c...-ZI_.P_~-~P-H ___ "-,-__ ---,1 BROKER# /
•. ../ .
Ul'L_ .LYING
(IFANY)
..,,,.-----.i...--..i.....---,i------"""""'f TRUCK# {/1)/if, l;l
SHIPPER
CONSIGNOR
CITY/STATE/ZIP (, 1 · 1. · ·-/ 'D~l ·
NAME AND ADDRESS OF DEBITOR IF OTHER THAN SHIPPER/CONSIGNOR
TRAILER#
RECEIVER
POINT OF ORIGIN
POINT OF DESTINATION
~UIPMENTTYPE O SUPER TAG O END DUMP . PROD. AREA )2j-HOURLY
ILi 10-wHEE~ER o TRANSFER o s1DE DUMP DELIVERY ZONE ~0 -TONNAGE RATE@$ 0 SUPPER DUMP O DBL BOTTOMS O TRUCK & PUP ~-=------1 0 4-AXLE O S~MI-BOTTOM O. MILEAGE 0-PER LOAD
3
4
5.
i
7
8
9
10
START DRIVING
TIME lASTTRlP
TOTAL TIME DEDUCTIBLETIME NETTIME
. . .. '-~ ..... _.:, ··-·· '·-
RUNNING TIME
LAST TRIP
... ·'--· ·-· . . ... -.. ---·----·----... --··-·---····--· -··----....... ----··-·---···-----·-··-~·· ··-----··-···-
, 9
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1
0=6=3=5=9-._. =l --====-~----"'---~~~---------__,_ _______ -----t JOB# j
11------,--------~J
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( TRUCK# \1
\,__., RLYING CARRIER 11------+--------J
-;,f~"'~"'~"';~~"'S:--------'------------,;pniH,----------J-TRA_IL_ER_#-1------~ ;1
-------------------..i...--------CA_#_ ...... _______ .,j
SHIPPER
CONSIGNOR ADDRESS OR BOX
RECEIVER
CONSIGNOR
ADDRESS OR ao_x
:'':.;
:l
·.J
"':A=i:""':,=:=r:~:=:=:=~:cc-S-S_O_F_DE_B_IT_O_R_IF_O_TH_E_R_T-HA_N_S_H_IP-PE_RI_C_O_NS-IG_N_O_R __ --il-:=~=~y"":T~Sl=:c=:=:""/:"'::=-,N-.-.\-'. _______________ !
------........... ~-----~~--..... .,,.,,=~~Pe<'!O_l_N_T=O-F_D_E_S_Tl'i"N_A_n_o_N ____ """'I' __________ ~,
EQUIPMENT TYPE D SUPER TAG D END DUMP PROD. AREA [J -HOURLY J
010-WHEELER 0TRANSFER 0SIDEDUMP DELIVERYZONE 0-TONNAGE RATE@$ ··• .. ,.·'.!. D SUPPER DUMP D DBL BOTTOMS D TRUCK & PUP 1--------] 0 4-AXLE D SEMI-BOTTOM D MILEAGE O -PER LOAD j
i'!'l!'5m'I'!~ . ::.i
]
_2+------l-------l------l------l------1-----+---------------~ii
3 i ~----;----t-----+---'-t------t----i----r--:;;:--------t----~ ·l
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RR~EP'*o\i'iR:"j'jTIMNGr-T:"'i'i1l:::M~Ei':"Ei:i:No~1t.'.NG;;;,'lTll:::M~E-T-TrrorrTA:iL"'iT'll:1M~E~"'"T~~;'c:"nu'c:'~rn~-~=+i!rimrr~:i',';"'--=--1~~:;.;,',.;i'.:;;;Yi'j'.;;;'ri:O-.._· J;j
···-··') ' . -··, . r· .. , ·f :! ; : 1··../ : · I :l
START DRIVING ARRIVAL TIME AT END LOADING RUNNING TIME TIME LAST TRIP DUMP LAST TRIP LAST TRIP LAST TRIP
CARRIER NAME DATE
I
DRIVER.SIGNATURE
X
~-.'.~-:.:.,... ,;.~.-:~'lf!: ~ ,'1:::;""' .... i;-·--~ ·,~~........, ..:.1''''
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CARRIER NAME·. ll&Era!B!!.1:mt•'(I ?~
~~~: ;{~~'
0
' __ ~'._. ---~=~-=---JOB_ .. _ ]
.,,=r·---·~;.
SHIPPING OROER ANO FREIGHT B1LL
IViOU~TAIN MATERIALS INC.
1117 Tavern Road
Alpine, CA 91901
619-445-4150 t. ;~===================================================
CONSIGNOR -\.,-... _,-~-•. -.... -.~-,?-·-::-:,-·.·"-~'·---~l"-,,..-.-.. -... ---,-i~--.>-.,,.-,,-,.-.-.,.-, -... -.. -j----.--,f-~~~-}.-,-. .f-.. -,\-0-.,.,.----.. -, -r;-:·-,,-.~-.-.·-~ .•. -.-~,--~-.--~-)-(-.-t-\-,-... -.,iJ-.,~-~ .. ,-, ----.i_,:_-,~~-·~, __ J __ -.. -(-f-J',-... -\-), ~-./-c, ---:,-;; ·."-c/,:·~-'--"·1:--,..--,_-?: --,,1-:_.,-..... ,-.;i_-----.~-c_/o,:},-··.:-! ---:cc;;':,-----:-c:-~
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CARRIER ----+·r_'"_.,1.{'......~-,.,..-'·-"1.; _ _,_-ei-i/_i".,v_'''_·\,....._.._.,~-·,,,1=~----OWNER ________________________ TALNOS --.--.. ,-... -.... ,-.. /H-~--""~/~ .... -"") _____ _
REPORTING ·"'«,.
TIME }
ENDING
TIME
OVERALL
HOURS
DEDUC-
TIONS
STR/\IGHT
TIME HOURS
M.M.I.
JOIH
CUSTOMER
SIGNATURE
/TICKET
NUMBER
TIME STARTEO
LAST TRIP
TIME ARRIVED
TO DUMP
RUNNING TIME
LAST TRIP
EXPLANATION
OF DEOUCTIONS
TRAVEL TIME
White -Billing
TIME STARTED
LAST UNLOADING
TIME ENDED
LAST UNLOADING
LAST UNLOADING
TIME
Green -Sub Hauler
NOOF
LOADS
TYPE OF t
LOADING[
CHARGEABLE
HOURS ;:;\ RATE
cusi'<JMER
PON
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f
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ARRIVE
JOB
CAPACITY ______-6_ TOiiS CU VAROS
NO OF AXLES /:,-1 WHEELBASE
DISTANCE RATE ------------
NOTICE DATE _______ NO ___ _
LEAVE
JOB
TOTAL TO
COLLECT
CHG COD PREPAY.
TOTAL
TONS
TONS OR
YARDS RATE AMOUNT
.. -. .· -~. _ .. ··.,~ ......
SHIPPING ORDER ANO FREIGHT BILL
MOUNTAIN MATERIALS INC.
·t:
,, 1117. Tavern Road
Alpii'l~i,,CA 91901
619-:lMS-4150
CONSIGNOR _________________ ___:_~~---------'-------A--------,.--,-------------+----
cpNSIGNEE ___ l,,_A_,,_J . .,,t.,_3,c...~;,,..-.; .... r='"·;z~~-"'l_:?A.,,·_ ..... ..,.1_· __ ~1'--'f-'-.~""-:.,__h_,1/.,..v_t ___ ..,,~c...r_,_··"-: _____ JOB CONTACT _ _,_i_<'f.1..,c"":.,1.'_., . .,_· __ ·.,.7~11,(:,.·,,,..:l~~,)i"""'_ ......... =...,,,..~!"'9'-.... -........ .....
UNDERLYING /l/f /11 L' TRUCK ·--· TRUCKNO 5, z J ... ,,,,,
CARRIER --------'-'----'--4-'---------OWNER ____ ~----------------11 TRLNOS -"-"""c..,<.'--=-/------
~l~EORTING -...7 I '6 ~~~~~~~TED ~~~i~~i:~t,IG ~gA~ /~/ CAPACITY /,~ TONS ___ ' CU YARDS
ENDING :., J j <""' TIME ARRIVED TIME ENDED Ii I ti},-NO OF AXLES~}'/HEELBASE _. --
_r_1M_E _____ :_.(l---'4--''"':::.~'--TO_DU_M_P ________ l-lA_S_T_UN_L_o_A_DI_NG _____ -+_c_OM_M_O_D_11_:,Y --S,.?~'-j'f-.''--'' /(,,.,_._' ,l ___ -ll DISTANCE RAW ------~---
OVERAll c,/,.., ,. , RUNNING TIME LAST UNLOADING ·NOTICE DATE ______ NO __ _ i HOURS '·-·,.?.; , C:') LAST TRIP TIME
DEOUC-EXPLANATION
TIONS OF DEDUCTIONS
STRAIGHT
TIME HOURS I CHARGEABLE
HOURS
I LOCATION DRIVER
REPORTED FOR WORK
<::::;/ t":~ I RATE
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1
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M.M.I.
JOB#
CUSTOMER TICKET
NUM~/cR
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JOB
NAME
TIPEOF
MATERIAL
PLANT
ORPIT
ARRIVAL
TIME
I CUSTOMER ..
JOB#
LEAVE
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.. LOCATION
./, / .. /
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SIGNATURE
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/;t,i,~~.f-"""'-'1~
CONSIGNOR, CONSIGNEE
While . Billing · Cana~y · OUice· Pink -Customer.
SHIPPING OROER AND FREIGHT BILL
MOUNTAIN MATERIALS INC.
:1117 Tavern Road
Alpine, CA 91901
619-445-4150
OWUC· !LOCATION DRIVER ,'/;'.,,, •.•• ,,,.,,.,,, ,-' .. ·)' i i /r
TIONS REPORTED FOR WORK .{:. c·· {=·::t, · / .i' / · '.,;// i.
M.M.I. !CUSTOMER I CUSTOMER I TOTAL
JOB # JOB N PO N TONS
CUSTOMER
'•.)
SIGNATURE X .. ,,,
t\ ?,
,,' )·,, ,J. · ·"-"'. · V rT , , • f-,_ t fl I
CONSIGNOR· CONSIGNEE
LEAVE
TIME
1/,l() I r
While~ BiUing
JOB/DUMP
LOCATION
TOTAL
STANDBY
DEL
ZONE
· .. y· DRIVER /
Pink · Cuslomer
ARRIVE
JOB
LEAVE
JOB
TOTAL TO
COLLECT
TONS OR
YARDS RATE AMOUNT
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ANDTRANSPORTATION.A.GREEMENf······
i"""',,Y/STATE/
\., =••~D~RLYING CARRI
(IF ANY)~~~~
ADD~~~/ ;;J -"ll '"~u.-~-.Jfif I.
