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MSV TRUCK CERTIFICATIONLooks 1 / NO- Great Services TRAILER MEASUREMENTS LENGTH: TRUCK CAPACITY CERTIFICATION HEIGHT: CLIENT NAME; - ' eS � 7� Z 4 (INSIDE DIMENSfON rWSIDE DIMENSION y aiYl y ) Y10 DISASTER NO: J J (IFAPPLICABLE CONTRACTOR NAME: e y� S W y� ' r `P'S (PLEASE PRINT CLEARLY) r y G TRUCK OWNER NAME: I' f G 7 T o T DRIVER NAME: II ('0 FT DRIVER'S LICENSE #: TRUCK/TRAILER MAKE: _,,r iQ -M _16,_r ASSIGNED TRUCK/ �1 y 1 � LICENSE NO: Cy STATE: MODEL: TRAILER NO: yJ - l TRAILER MEASUREMENTS LENGTH: WIDTH: HEIGHT: GROSS CY: DEDUCTIONS' NET CY: (INSIDE DIMENSfON rWSIDE DIMENSION INSIDE DIMENSION MONITOR /INSPECTOR: (IFAPPLICABLE TIME: FT FT FT � 1N IN IN Cy Cy CY SIDEBOARDS: YES/NOt Are the following in HEADLIGHTS: YE NO SIGNAL UGHTS NO .LOADER SEAT: YES O �/ acceptable working TAILGATE: YE O Condition? BRAKE LIGHTS; YE- NO BACKUPALARM & NO TIRES: ES O DESCRIPTION OF DEDUCTIONS: (IFANY) WNITE•Prime Contractor GREEN- Clfent(cky county state) YELLOW - Contractor MK- Monitor /Gov Rep GOLDENROD- Driver keep In truck PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: DATE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: WNITE•Prime Contractor GREEN- Clfent(cky county state) YELLOW - Contractor MK- Monitor /Gov Rep GOLDENROD- Driver keep In truck Looks 00 938 Services TRUCK CAPACITY CERTIFICATION CLIENT NAME: ! r �j t / F+�, (,,� IDISASTER NO: %! CONTRACTOR NAME: R ,�Q`} TRUCK OWNER NAME: "4 ( � � n (PLEASEPRINTCL£ARLY) `J L- ��w+ DRIVER NAME: C4, i "P DRIVER'S LICENSE #: A � !L-1' , r^ TRUCK/TRAILER j MAKE: ASSIGNED TRUCK/ LICENSE NO: STATE: ..f MODEL:n TRAILER NO: TRAILER MEASUREMENTS LENGTH: WIDTH: HEIGHT: GROSS CY: DEDUCTIONS: NET CY: INSIDE DIMENSION) INSIDE DIMENSION) (INSIDE DIMENSION ) (IF APPLICABLE FT FT FT I IN IN Cy Cy Cy SIDEBOARDS: YES /NO Are the following in HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO acceptable working TAILGATE: YES/NO condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (fFANY) PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: DATE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: WHITE -Prime Contractor GREEN- Client(clty county,stote) Y €GLOW - Contractor FINK- Monitor /Gov Rep GOLDENROD - Driver keep In truck Great��" 003940 Services URAILER MEA5UREMENT5 LENGTH: (INSIDE DIMENSION TRUCK CAPACITY CERTIFICATION HEIGHT: INSIDE DiMFNSION GROSS CY: CLIENT NAME: ,) DISASTER NO: 7 fT CONTRACTOR NAME: CY � 1 4(--, IN (PLEA5EPRINTCLEARLY) TRUCK OWNER NAME: -�,.. P Are the following In acceptable working condition? HEADLIGHTS: YES /NO `1� LOADERSEAT: YES /NO TAILGATE: TES /NO BRAKE LIGHTS: YES /NO DRIVER NAME: i V f�-�r \ t 1 DRIVER'S LICENSE tl: TRUCK /TRAILER MAKE: ASSIGNED TRUCK/ LICENSE NO: ! STATE: f V MODEL: TRAILER NO: URAILER MEA5UREMENT5 LENGTH: (INSIDE DIMENSION WIDTH: {INSIDE DIMENSION) HEIGHT: INSIDE DiMFNSION GROSS CY: DEDUCTIONS: (IF APPLICABLE NET CY: FT FT fT �(„ , { I � CY CY f +, CY IN IN I IN SIDEBOARDS: YES /NO Are the following In acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADERSEAT: YES /NO TAILGATE: TES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: '�� PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: WHITE -Prime Contractor GREEN- Gient(cit),countY,state) YELLOW - Contractor PINK- Monitor /Gov Rep GOLDENROD- Driver keep In truck Looks 004000 T04ft Services 1* -- TRUCK CAPACITY CERTIFICATION CLIENT NAME: yyy DISASTER NO: CONTRACTOR NAME: (PLEASE PRiNT CLEARLY) _ TRUCK OWNER NAME: DRIVER NAME: Y� �� Y- 1 `' 1[ DRIVER'S LICENSE TRUCK /TRAILER MAKE: ASSIGNED TRUCK/ LICENSE NO: STATE: MODEL: ITRAILER NO: TRAILER MEASUREMENTS LENGTH. (INSIDE DIMENSION) 7 WIDTH: HEIGHT: jiNSIDE DIMENSION) INSIDE DIMENSION GROSS CY: DEDUCTIONS: NET CY:. (1F APPLICABLfJ FT / FT L FT /1f � � y � � �• i� �. IN IN IN CY CY SIDEBOARDS: YES /NO Are the following in HEADLIGHTS: YES /NO acceptable working SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO Condition? BRAKE LIGHTS: YES /NO BACKUP ALARM; YES /ND TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: L/ PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: MONITOR /INSPECTOR: FEDERAL INSPECTOR: WHITE -Prime Contractor GREEN- Client(citgcountystate) YELLOW - Contractor PINK- Monitor