2
3
4
5
6
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10
11
12
13
14
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CAL-T #143-112
E.P.A. ID. NO. CAR000187922
(619) 443-6193
FAX (619) 443-9364
' .·
RUST&SONS
TRUCKING
1 5353 Old Hwy 80 • -El Cajon CA 92021
FREIGHT BILL
~:i:i~~~=Ro_v_E_R-~-~~'-\_/_1 __ -_··1_,_-~-~i-~ ____ ~~~--'-,---D-A_T_E_''~'_,_·_-~·/_·_t~j ___ "'_l_TRIP# ________ ~
,.,..-. .l·
( / .J ADDRESS----------------------------------~
CITY ,,../ STATE ___ -----'-"-''"'---------------,__ ______ 2_1P ___ ~ _______ TRUCK# ______ ----,::--
TRAILER# __ __,Cl~·,_f_·{_· _·I_,-_"_ UNDERLYING
CARRIER (IF ANY)
SHIPPER
... \ ./A . ....-./. .. -1 /
CONSIGNER ____________________ _
,.
SJREEJORBOX _______ -"-------'---·~/ ___ _
'
CITYISTATEIZIP CITY/SJATEfZIP
.··\
NAME AND ADDRESS OF DEBTOR IF OTHER THAN CONSIGNOR
PT. OF ORIGIN / .. {.
·.;, .·· ·-,_,··( .
• •:$
BEG. ODOMET!;;R .:.:~ i.: :t 2... -·~ I ENDING ODOMETER JOB NO. I TOTAL MILES I ,@',..HOURLY I
0 TONNAGE
P.O.NO. I RATE
TAG NO. WEIGHT . LOADING UNLOADING BREAKDOWN / COMMOO,ITY f-------.~----+-----,-----1 STANDBY REASON FOR DELAY ARRIVE DEPART ARRIVE DEPART TIME
TYPE OF DUMP TRUCK EQUIPMENT
D SUPERDUMP
TRUCK
D 2AXLE
D 3AXLE
,... . .......,_
( \
TRAILER(S)
f-: . f ; . ·· .. 'f
AEPORTING TIME
····_7
StART DRIVli.'G TIME
lASTlRIP
ENO UNLOADING
iAsr TRIP
i (
END1t,:B TIUE
ARRIVAL TIME At DUl,IP
LAsrrruP
RUNNJ~G TIME
LAST TRtP
';· ''
,.#-·····
.} (=:.· /
TOTAL TIME TOTAL TONS
6 :
DEDUCTIBLE TIME UEl SURCHARGE
NET TIME TOTAl CHARGES
\_~ARRI ER
X ; , Thi~i;N\fi,1~ft8~AaiGiA~ur1r:~~-rri~1r:a~~ J8JM, pus u c uT I u TI Es co MM , s s Io N
~----cc-+~-~---------GOSTS,ATIORNEYFEES,ANDALLCOSTS1HATAA!SE FROM ANY REQUIRES PAYMENT FOR THESE
DRIVER~. ~G-~i'i-~~,~~.f ·1 ·· 1 f !"'> ,! , .. :g$[~~2~fJR1J:6~oo~~~pg~Ti~~~gJrJils~i~J~JrLr CHARGES NOT LATER THAN THE x » _____ ;, v c.,,, ,~~~~~-.-y,_,:1 -~~:j,"'y-~)-r--·· BEPAIDBYTHEABOVEGUSTOMER. 25THDAYOFTHEMONTH FOLLOWING
CONSIGNEE SIGNA;URE ATTENTION UNDERLYING CARRIERS: No payrnenl will be made for DATE OF THIS BILL. TICKETS NOT COMPLETELV filled oul.
CALIFORNIA DUMP TRUCK OWNERS ASSOCIATION• 334 NORTH EUCLID AVE., UPLAND, CA 91786-6031 • (909) 982-9898 • FAX (909) 985-2348
······· ··-···-·· ············--·-·-····················· 1
I
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ADDRESS.~~~~~~~~~~~~<--~~~~~~~~~~~~~~~~-
CITY
STATE_~~~~~~~~~~~---~~~~~~~-ZIP.~~~~~~~~~-
UNOERLYING
CARRIER IF AN
SHIPPER CONSIGNEE
PHONE, (619) 561-3620
:~:::· {~27
TRAILER#-....=/(-""'~ 12-.. -.. \-~o-F-r-,.,,_.-···
CONSIGNOR _ ___,~ ___ _,_ ___ .,__ __
STREET
ORBOX.~~~~-=-=:......c'---.---"'°-~4-,,~-"----"-'""...-.+-~~
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PT. OF ORIGIN
PT. OF DESTINATION
. ZONE RATES ONLY
( • f~ODUCTION ARE(l};:ETTER
JOB NO. BROKER NO.
~~
TYPE OF DUMP TRUCK EQUIPMENT
TOTAL TONS
\.
I I
-----~-~-----~-~--------~-~-----~-~-----~-~-----~-~-----~~------~-~---
NON~NeGbTiABLE•s'1i1E~ofi;UA.OING+<:<I AND TRANSPORTATION AGREEMEf\lT ..------._,.,.,..,,,...,.....,.,...._, _____ _
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CITY/STATE/ZIP ; ...
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UNDERLYING CARRIER' '' ·. ·. . . . .. ~b&~efs;cs,'*'S5~ ... •.:.·.~s~~~?{zs; •. :.···.·•·····.•·.•······ , rRAit.~~ 11 · o 1:: :. · · ·
,, CA#. ttJ'fio'l: ·.·
s~~f;j~y ~t''•T~~~'-4:,'. JJ~ ",<:t: • •· ..
ADDRESS ;:. ·fi'·: ·,.·
. ... . REGJ;l\(ER
CIT)'.'/STf,[E.,';pfL . > ·. · .
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0655,_:·.0• 92368144 · TR NSPOR'l'AT ON
r · Customer Job. No:" WEIGHMASTER STATION
LEGO LAND
Map Ret Zone
4235600 , Truck Type
Transfer
· Tr~pk No. ·· . :. :,
SDJMSSOt
Vehicle or License Plale No. Trailer or License Plate No. Jrailer or License Plate No.
J,-2;i60 Highway 67
-:;c;abci"side, .. CA 92040
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Hauler/C~rrier No. Load No. Cum. Prod. Qty.
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. ,'.•; . ·: :i: .•
(Q#142657)''f i-\
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Gross ______ _
Tare _______________ _
Net _________________ l
~ln1i;~r1f~IB8':~~I~r~},\Jllij;~~'J}il:"i11
Drivers Always On
Driverolf'D
Qt D D
Scale 1 Scale 2 Scale 3·
X Randall, Ka..tllY---Deputy Weighmaster
f
~o one avan.able to sign, customer waives receipt Received By Signature
signature. (First delivery ticket Buyer/Contractor
Signalure rele~se must be signed;)i D X ,,,,,
Arrive Jd~ ( ·:. ,.: t , . Start . I{,
. . Uni admg
Finish
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,.-;, Eac);l ''·'
···:"f.1:): ... :~r-.. ~·
WEiriHMASTER cifi{-i~~~~ATE
..
1. 00
TiitS JS TO CERTIFY that the following described co1nmodi1y was
weighed, ·me-asured,. or counted by a weigbmaster .. whose signah1re is
on this certificate, ,vtio is a recognized autho1ity of accuracy,. as
prescribed by Chapter 7 (commencing "'tl1 Seel ion 12700) of Dh•isiou
5 of the California Business and Professions Code, ndiuinisternd by the
Division of Measurement Stnndnrds of die California Department of
Food ru1d Agriculture ..
Print Name (C&~ihmer)
X
SJanding
Time X
Cartage
Sales Tax
Total
lillllllll
iill!lililii
Hanson AggregaJes Pacific South\vest, Inc P.O. Box 639069, San Diego, Ca. 92163-90691 1-800-500-7465 e;;.xt,.,2=-----.------~,.,------.------~
lilHIHanson·
HEIDELBJ:RGCEME~T Group
;_,r·.,:·
WElGHMASTER STATION . ,·,:... '· :··
Broker Copy CHECK IN TIME 12:00:00 am
TICKET Jffl> 1004530 TICKETTIME 11:24:10 am
i\:customer Name Customer No. ·
·8370655
Payment Type ··Account <rs>i; WESTERN TRl\.~S_PORTATION
Cl/.k)omer Job. No.
.,LEGO LAND
Customer P.O. Map Ref.
DATE 03/29/2017
TIME LOADED 11:24: 10 am
Oeder No.
92368144
4235600 ~
12560 Highway 67
Lakeside, CA 92040
Truck Type Transfer Truck No. Vehicle or License Plate No. Trailer or License Plate No. Trailer or License Plate No. SDJMSSO;J.:
Hauler/Carrier No. Driver's Name Today's Tonnage Load No. Cum. Prod. Qty.
2.00 2
S23DMP-VARIOUS PROJECTS (QH42657J
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, , . -, · · Rroduct · --' . · . . Descri Uon ' . ·, . JTotal ' .lJhifBrice · ;4;moilnt ·.
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Gross
Dump-Semi-Concrete
Environmental Fee
;-,,,Drivers Always On
'iJ,:;. Driver Off D ·
Ox D D
Tar{ Scale 1 Scale 2,~ Scale 3
X Randall, .'Kathy
Net __________ -----' DeputyWeighmaster
No one available to sign, custome, waives receipt Received By Signature
signalme. (firnl delivery ticket Buyer/Contractor
Signalure release must be signed.) D X
Arrive Job Start
Unloading
Finish
Unloading ___ .
Each 1. 00
· ""!'l> WEIGHMASTER CERTIFICATE. .
llltS IS TO CERTIFY that the following de,,cribed commodity was
weighedtutflasured, or com1ted by a weighmasier; whose signature is
on chis certific~te, who is a rccoi,mit.ed aud1olity of accuracy, as
prescribed by Chapter 7 (comnienciug with Section 12700) of Division
• S of the California Business and Professious Code, administered by the
Division .of Measmement Stnndards of the Califomia Department of
Food Md Agrioulnu·~ .
Print Name (Customer)
X
..
Cartage
Sales Tax
Totai
liiillilliii lill l!ll li!I ·Hanson Aggregates Pacific Southwest, Jnc Py-L>...L:'11X.!l.>."'/''i',,'l\11lLl,liql\W,;l/,,Miw.;~~.J.,.l,;.Jl.!!!l;:;!lA!c..L'Jl!!.1~===..::.:..::.::::i-RU1.\!..U/.!L,i!!!!._--,(>.--~=-..:_-1_..:::..:~:!...'.~~--< m•mttc111!i()l1 ~T_IC~KE~TrNO~.H-S~Hft~---~~~.---.:::~-A.~::.:__:_::.::.._..1_.l.l.;j~~L.........c...:..::.::=-=-:=:J~~~~--<
12:00:00 am DATE 03/29/2017
[
i
HEIDELBERGCEMENT Group Customer o.
Wl::IGHMASTER STATION
tf ti;I,iJl~. ,,
Lak~sidei CA 92Clfl-0
Gross ___ _
8370655
D1,1mp--Semi :'.:concr~'te:: ... . ;,o" ·A
Environmental.Fee·
[2j
Drivers Always On
DriverOrtO
D D
Tare~-'---~----------~ Seal:', 1 Scale 2 Si;/'lte' 3
;!'j , ·,;.r. .•.• ; X u.'iindall, Kat'::v · Net __ '·-··"'\cc··i:-~ ~-'-c~ •. -\"'c· -~"'---------' :1;iJ)~Pu\y Weighmf,ta~~~
l No one available fo sign, cusloriier waives receipt Recei~'.'d By Signature
signature. (First delivery ticket Buyer/Contra~or
Signatme release must be signed.) D X
Arrive Job Start
Unloading
:;1.
Finish
Unloading
·24·10 am TIME LOADED 11:24:10 am
Order No.
TRANSPORTATION 92368144
Map Ref. Zone
·, • ,~•I,.
· · Vehicle or License Plate No. Trailer or license Plate No. ,'(.•:.: ' Trailer. or License Plate No.
Today's 1. Hriii!,je · ·-~· :
Load No.
2
Curri. Prod. Qty.
2.00
· 1111!1111111111111111111111111111111111111111111111111111111
1.00
.:i~.'
WEIGJII\IASTRR CERTIFICATE
, TiilS IS TO CERTIFY that the fottowing described commodity was
weighed, meas\lred, or <:OlUtted by a weighmasler, whose signature is
on I his certifi6f\te1 ~ who is a recognized aud:10rity of accuracy, as
· prescri!>J.it Ii}; Cb~pter 7 (co1mnencing with Section 12700) of Divisiqn
5 oftlui''6alifornia Business and Professions Cpde, administered by !he
Division 'of Measurement Standards of 1b e California Department of
Food and A riculture
Print Name (Customer)
Stand1ng
llme X
Cartage
Sales Tax
Total
Hanson Aggregate, Pacific Southwest, Inc P.O. ~~x 639069: San Diego, Ca. 92163-90~N'J~ci-500-7465 ex.,,tc::,2:.._ ___ -r-------_,------,-------~
· :{,' . ,.,,, CustomE1:t' Copy •. , . CHECKINT~ME 12:00:00 am DATE 03/29/2011 nson TJ~ETa$ 1004530 ' . TICKEI,TI~~ 11:24:10 am TIMELOADED 11:24:10 am
rlEIDELBERGCEMENT GroQp · Cust
8
om
3
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7
r
0
No
6
.
55
Payment Type Customer Name ,-, Order No. ·\. ', Acc0unt WESTERN TRANSPORTATION 92368144
WEIGHMASTER STATION
4235600
Customer Job. Noi
LEGO LAND
Customer P.O. Map Ref. Zone
12560 Highway 67
L.akeside; CA 92040
Truck Type
Transfer
Truck No. Vehicle or License Plate No. Trailer or License Plate No. Trailer or license Plate No •
. SDJMSSOl:
Hauler/G;irrier No. DrJyer1s N.~me
~
!;,,23DMP-VARIOUS PROJECTS (Q*142657)
Today's Tonnage.,·. Load No. Cum. Prod. Qty.
2.00
VARIOUS ~
111111111111111111111111111111111111111111111111111111111111
; •• Product ' '·. ·
805 Dump-Semi-C.oncrete
Environmental "Fee .J;:
Gross ___ , ____________ ,
Drivers Alway1 On
Driverdri'O
D • • t
UOM
Each .. 1. 00
·(
WEIGHMASTER CEilTJFJCATE
~ D D
Tare( Scale 1 Scale 2 Scale 3·
X Randall, Kathy
· THJS JS TO CERTIFY that the following described commodity was
:.weighed, ·measu~d, or counted by a wcighmaster, whose signalure is
· on this certificale, \mo is a recognimd autl101ity of accuracy, as
. prescribed by Chapter 7 (comniencing with Section 12700) of Division
5 of the California Business end Professions Code, administered by the
Division of Measurement S1rn1dards of the Cruiforoia Deprutment of
Net-----------------1 Deputy Weighmaster
No one available \o sign, customer waives receipt
signature. (First delivery ticket Buyer/Contractor
Signature releiise must be sii)ned,. ' D
Start
Received By Signatur\l
X
L\rrive Jc;i~ f· · Uni ading
Finish
Unloading
Food and Agriculture _
Print Name (Cu~fqrner)
X ~.
}~·. X
-' Amount
Cartage
Sales Tax
Total
11:24:32 am
Order No.
92368144
:vvt;i~_HJV!i\STl:;!;IJ:STATION i:t Zone.· . ;; .· ):{/!:~ifr:};. ·;;j;; :• .
4235600· I
_12~60 Highway 67
.L?tkeside, CA 92040
l'iucklype . · Truck No. Vehicle or Lic~liM Plate No. Trailer or License Pl ale No. Trailer or License Plate No.
·.:ti: Transfer..•· S.DJM$S01:
Hauler/Carrier Nii''·· Driver's 'Name ... · .. ~.~.: Today's Tonnage Load No. Cum. Prod. Qty.
':J{~~\/·;;' '• .
.·-.. · .. _;//. :;_:·· ~---·· .. : : : \ •: ;;~:'.·:r:~·t .. ._ -;,;.,(. f"I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIH 1111111111111 :tr_. .. .,,t\· . . .
825" Dump-Oversize Charge {_~A) ·t:., Each 1. 00
Environmental Fee ... , :"'
. : '''WEIGHMASTER CERTIFICATE
Drivers Always On •.
Gross_·~-~----..:--------! • • Driver Off D ·
Tare .-.i;:(:_r·_··~~·-1~;·_1r_; _______ , _s5t. s5L ,, S~e~·
·THIS j~ Tci'CERTIFY that the foltowing described commodity was
wciglte<J~fo.easured, or co1mted by a weighmaster, whose signature is
on this ~rtifioate, whO is a rccogniz.ed au'thmity of accuracy2 as
prescribfd by Chapter ? (commenchlg with Section· 12700) of Division
5 of the California Business and Professions Code, administered by the
Division of Measurement Standards of lhe Califumia Depru1mcnt of X_.Randal 1, ~athy Net ________________ , Deputy Wei~hniaster
I~
No one available to sign, customer waives receipt Received By Signature
signature. (First deliveI)' lickal Buyer/Contractor
Signature release musl be signed.) D
Arrive Job
,t'
X
(_ .,{.,L.,......... , , .
Finish
Unloading
' Food and Agriculture
~rint Name (Customer_),
X
. ·standing
]m_1;1 X
. .
Cartage
Sales Tax.
Total
· :!'f;j?r~·! (_ ~ . ./ ·· ... ~-· /··,.,!·
·Hanson Aggregates Pacific Southwest, Inc P.d?Box 639069, San Diego, Ca. 92163-9069 / 1-800-500-7465 e,;,.,,.,..__~·"":c.-·. ---.....--------,-----.----------...
::: ~ . Bro1'er Co CHEClftNTIME 12:00:00 am DATE 03/29/2017
gem Hanson ~T_I_CK_E_T_~_%_..___1~0_0_'4_5~3_1 _____ ~--,----~----~-1_1_:_2_4_:3_2_a_m_~TI_M_E_LO_A_D_E_D,__,11_:72_4~;3_2_am_-...;
Customer No. Payment Type CU§tomer Name Order No. HEIDELBERGCEMENT Group 8 3 7 O 6 5 5
WEIGHMASTER STATION
4235600
Customer Job. No.
LEGO LAND
Aocount
Customer. P.O.
WESTERN TRANSPORTATION .. 92368144
Map Ref. Zone
12560 Highway 67
Lakes'ide, CA 92040
Truck Type
·Transfer
Truck No. Vehicle or license Plat!}_ No. TraUar or License Plate No. Trailer or License Plate No. · so.msso1:
. : 'hf:t;· 'J • :,1, 1~.
::,,~ .
H~\~r/Carrier No. Driver's Name Today's To,rnage
ff'i·"
load No.
2
Cum. Prod. Qty.
2.00
523DMP-VARIOUS PROJECTS {QU42657:);-.
.VARIOUS
I llllll lllll lllll lllll lllll lllll lllll lllll 111111111111111111
. -· . Proc:luct , ' '" ..
Gross ____ _
· Descri tion
Dump-qyersize Charge (EA)
E.nvironmental Fee
-;~.
Drivers Always On
DriveronD
Dx D D ,-,.
UOM
Each if~
WEIGHMASTER CERTIFICATE
..
1.00
Tan( -~~~~----~-----Scale 1 . Scale, 2 Scale 3
THIS IS TO CERTIFY that tl,e following described commodity w ..
weighed, measured, or counted by a weighmaster, whose signature is
on tlii, certificate, who is a recognized a11tl10rity of accuracy, as
prescribed by Chapter 7 (commencing: widt Section 12700) of Division
5 of tho California Busines_s and Professions Code, administered by the
Net 1 ;:;
! . j '.?i .. ,: • • ~1~·\ .
X ~andal·l, Kathy·'.
,,.!),eputy Weighmaster .
No ooe avai!abl~)o.sigri; cus\ol)!ef waives receipt
signature. (f'irsi 'delivery'tickei Buyer/Con!facta-
Slgnalure release must be signed.)
, Rece[ved By S!gpatuie
Arrive Job
X
Start
Unloading
Finish
Unloading
• · Divis'.:ipf Mea.{u-ement Standards of tlte California Depru1mcnt of
Food ,.A~riculturc ... fc"
Print Name (Customer)
X
Standing
TI me X
• Amount,·
Cartage
Sales Tax
Total
. Hanson: Aggre&ates Pacific &outhwest, Inc µ.w:wx..tU"\"l!t,-~l!,.-!,l~&JY'l-c~!-?-==u...i==lill1.c1.,m.:i,t,1<-LL====+.......:.~===L._1!am~>D~A..::T:.:E:.._. --t.......:..J0!L3!.U2;;!.9£2~0sLlLJ7r__---< .nson . !ffiL~_ERCiCEMENTGroup .• f: .. ·:. -} . -. -·~ . ·:··· :-~ ,_: ,, .:-. . .
Order No.
. 92368144
• WE;IGHMASTER STATION Zone
(. '.1lt1Ui:L,;;:,' .· i;;f'.::: :
,42:35600. -iti'.. Vehicle or License Piaf,i'No. Trailer or Llcens.e P!~te No.. Jra1!er:cir licen_se Plate No.
907}?.i~·:l· '12}60' · ~ighway 67,.
La,J;:13aide, CA 92040 Load No. Cum. Prod. Qty.
.$23DMP--'VARIOUS PROJECTS (Q#142657)
\:,ARIQUS .•.
}/i\t}(\k,:;r:\}it~\I·: .. <~J.11111111111111111111111111111111111111111111111111111111111
:Each 1 .. 00 ;_t..:'·
.'." ... ~,· ---~· .. ·-_,,._:•:.,
Gross~-· ·-.-------------•
Tare -/:,:,i, .'· · .,-,.
Net .f\jj;t" !t.·v
. ·. ·, . '
Drivers Always 6n
QriverOffO
Q. . D .. fi:D·'
Scale)· · Scale 2 Scale?..
X '·\BaudaJ J Katby
· Deputy Wei9hmaste,r
No one available to sign, customerwaives .re elpt Received By Signature "\
signature. (First delivery ticket Buyer/Contractor
Signature release m_ust be signed.) D X
Arrive Job
(
Start
Unloading
·Finish
Unloading
,,,. . . •.• ··:j-,\c WEIG HM ASTER CERTIFICATE
THIS IS TO CERTIFY that the following described commodity was
. weigl10d, m~1.•~~i · or -colUltcd by a weighmasler, whose signature is
···on lliitif."riifioaie'; who is a recoguiwd attdtotily of accuracy, ~
prescribeij by Chapter 7 (oommcncius with Section 12700) of Division
5 ofth~ l'.!alifomia Business end Professions Code, admiui&cr<d by the
Division of Measurement Standards of the Califomia Department of
Food and Agriculture .Yi ·· ....
Print Name (Customer)
X
Standing
·. ,Time X
Cartage
Sales Tax
Total
l!l!lllllli lllllfH!I
lfflllllill
, : '·, . .c,~;__ .... t ·' ·•·;,;
:fl~i1;~~~:~ggrega~s Pacific Southwest, Inc P.O. B~x 639069, San Di~go, C,a. 92163-906? l)-80()..500-7465 ex:,,,·t,_,2'--__ .lc..' '-'. ~-----~-~---~-------
.' •i'\{·.' ..... , ' .-.. ·i·· · Broker··copy ;''. CHECl(INTIME 12:00:00 am DATE 03/29/2017
11:19:lOam
Order No.
92368144
.· . ,, .. l . ~f;, . -~l-::. . ,.; , n'son . TICl<ETl1(6 1004528 TICKETTIME 11:19:10 am TIMELOADED
HEIDELBERGCEMENT Group Customer No. :" Payment Type Customer Name
WEIGHMASTER STATION
· 4235600
8370655-· Account WESTERN TRANSPORTATION
Customer Job. No. Customer P.O. Map Rel.
LEGO LAND
Zone •. ,
,.12560 Highway 67
La1'eside, CA 92040
Truck Type
TANDEM.
Truck No.
SDJMSS02:·
Vehicle or License Plate No. Trailer or License Plate No.
9D76693
Trailer or license Plate No.
. .• ~ .,'./L
Driver's Name
:'"JUAN /:·.:.
Today's Tonnag/.', Load No.
1
cum. Prod. Qty.
1. 00
5-23DMP-VARIOUS~ PROJECTS. (Q#142657t~
VARIOUS , '
111111111111111111111111111111111111111111.11111111111111 IIII
UOM
':' Product . , ·• ·· , Description -· ..
i Ta\
Net-~,-..-"---·
tdf.
h; ..
Dump-Semi-Concrete'
Envirorimental Fee ·i'~f.,:
Drivers AtWays On
· DriveronD
Ox D D
Scale 1 Scale 2 Seate 3
X Randall, Kathy
Deputy Welghmaster.
No one avail/\tiJa,fo _sign, customeo)'aiVes receipt Received By SigMture
si~nature. (Flt~\ ~6'iverv,Jicket Bti)!ar/Conlractor ., ·
Signature rE1!~il'i~,iJlust be slg_o.eiif.) D . X
Statt
Unloading
Finish
Unloading
Each · 1. 00
WEIGHMASTER CERTil1ICATE
WIS IS TO CERTIFY that the following (],,scribed commodity was
weighed, n1easured, or com1ted by n ,vciglunaster, whose signature is
on this certificate, who is a reoogui7.ed anU1ority of accuracy, as
proscribed by C::hapter 7 (commencing wirl, Section l2700) of Division
·· ·· 5 oftl1e California Business and Professions Code, administered by the
Division of Measur~ment Stmdnrds of the California Department of
Food aod Agriqult;irc
Prln_t Nam (Customer)
X
Standing
Time
' .
Cartage
Sal~sTax
Total
DATE
TIME LOADED
8 70655 Account . WESTERN TRANSPORTATION 92368144
W!:IGHMASTER STATION Cust!'Jner Job. No. Customer p;o. -..-i,. Map Ref. Zone
... / -~ .....
42_J5600 Vehicle or Licen~e f:late No. Trailer or License Plate No. Trailer or License Plate No.
·;.· .. · ' ~ :1}5~0. . Hj,ghway 67
Lal(e$i.cte; ;CA 920,4.o . . -· ~-. : . . . " .
Hauler Load No. Cum. P:rod. Qty.
1. 00
~ .....
PROJECTS
· :J·f 11111[ iilll lllll lllll lllll lllll lllll 111111111111111 !'111111!
. . .
Dump-Semi-co~cf~:~~ ...
Environmental .. Fee:.·
Drivers Always On
Tare __ ·._!i~"'U""i_;_:~i~···~'· ·-~'·~)ir_;_· _____ sfafjD~i:e~tt2 D ssi·~,
i·'.'?t~'>: '\. \f{,t
Net X~c:J.al 1, KaU1~· ---'---------~ii------• Deputy Weighl);l,aster, ..
No one available to sign, customer waives receipt
signature. (First delivery ticket Buyer/Contractor
Signature release must be signed:) D
Received By Signature
X
, Arrive Job · Start
Unloading
. (
Finish
Unloading
Each 1.00
Tf[IS IS T\)_.{;Ell,TIFY that the following described commodity was
weigh1;t~Jn:easurea or counted by a ,·,:cighmastCi, whose signature is
on this ce-rtificate." who··ts a 1eoog11ized auUtority of nccurncy, as
prescribed ·1;y Chapter 7 (commencing with Seclton 12700) of Division
5 of tho California Business aud Profussions Code, administered by the
Division of Measurement Standards ofJhe Cruifomia Department of
• Food and A riculture
Print Name. (Customer)
X
.Standing
Time
·.:,:f;:t\, .
X
Cartage
Sales Tax.
Total
.;;:;!;;!::> ·!~{ . ,i,: ;": . ·~. ... "' ~anson Aggregates Pacific Sou_thwest, Inc P.O.;Box639069, San Diego, Ca. 92163-906~ / 1-800-500-7465 e"'x.,_t 2"-----~------.~---~------~
::: ! '):1:;1:. :+ · '-1,, customer Copy CHECl\!(HIME 12:00:00 am llill!lllilHanson TICKET 1004528 TICKETTIME 11:19:10 am
. Payment Type Customer Name
HEIDELBERGCEMENTGroup 8370655 Account · WESTERN TRANSPORTATION
WEIGHMASTER STATION
4235600 .
Customer Job. No.
LEGO LAND
Custotner ·P.O. Map Ref.
DATE 03/29/2017
TIME LOADED 11: 19: 10 am
Order No.
92368144
Zone
!2560 Highway 67
·:i.,ake~ide,. CA 92040
Truck Type
TANDEM'
Truck No. . .. Vehicle or License Plate No. Trailer or License Plale No. Trailer or License Plate No .
:J)ltiilil,T ::l Hauler/C;mier No.
1·~~:
523DMP-VARIOUS PROJECTS (QU42657)·\
VA.R;(OUS
..
Dump-Semi-.--Concrete ·
~ Environmental Fee
Gross·----~~ -~--------!
Ta~
\
Net_+-c+···L'··~·L··---~-.--------I
, . ·' ':• ,;. .. f No one availa~J~ IP.'"' fustome)&)aives receipt signatu~. [~i¢t~lj Jyt[cketBuyer/Contra<:lor l Signalure reJ~a:;\l:must ba sig!l~d.) D
Arrive Job Sta~
Unloading
Finish.
Unlpading
II•
.... .-SD,TMSS62: "*'--:~
JUAN
Standing
Time
9D76693 ,.
Today's Tonnage·'. Load No.
1
cum. Prod. Qty.
.. 1.00
I llllll lllll lllll lllll lllll lllll lllll lllll 111111111111111111
UOM .. · , Amount'"· ;
EadiI_ 1. 00
Cartage
Sales Tax
Total
X
4,235600
· 125150 J,Iig4~ay 67
Lakeside, CA .92040 .. :.., . -. :·;_/:<:::·_;';,.•.
Truck Type
TANDEM
Hauler/Carrier No.
92368144
Trailer or License Plate No.
C.wn. Prod. Qty.
1 1. 00
·. ·f::~·-:
,.:lii\.,·,11111111111111111111111ii lllll lllll li11i111111111iilll llll
Tare _______________ ~
,.· ••!'"'-·•.
Each
. .
1.00
\VEIG 1/MAsTim CERTlflCATE
;,{, Drivers Always On TIIIS IS 'ro CERTIFY thal the fultowing described commodity was
,·•t(:\ , ,Drive/ Off Q . weighed, measured, or oonnted by a w~il!hmastcr, whose signaturu is
r:i D O on this certificate, wbo is a recoguiied nrnltoiity of accuracy. as s~ 1 Scale 2-i.;. ~~ale 3 • proscribed byChapler 7 (conunenoing· ,viti, Section 12700) of Division
-;,... . 5 oftl1e California Business ru1d Professions Code, administered by the X Banda 11, Kath¥-,.-·. Division of Mea·surement Standards of tl,e Califomia Department of
Net ________ ·-----~--, Deputy Weighmaster ... Food and Agriculture
No one avalable-to sign, customer waives receipt Received By Signature Print Name (CJ,Jstomer) .:-:: . . ·:~ ~~ signature. (First delive,y ticket Buyer/Contraclor
Signalure rel,~ase must be sig~ed.) D X
Start
Unloading
Finish
Unloading\
X
··~·
Cartage ..
Sales Tax
Total
. . 9 . ..• ;,;.>,. . •
Hanson Aggregates Pacific Southwest, fnc P.O. Box 639069, San Diego, Ca 92163-9069 I 1-800-500-7465 e,>'x'-'2"-----,-------.~--~~------~
I 'iiroker Co . CHECK IN TIME li!llllllil!
llllillllil . !Hg)Hanson
HEIDELBERGCEMENT Group
· WEIGHMAST.ER STATION
Customer No.
8370655
Customer Job. No. .··. -bEGOLAND
Payment Type ' Account
Gustome( f'.,O,
.,i-5"·.-' ~
12:00:00 am
11:19:28 am
WESTERN TRANSPORTATION
• 1Map Ref.
··~···· .
DATE 03/29/2017
TIME LOADED·· 11: 19: 28 am
Zone
Order No.
92368144
I ,4,2~5,600 ;{
,12~.6Q ··Highway 67
L~kesicle/! CA 92040
Trj,!¢.kType
./~t;T.A.NDEM
. ·, 'truck No. ..-., -'" Vehicle or License Plare No. Trailer or License Plate No. Trailer or license Plale No. . SDJMSS02:
9 Hauler/Carrier No.;'). '!', Driver~-Name
-,.,,. JUAN
9D7~J93
Today's,onnage Load No.
1
Gum. Prod. Qty.
1. 00
523DMP-VARIOUS PROJECTS (Q#l42657)
VARIOUS I llllll lllll lllll lllll lllll lllll lllll lllll lllll lllll llll llll
.,
;:\·
'r .,
UOM
'· . P1oc!uct •· • · · Description · . ..
825 'Dump-Oversize Gha'rge (EA)
Environmental '"'Fee
'Each 1. 00
[
Noone avatiablelo;tgn,~ustornerwaivesre ipt Received By Signatur~ <{ '':
,ignature. (First delivery ticket Buyer/Contmclor
Signalure release must be signed.) D X 1 ..
. · Start Finish :,mve Job. · .. Unloading Unloading
.;',. WEIGHMASTER CERTIFICATE
,. THIS IS TO CERTll:_Y that the fullowiug described rommodity was
weighed, m',ll!lw;<;d,' or cowtted by a weigllmaster, whose signature is
_.,. · ou tlii!, ccrtifii:ate'; ,mo is a re<:ognized authority of accuracy, as
prescriligi by Chapter 7 (commencing widt Seqtion 12700)ofDivision
5 oftbe ealifomia Business and Professions Code, administ_ered by the
Divisio~ of Measurement S!Mdards of \he California Depm1mcut of
Food and Agriculture i;:" ·
Print Name (Customer)
X
Standing
,Time
• Amount
Cartage
Sales Tax
Total
ESTERN TRANSPORTATION r WEIGHMASTER STATION Customer Job. No. Map Ret. Zone
I ( ,,fis,oo • Ve~icle or Licfc'nse Plate No,_: ,Traileror License Plate No. Trailer-cir License Plate No.
I ; lti1tifili,o load No: · Cum. r,rod. Qty.
1,;;. 1.00
: ·~ .. ,.~ • ~, :-!'· '· =··
523bMP-VARIOUS PROJECTS
\1ARIQUS . I 11111111111111111111111111111111111111111'111111111111111111
•.,·-·;
. ·l ~-.
WE!GHMASTER CIJRTJFICATE
Drivers Always On , THIS IS TO CERTIFY that the follo\\fog described commodity was
Driver Off D weighed, measured, or counted by a weiglunaster, whose signature is Gross_·---'----------'------!
[x D D ·on this certificate, who is a recogni2ed mrth01ity of accuracy, as
Tare Scale 1 Scale 2 Scalii'3 .. ., prescribed by,Chopter 7 (como,encing with Section 12700) of Division
I · '·' 5 oftl10 Califomia Business and Professions Code, administored by the
Net X~aJcl, Kathy · Division of Measurement St;,ndards of the California Department of ---~~-----------• Dep~tyWeighmaster ... I'ood ,dA 'aulturo
No one avaiiB_~l~ \9 Si9fl, customer,~Jves receipt Received By Slgn,atu(.e :;·, ,., 1 Prfilt N a~(Customer) ·:,
signature. (f,is\ioetivery ticket B~Y,WContractor
Signature Ie!e{!s,e,'rnlfst ll.e,$igped;)' ' D
~t·i: ·-M~T ... i;' · ,~t·· .Arrive Job · .
(
J(
Start
Unl&ading
Standing
Time X
.. '\(>;rhciunt ...
Cartage
Sales Tax·
Total
Harison Aggregates Pacific Southwest, Inc P.O. Box 639069, San Diego, Ca. 92163--9069 / l.80()..500-7465 e-;,xt,,2"----..,------~.----.......... ------~
i!lllill l!I · • customer. copy · · ' CHECK IN TIME lil.ltlll!!I .. 12:00:00 am
lilllifl~.-H·:, .. a.··.·.nsnn TICKET~81004529 •. ii))i,,_.' ~ Cuslomei'No. . p\tiyment Type \'<il!I< Custorr,er Niime
! ii. :,~~'~GCE~!~T_Group -.:;,;'.8370655 Account .. f.;" WESTERN TRANSPORTATION
TICKET TIME 11:19:28 am
Map Ref:
DATE 03/29/2017
11:19:28 am
Order No.
92368144
; } w4,~21,G3;:;·5~·6~0AO::siE~ STATlf N . Cu om.er Job: No. Customer P.O.
>=---~L~E~·G~O~L*AN~D~1:_ . .L....--,r:-:--:-:-:--~~~~.:-::cc:--~~~~~l--~~~~~--1...-~~~~~~~
Truck Type Tr~_ck No, Vehtcle or License Plate No. Trailer or License Plate No, Trailer or license Plate No. 12560 Highway 67
_Lakeside, CA 92040 TANDEM SDJMSS02: ,, 9D76693
· Hauler/Carrier No. . . ~.,. Today's Tonnage ·.,,
Load No.
1
Cum. Prod. Qty .
1. 00
. :~'I llllll lllll lllll lllll lllll lllll lllll lllll 111111111111111111
r·.-· UOM
: · · Product · · ' · , · · • • Description .. . .
825 Dump-Oversize Charge .(EA)
Environmental Fee. ,,1, Each 1.00
Net
,J;' brivers Always On
; A'!il\: Driver Off D .
CX ' D .J-;,p
Scale 1 Scale 2··1• .. Scale 3 X Randa.li~;.'Kathy
Deputy Weighmaster
No one available.to sign, customer waives receipt Received By Signature
signature. (Firs\ delivery ticket Buyer/Goriliactor
Signature rele~se.mustbe sigRed.) D X
Start
Unloading
Finish
Unloadinff = \~!
WEIGHMASTER CER'flFICATE
TI-IIS lS 'rO CERTIFY that the following descdbed commodity was
weighed, rneasu,red, or counted by a weighmaster, whose signature is
on dus certificate, who is a recogniuil auUtonty of accu<acy, as
, pre;sctibed by Chapter 7 (co1mnenci11g witl1 Section 12700) of Division
S of Ute (;alifomia Business and Profussions Code, adniinistered by the
' Division of Memaireineut Stan<lards of the Califomia Department of
Food mid Agriculture
Print Name (Customer) .
. .
Cartage ;
Sales Tax
Total
RAM CD
DISPOSAL RECEIPT
8354 NELSON WAY ,,. ESCONDIDO, CA 92026
760-205-1797 ,. FAX 760-749·1717
~ ·~ .• ,..-/-:·\::= ,·
/'······ .~ .
f i J ! [l.
A.AMCD
DISPOSAL RECEIPT
8354 NELSON WAY ,. ESCONDIDO, CA 92026
760-205-1797 1. FAX 760·749-1717
. ...
\.-
-x <
.. 11ER'S SIGNATURE
PRICE
PRICE
I.
CAL-T#143·112 "'·""·_.,,_,,J,,1;· ~·
E.P.A. ID. NO. CAR00018792~
(619) 443-6193
FAX (619) 443-9364
RUST&SONS
•-TRUCKING
15353 Old Hwy 80 • El Cajon CA 92021
,., .
DATE
FREIGHT BILL
ADDRESS --------------------f···~·'~'i+-c---'-c-c---------~--<•;----~
~~;E _______ ~--------------·· '_"''_' _" ____ Z_IP ___________ TRUCK# -7:::.~~ 1 ·::1,:·?;)
UNDERLYING
CARRIER (IF ANY)
SHIPPER
,,..-'.,·'r'' · ..... TRAILER#
CONSIGNER _____________________ _ CONSIGNEE _____________________ _
STREET OR BOX---------------------,_,,_,. l>JREET OR BOX--------------------
CITYISTATEIZIP
NAME AND AD1)>lla$._S OF DEBTOR IF OTHER Tl;l.Ml.Q,QJ;!SIGNOR ,,..,
PT. OF DESTINATION
BEG. ODOMETER
Jt,'1D-~,55
TOTAL MILES
TAG NO.
. -L· ·. i ,..., ; 1 . . . :~,.iJ·jr~ ·.·· .. i!l'·t~_
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\ "'t' f'' . . t .
,.
CITY/STATEfZlP
RATE JOB NO. ,:? . P.O. NO. " ,.
·u u?/ ?~ .£Jt't·' -.$'-. ;··i.,:i;:· """'1r~ : J '',J~y > / ':L/~-~ "'' .. .J-·~--.--\.., .•
----------+-------+--------+---~--~~--~--~,-------+-------,,-------+-----+------
{ _I,
OF DUMP TRUCK EQUIPMENT
UPERDUMP TRAILER(S)
UCK
0 2 AXLE
D 3AXLE
X
TRACTOR D BOTTOM DUMP DBL
D 2 AXLE D TRANSFER
D 3 AXLE D END DUMP SEMI
D
REPORTING TIME
NO UNLOADING
STTfllP
ENDING TIME
AHRIWiL TIME AT DUMP
LAST TRIP
RUNNINGllME
LAST TRIP
NET TIME TOTAL CHARGES
0~~~~ .. -r"'.,-· .... ---·,c"' t··\ TERMS:ASERv1cE CHARGE oF 1i1% w1LLBEAsSEssED roALL PUBLIC uTiLITIEs coM Miss ioN < .... J,1 • \.-~1._,J:.,,.. i') ACCOUNTS PAST DUE 30 DAYS AS PERMITTED BY LAW. COURT ,,t } ',\ . ,, 'L COSTS,ATIORNEYFEES,ANDALLCOSTSTHATARISE FROM ANY REQUIRES PAYMENT FOR THESE
DRIVER f 1 .-'oil''" _ N_ .. /,_/ :~g~m~~~6hWiRiii~~~g~T:~~g~rJ~s~~~J~J:t.1 CHARGES NOT LATER THAN THE x / (_,J'.-,,fr r··o..,.-.-"'\· _ . BE'PAIDBYTHEABOVECUSTOMER. 2srnoAvoFTHEMONTH FOLLOWING
GONSIGN[E$lt:!f1ATLfRE'-~'"''~''-· .. ···t ; ATTENTION UNDERLYING CARRIERS: No payment will be made for DATE OF THIS BILL. , I f TICKETS NOT COMPLETELY filled out.
CALIFORNIA DUMP TRUCK OWNERS ASSOCIATION • 334 NORTH EUCLID AVE., UPLAND, CA 91786-6031 • (909) 982-9898 • FAX (909) 985-2348
ADDRESS
C ITV /ST/\TE/ZI p
, UNDERLYING CARRIER
'f ANY) ___ ~~
~-<DDRESS
SHIPPER _Sf)
2
3
4
5
6
7
8
\
.!
\ -10
11
I -12
13
14
15.
--. .---------~------...... -~--~ -----~~,·-· ~-·· · .. · ... ::,: .. : .. ~···~----~----,.,-------------~---
ADDRESS
H.·· .. 12 i, . . ,
13
14 .
15 ..
REPORTINGTME
~~)':# t)l~')
START DRIVING TIME LAST T!:!IP
fNcg\;~i~.J~H}NfTJ~~i,~!~~1~~\2?},
~~~rS~tL f?f\f~~\,~\~ • ...
ADDRESS
CITY/STATE/ZIP
•• 'VNOERLYING CARRIER:
jlFANY) ···
'" 'ADDRESS
SHIPPER . <:~~,
:~~.._J
4
5
6
7
10
11
12
1-
1
-:-1
3 '----t---:---:-::1r.~--:-~--:---::-:1:tt~'7Sf:s:;:77tti:::t777s::±i:-tt'~c:f7'.37tT:t'rt~T4:i4 ii. 114 :I i.:.15.:.J----l--____:__+~--l---.::...l...-442.§:21:p~EdpLSiligP1Li.:L+J.Li:i2S'.b.2~~,1
GTJME \
.l A'"-/
ErtGTIME'
f..J• '
ARRII/AlTIMEAT :. DUM.P LAST.TRIP
.,,I" .// . ,,,,~,<:.:~i: .. ' ... ,.• .... ·· ... • ........... ·
1, ... :::;:;;·oRJVER SIGNATURE .·
,Xtl
··:.::.·..s:,'.:<·"i····:?'.\''":····:· r1
..• , .•••• ,:" ,.~~~;
1·:r::2;s~;.t->(:::1S~tt ...... ·. 1
.... ·c~!~E_R~~.~~~·.OR DEBl~ORf S}~NAT~~~--1 ·.-..
····----->,-·-·····-·····
tii.ttAl~TlO '°"· WOfl~
t'". ·,.":/
STAilUlfitQ 1/Ml LAiSTTllt• ..
lHOOI lASfJlllll . .. ...
T\JTAlTIIIII.~ TOtAt..lMt UISl Tf\Wl' -~'A:..-_/ /t -~ HRS . ... . /otouc~ '"· SJ AAT UNLOM>IHO tHO IJMLOAO ... Q JOtaitNl . . --,.o .. ~,+--::-:=-,--,-,c-1-'--,-,-,,-c..,.,-+------II
V.St "'" 1,.AS{'TII~
nNlOAOt°NO
... ...
LAST UN..OAOUilG
TIIA_WIL 1(1,1(
""''" ... OWIOts
....
lTC
· '.•"'" Terms: Payment due
,30 da.ys·from Invoice date.
. ~ ..
WHITE , ORJGINAC • PINK· BILLING • GREEN · TRUCKMAN'S • YELLOW -.DELIVERY ·', ,,·,~:.:.::_.. . ' .
..:•
/ ... ·
CAL-T #143-112 "·""'·-·" ... '.;,;1; • #.•
E.P.A. ID. NO. CAR6001ff792~
(619) 443-6193
FAX (619) 443-9364
RUST&SONS
····TRUCKING
15353 Old Hwy 80 • El Cajon CA 92021
DATE
FREIGHT BILL
ADDRESS --------------------.. =i{~~.ic'':I-: .. f-------------''-'.----~ =i'l-""Jvt'-~~j !ii ,,..,~, •. ._.,,,.. ~~~E ZIP TRUCK # 1~:._ I ·:t,~ ,.c;:;
UNDERLYING
CARRIER (IF ANY)
SHIPPER
TRAILER#
CONSIGNER _____________________ _ CONSIGNEE _____________________ _
STREET OR BOX--------------------STREET OR BOX ··f*-<'·'·--·· ---------------------
CITYISTATEIZIP
PT. OF DESTINATION . e .
BEG. ODOMl'.TER ENDING ODOMETER jr-Or, 1 t::. c.: • iJ , v~,,,,,,,:;--
TAG NO. WEIGHT
\
;.
CITY/STATEfZlP
TOTAL MILES RATE JOB NO.
·~ .. r, ..
P.O. NO. f} i , ,.., _ A I .,
{)"~ ::)-:r~~:J.1/)
c_· __ -.,-·.!Ji_ .. _;-· --------1--------+--------+-.a'-"-'.r._\_'_c· •"'';JI"':~-'-"". 'l-_·:------lf-----+-----1-----+-------. -¥. i ,,/ ,,, -~ ...... ,.,.r'fk;,,.··.
----------+------+-------+---~~--~,~4-------+-----+------c-+---+-------
OF DUMP TRUCK EQUIPMENT
UPER DUMP TRAILER(S)
UCK
0 2 AXLE
D 3AXLE
X
TRACTOR D BOTTOM DUMP DBL
D 2 AXLE D TRANSFER
D 3 AXLE D END DUMP SEMI
D NO UNLOADING
STTl11P
.> ~--.;::: .. -
ENDING TIME
ARRIVAL TIME AT OuMP
lA6TTRIP
RUNNING TIME
lASTTRIP
NETTJME
TOTA\ TONS
1 I .I
FUE . SURCHARGE
TOTAL CHARGES
CARRIER_.,-,,-·--('\
··-"-\ .. ,.-"·'/(----• r1 x~i~ME~~¥Eo8~\iGgA~n~o/p:~1r~M8l;txWJ8tkf PUBLIC UTILITIES COMMISSION < · } , ,\ \._~~trtO cos1s,AnoRNEYFEEs,ANoALLcosTsrnArAR1sEFRoMANv REQUIRES PAYMENT FOR THESE
DRIVERS( ,,.,r 1: // .. PROCEEDINGSFORTHECOLLECTIONOFAMOUNTSDUETOTHECHARGES NOT LATER THAN THE
I' _}, .. ·"f( f / l ABOVECARRIERFO,iWORKDONEFORTHEABOVECUSTOMERWILL X / 1,.../.,:·n /! \,._;;,L,,./ ! . BE'PAIDBYTHEABOVEcusroMER. 2STHDAYOFTHEMONTHFOLLOWING
coNSIGNE,E"s1G"l(Aru'Ret,·;o•·'·· · .. j! j ~1J"ifr~ii~~g~~tl1ilitvcf:~~~rs: No payment will be made for DATE OF TH IS BILL.
CALIFORNIA DUMP TRUCK OWNERS ASSOCIATION • 334 NORTH EUCLID AVE., UPLAND, CA 91786-6031 • (909) 982-9898 • FAX (909) 985-2348
j
...... ':>':".~~---:--:,~~·.--:-:-... . .... ,,., .............. ·.·.····· .
~~w~{~~\-f '1.'i\
ADDRESS
CITY /Sl".tffE/ZI p
_ ,.UNDERLYING CARRIER·
'f ANY) _ ___cc.__.___c~
2
3
4
5
6
7
8
'1
10·
11
12 .
13
14
15
ADDRESS
CITY/STATE/ZIP
P' -'\IIDERLYING CARRIER"\'":') .....
FANY) U f
\icmRESS .
SHIPPER
11. ' ..
12 (
13
14 .
15 ...
REPO
· ~~)'~~ tJ1{P)
START DRIVING TIME LAST TRIP
-----··---·--~-~-----~--.,_.,,.,...,_,,..,..........,...,..,..,....,_,..__...,..._~~-"""====='c='S="===,--------:----
NON•NEGOTIAB~Ei•,i,·· .• :;'• --·:F~Jili~.P'.INai•;;:
AND TRANSPd'RTJ.ltff GREEM ENT
r:~rS[tL · Ptvg-~:;:,~".\W£J;,~~~1: ·
ADDRESS
CITY/STATE/ZIP
4
5
6
7
_.-,.,.,·."·=
10
11
12
13
14
15
ErrGTIME• ...
/.,J •: . ·.
~ti' .4· '=·-_,,<tf'..::l· ... • ... : , .. : ... · '.' :·-.·.:. : .. · ... , .. ··.
KISSINQER GR01'P,IN~.
P.O~ BO)( 1127, SPRING VA{LE/CA 9\979' . > . (619) 660-7488 :t.. ) </.
CA• 23244 DATE// ,,_;· ·'
~ 9 i;-·o· .t'1 TAU~ At ......;~~=;.:.:...=.:_.__,...,......-:;:::-.r -~~~. J
-
PRODUCTION AAEA DEL.ZONE POINT HRS, OR TONS A.-.TE
AAYMINl OIAIY h+t;1)t .. or1H(.rOLU)W<HG WONf" C.lfORAGl'lllS ,o,.AYllOM,. fHSNtOOTHUIICO\UC1'fOHCOSTS.
AHO ON( f"t"CINl ft!KMOtrttM Ofl OlllfliOOlN'l AG(X)UNTS .
.... ...
IUJn UNlOAOJMG
1>$T '"',.
.... ....
WATl~L(v'tLi',
C,Ali4(;1l't:
ALL OVERWEIGHT TICKETS
UfOOf \.ASfTA,. . .. ••
'tNOUfilO.-O!NO wr,~
MIDQ( TOllS
AAE CUSTOMER'S RESPONSIBILITY,,
DR1V£ROROYINER · ·ev,.-.
....
ITC
Nt.T
0
TOTA!-
WHITE • ORIGIN,/1.l • PINK· BILLING • GREEN • TRUCKMAN'S YELLOW • DELIVERY
' t,;:-::.1',
l
' ' ,,
,<'
. '
\. \ \ ~-t ·!~ FREIGHT BILL/ BILLOFLADING
BECKY HOURANI TRUCKING, LLC ·
P.O. BOX 16674
SAN DIEGO, CA 92176
PH: (619) 843-2105 • FAX (619) 269-9833
CA3512%
No. 7827
LJ /; /1;1 ' -I r -~-DATE
SHIPPER/ -!.r ',(' 5~ 'fl/ ,, "'.: £.) CONSIGNOR~~'~~!,.__l~~:.....::_.:l._,,__......t6~~~t;:"--"f~~~~~~~~~~~~~~~~-ADDRESS~~~~~~~~~~~~~~~~~~~~~~~~~~-
CONSIGNEE ,r r e 12 1r. A /!_A c ,-r-I< ADDRESS
UNDERLYING /3)/ l.f. {/ C. A. I 'fl) CZ TRUCK (? L-1 CARRIER OWNER CANO. .......
REPORTING I., ' /) () TIME STARTED TIME STARTED NO.OF 7. TIME :::, • ' LAST TRIP LAST UNLOADING LOADS
ENDING JO ; (JO TIME ARRIVED TIME ENDED
TIME TO DUMP LAST UNLOADING COMMODITY
OVERALL t/ < () RUNNING TIME LAST UNLOADING TYPE OF
HOURS LAST TRIP TIME LOADING
DEDUC· EXPLANATION I LOCATION DRIVER
TIONS --OF DEDUCTIONS REPORTED FOR WORK
STRAIGHT 1/. 0 ~~JCHARGEABLE l{ i} IRATE TIME HOURS TRAVEL TIME HOURS I --
JOBNO. 96 I{-/ b dP.o.rgf,I.S-lh
)ANIFEST NO.
LOCATION
IN/OUT
/.,:ooUJD
(fJlj/J]lJ
/?]5 !~'15'
( '&p/
I
I
I
I
I
I
I
I
I
I
SIGNATURE X
PRECISE POINT-~-·--· OF DESTINATION
/e -1 t) / 1u/ cl 'N-+,,L
f)l)M /J
IE Go I .qi\/) I I
DvM;O
-· ....... ..--6 ' 5. " ~--~·
I
~PERI WEIGHT KIND OF
TICKET NO. MATERIAL
TEAMS: A SERVICE CHARGE OF 1th% Will BE ASSESSED 10 ALL ACCOUNTS PAST DL!E 30 DAYS AS PERMITTED BY LAW. COURT COSl'S, ATIORNEY FEES, AND ALL COSTS THAT ARISE FROM ANY
PROCEEDINGS FOR THE COLLECTION OF AMOUNTS DUE TO THE ABOVE CARRIER FOR WORK DONE FOR THE ABOVE CUSTOMER WILL BE PAID rN THE ABOVECU$10MER. ATTENTION UNDERLY·
ING CARRIERS: No payment will be made for TICKETS Nor COM-
PLETELY lilied out.
COMPANY·ASSUMES NO RESPONSIBILITY FOR DAMAGE FROM DELIVERIES MADE INSIDE CURB OR PROPERTY LINE AT CUSTOMER'S REQUEST.
White-Billing Canary-Customer Pink-Office Goldenrod-Sub•Hauler
TRUCK NO. ~
TALNOS .
CAPACITY ___ TONS __ CU. YDS
NO. OF AXLES-¥---WHEELBASE __
BRIDGE TOLLS
WGT. FEES . MISC. CHARGES
/t;6t> /l'J,LI d
CHARGES I RELEASE NO.
NET WEIGHT
IN TONS RATE AMOUNT
' TOTAL lO COLLECT
-· SubJecl to Sec11on 7 of coni:t111ons of applicable bHI or ladlng. 11
this shipment Is 1a be daliverect 10 Ute con:iig11ee without recourse
on the consignor, the consignee-shalrsign lhe rc;iltowing statement:
the carrier shaH not make delivery of this shipment w1u,ovl pay-
mel'll of frelQhl and au the olhor lawful charges.
SJGNATUAE OF CONSIGNOR
.. ~ I· ; !
... .A
·-~·-·· ..... _·.-.···· . -.;····.··---·--···· u P TRUCK ·BILLIN F ·R
-a·-4=---H~\URL Y ·:r ' TONNAGE r~).? 9,~_;_•_:f./1 / )
C ..... . \ v {2 V (' i t,, · , o · ( 1 arr1er ____ -+-'-----~·· ~'· ~'·~----c·= .. ·· ... ··"c..""'-""'"'" . .....,,.'"".--'~-'-....,..---..,,-,.,........-...-'""-"·-,,.. a.te,,· ·,·· , I ... , 1 l >l C:, "·-:-1 .::). '};_,,. ,r) ;/ =-:~1-"'>""i~--------;----
1 /·1 1 ./ ... c" , •· .. L-4 ... :_f·~·. , , 1 .... ..--·
Address _____ ""·_-_ ... ,.._(_ . .,,._·\_. _t·_;:_.:,_{_:>_' _· .. _~'._,......o._(_:<_ •.. _.,..(-··:_....._ ________ City __ ··_f_i_-_______ Stote
\NDERL YING CARRIER
.... , ... f any)
GENERAL CONIR.
(Consignor) ·
RECEIVER ·.-. .;,.;:.:..":,.:c: . .-.,.·'
{Co.ns.igriE!e) · · ·
NAME .Of : :: ' '
Dl;BTOR: · .. ·. ·
PRECISE POINT
OF.OESTINATlON
· PRODUCTION AREA
MATERIAL .HAUlEO
:·.:.
:.···
Addren
( i
\\, i (
1
f .. = CA (>\.
········· ···~,. ' . ____ ....,..
POINT
', \ \
·------~--~ ... _
.::~: ..
! ,J
c .... \
KRS. OR TON$
........ ,, ... , ........... _
·-... ,1, .. ,., ....
.f
City
City
RATE TOTAL
.,
·-t ' • f\ ' t· \~ .. /" \.J \..',.,\ \ (.,.·· '' ~-~
TIME REPORTED
fORWORK
. END llME
.. -.~'
· .. ,.,-··"···-'"·········' ..
· .. ·-·-.................. ·.,· ........ ,.., ...... .,., .. ., ........... .
STARllNG TIME
. V.~T TRIP
. A.M.
P.M,
START UNLOADING ·
1/lST.lRIJ>
END OF
IAST TRIP
/. ,.· .... J l ''l',,C) l..,j, J :}M"-
f·M·,
TOTAL TIME Of
~STTIIIP
HRS.
1:NO UN!OADING . TOTAL ltME
LAS I TR!? tAST UNlOAOlNG
,.,r~TA4lfM! < r "/ .. '--· J1. v ::~, \ ..... / . /'
l:!11.~,
·>j·IEHIMt"( ....
TRUCl(MAN'S n NUMBER
These charges include ! I) fees·
AM.
·P.M.
AM.
P.M. HRS. 'io pay for: iegulohori · of 1,ons.' ·AM. ,, · P,M,
=:==.,:==:::;:::===l=======:J::=======:t=;======:1h-----l!lllllftporlal1on companies by the
EQUIF.l, NO. . WATER lEVEt TYPE LOADING TYPE OF RlNTAL PRIVATE l ·.-!· . . CAPACITY PROPERTY California . Public Utilities '·"''-'{ . : D Commission ond (2} Imes p1;1id to
TRUCK OR
TRACTOR lfC I
TRAtlfR UC. N No. Of AXlE.S 1--'------UColilornio cities instead of e-cise
or business license to~es they
covld otherwise impose.
LONG D!$TANCf HAULING ONLY I
MllfS IIA!l' ________ CHARG~S-~~---.----I ti ATE DISTANCE RATE NOTICE
DRIVER OR OWNII!
. \I
. ····1
'',
_,
l ,j ·.:,! ·. :·_:')
:'.'!
·.J .· .. 1 . :'j
NON-NEGOTIABLE Bill-OF-LADING
ANO. TRANSPORTATION AGREEMENT
BltLNO.·
PRINCiPAL \ j t.'.;
CARRIER --+l'-':: .. ,,_. --'-\-'~•~~!"-.. ·--<.: ... --,, ...:c\_.,,.C""1, 4,(i.=:;;~·"=;;;_·· ----~•· -~\,__._1--..;.------'--'-t >~r}, ..... l ADDRESS
( ')STATE/ZIP .
.. UNDERLYING CARRIER\;
(IFANY) . h.
ADDRESS'./ l? :l),
SHIPPER
CITY/STATE/ZIP
POl~T OF ORIGIN
0 SUPERTAG
D TRANSFER
5
6
,7 ...
i ...... __ .,.
9
10
12
13
14
15
REfORTING TIME
(~} ::, 00
START PRIVING
· TIME LAST TRIP
0 DBL BOTTOMS
Cl SEMI-BOTTOM·.·
ENDING TIME· l ~:,{:){}
ARRIVAL TIME AT DUMP 1./\STTRIP
TOTAL TIME •·"'" ..... ,
,!
.ENtfLOADING
LAST.TRIP
•. DRIVER SIGNATURE
DEDUCTIBLE TIME · ()
RUNNING TIME LAST TRIP
. CITY/SfATE/ZIP
POINT p)'=.DESTIN/\TIQ1'1.
BROKER#
TRUCK#
TRAILER# I
I (~.:~ {'.'.~~) l ,j .
O TOi'l'/AGE O PERL~ 1
··/ ..
SHIPPER/RECEIVER (AGENT .. OR DEBITOR) SIGNATURE
NON-NEGOTIABLE BILL;.QF-1...AblNG .....
., ·-ANt>'TRANSPORTATION AGREEMENT ..
PRINCIPAL \
1
,_.,(.· .. · . . ......... .
CARRIER \ ··:-. <. : l·\ '1 ( v· ·.
'-, .... ~) .
i • BILL NO. I
r Jl.r)ORESS BROKER# I
~-, Y/STATE/ZIP , . .,_ PH. 1--T-RU_C_K_#+(-..-)-),-1,-----..... .
UNDERLYING CARRIER \( <\, . ('\ \ V C·\ 'V \ < i~:" . TRAILER#
(IF ANY) ______ ~_.:_··'~=-'-' __ _.:_' --·---"1···c"--·' '-· ----------t-.....---1----......_...,....,~
ADDRESS } t ff-1. i\ CA# (' <'.(') C::/} I (
SHIPPER
CITY/STATE/ZIP
POINT OF ORIGIN
3
4
5
6
8
9
10
11
12 ....
13
14
15
0 SUPERTAG
0 JRANSFER
0 DBL BOTTOMS
D SEMI-BOTTOM
START-DRIVING ARRIVAL TIMEAT•·-TIME LASTTRIP DUMP LAST TRIP .
:\
DRIVER SIGNATURE .
D ENDDUMP
D SIDE DUMP
D TRUCK&PUP
D WATER TRUCK
DE~~B_LETIME
RUNNING TIME LAS TT RIP
. " ,., JI • f' ' PO)t-l.!J)F DESTIN~JION···· . . . .. \ ( . , · l ··5 i \ __ ye sY' c1w .. .. av o\ \ n \1
.p FLATBED
0 MIXER
D OTHER
TOTAL TONS
0 HOURLY D TONNAGE D PER LOAD
ACCESSO~IAL OTHER
JOB
-l
I I i l
! I ! ! 1
I I I I I
FREIGHT BILL
15353 Old Hwy 80 • g1 Caj6n· CA 92021
. ··.'·. . .
~Z.;,_,,A<,·<("" ;,, "~oe:;
1,:>·•'''
ADDRESS~-----------------------------------~
CITY ,,,., ·<"'"·''-·~ STATE __________________________ Z_IP ___________ TRUCK ii / C' .-"'
UNDERLYING
CARRIER (IF ANY) TRAILER ii
_,,,., /
CONSIGNEE""'..:;;?'' il·fl',:c'.'·· /4;.;'Z'.':",;.r<, JC:_. l;,,/fj?,."5'7'"'-'";··
ST~EETORBOX ____ ~/_
7
_-___ ·_._··~,.,--~·~-~------
CITY/STATBZIP CITY /STATEIZIP
NAME AND ADDRESS OF DEBTOR IF OTHER THAN CONSIGNOR
PT, OF DESTINATl~~;~-_,,w~·' . , ~-"",.. '"7·-~~-.,,.,,,,"-.,. "
;•' )
TAG NO. WEIGHT
D ~,AXLE
1'5'3 AXLE D 3 AXLE D END DUMP SEMI
D
ND UNLOADING
STTAIP
€i·1fou;w
D TONNAGE
RUNNING TIME.
LISTTAtP
RATE JOB NO.
UNLOADING
NETT!ME ,,
P.O. NO.
BREAKDOWN/
REASON FOR DELAY
TOTAL CHARGES // ,:::;:, ;:>;?...~-X
CARl;!JJ;S-/ t.f · • ~-:;;(,:<;:>~:,;,::;;TEAMS: A SERVICE CHARG_E O, '114% WILL BE ASSESSED TO ALL . . ,/·,::;:;:;;_.:P'"t,:;i!<,:_,·::,t:_._)_·.<i''.,;;.._;f~b:'_···'~ ,,,I,: ·:;," '.// ,1e<;)"~ ACCOUNTS PAST DUE 30 DAY~·AS PERMITTED BY LAW. COURT PUBLIC UTI LlTI ES COMMISSION ,_X'._.__ ·----.......;,.=,,---~"'<----,'.,''-'00--+s·'..c.'•·~·:-._.-.. ,e:;,i~__,·"t.ae'•_" COSTS, ATTORNEYFEES,ANDJ,iLLCOSTSTHAT ARISE FROM ANY REQUIRES PAYMENT FOR THESE
DRIVER SIGNATURE ·· : i' 1 / , !.-' PROCEEDINGS FOR THE COLLECTION OF AMOUNTS DUE TO THE CHARGE O LAJER THAN. THE '('' · j } .l ( ./ -': .. ,,.'\-.'.:: .. ABOVECARRIERFORWORKOONc.FORTHEABOVECUSTOMERWILL 8 N T )t,~';:'.;·r\, .. '; ~I., . -/j /-,,/A.// BE PA1DBYTHEAB0VE CUSTOM~A. . 25TH DAY OF THE MONTH FOLLOWING
CONSIGNEE SIGNATURE" ' .. ,,, "f , · , ATTENTION UNDERLYING CARRIERS: No payment will be made for DATE OF TH IS BILL TICKETS NOT COMPLETELY lilied out. '
CALIFORNIA DUMP TRUCK OWNERS ASSOCIATION• 334 NORTH EUCLID AVE., UPLAND, CA 91786-6031 • (909) 982-9898 • FAX (909) 985-2348
Carrier
DUMP TRUCK ;Bil.LING FORM
~~--'-, .. .-=-··------" _ HOURLY· ZONE· TONNAGE 3 970'2
\ --······--·· \ \ .
\ '2.' -'4Ct> ---"""t"'" \ Date '?:::J \ -.\ A l
( (
Address City Stole ,,~·-·~;\:.:D::E::.Rl=Y=IN=G=C=A=RR=l=fR:;;\=== .. =. ======;::::;;,:;;;;\:;;A;;:dl:I=,= .. = .. ===\=:.'..\::.· ========.:==-===
f I (-~ n • . n \ ~ ';,t'rJ,.,,:~;"";·-..... ,.. \""",:! :·ony) [\. \ >~)\•.!'-I r"--< \ _.) '\ .:,. ) (\. c\,,,,_
GENERAL CONTR.,._ .• ,. ... --.-. '-,' \\ Y) ',·<, ·· \ . , __ 1,., __ £ .._ \ v--\..,,_ (Consignor) --·--::~·-, \. 'Z.A f";.J::,... ,(•-t l:; -;:-' C... ·"-,.~J,.,.)c .. ~) ·
RECEIVER
(Consignee)
PRECISE POINT
OF DESTINATION
PRODUCTION AREA
MATERIAL HAULED t '"'),.,,.,:-A--i
TJME JU;Pormo FOR WOR(
ENOTtME;
SJAJHING llME LAST TRIP
A.M.
P.M.
START UNlOAOfNG
I..AS.T l'RIP
HRS. Oil TONS
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City
RATE TOT Al
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CHARGl\9f i% A80VE PRIME RAU Will BE AS.S(SSU> ON AH ACCOUNTS PAST DUE.
AM. P.M.
END UNLOADING LAST TRtP
TOTAt TJME Of lAS.T TRIP
HRS.
'fOTALflME
LASr UNLOADING
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DEOUCTfON
NETllME
lRUCICMAN':!i TI NUM8U!
lhe$e (hctge$ indude (I) fEfes. l; tD
\ /'') A.M. AM. AM. 10 pay for re9ulo1ion of lron!i• ·'-~c,, /f::;ff..-i P.M. P.M. HRS.
==,==a==u==,P==,=..,~o~;;:zf,:::=w:::A:::IE=R=,=EVE=,=,j:::=r=v:::Pt=,==o=Ao=,=..,=c=jr===IY=P,=O==,:::•==,..,:::r==A:::L =,,...-".,,"','"vA .. TI':'."""'"iPoriotion c::omponies by the
· "'" CAPACITY PR:OPERlY Coliforni(a Publi<. Utili1ies ,::~::t ·'"""'"· o Comm>Soion ond (2) Jaxe, pa;d lo
--,-.u-C_K_O,.,_,;---+--,.-A-ll-ER-l-lC-,-4--N-0-0-,-A-'-Kl"'<S'"---,-I~~ .. ~-1----"=--~IColifotnio cities lm:lead of excise
TR'AC-lOK tK. • or business license lo.:es !hey -.· .. ,. ... could olherwi!ill'!! impose.
tONG DISlANCE HAULING ONl y:-: ·. DJSTANC{ RATE NOTICE DATIS
••••••-••••--~·~•-a •• ~-'',. ----"Aa-•• -"•,, __ ., ... --•-••-.-~<............-,--•_J•-•-•
NON-NEGOTIABLE BILL OFLADING ·.
AND TRANSPORTATION AGREEMENT
PRINCIPAL /L~ ,.,· ,,. <>'' i . "' , • ., CARRIER 1./ /..(. '· J //\.d.1·bi<~
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DATE:;> •• ;,··, 1 .... 7 .. :> . /· ,e
ADDRESS ;:?<·;> {~ J~:)L{:=~,l \Al\!{;;,/ . ···:
CITvsrw1;lll Ur~ I({:/ . ST(/(! Z!P 1;h1~','\ PH(Cf~V-1,'1,;(.} l'/1l··2r
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JOBI/
BROKER II
TRUCK II
TRAILER#
CA#
6lLLNO.
37245
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ADDRESS OR BOX ________________ ---LI ADDRESS OR BOX--------------
CITY/STATE/ZIP -~~( CITYJSTATE/ZIP
NAME AND ADDRESS OF DEBITOR IF OTHER THAN SHIPPER/CONSIGNOR POINT OF ORIGIN
(tf5.') d/itv() (.t,/\·iC,t.:' /-fr C;<·
POINT OF DESTINATION
( ( 6-1> /,,.,lf.{, D /jt\,i? l{ij1 ){.s" ! :st lf( D
D DBl BOTTOMS . D 10-BDOSTER PROD.ARE~ ·. ;@·HOURLY
D SEMl·BOTTOM D 10-PUSHER DELIVERY ZONE 0-TONNAGE RATE@$ D END DUMP 0 SEMI-HAT 0-PERLOAD 0 SIOEDUMP D MILEAGE !
2
3
4
5
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8
9
10
START DRIVING TIME
LASTTRIP
ENDING TIM(
.:? !(;;;·-
ARRIVAL TIME AT
DUMP LAST TRIP
ENO LOADING
lASTTRI?
DEDUCTIBLE TIME
RUNNING TIME .
LASTTRIP
>·'// DRIVER SIGNATURE
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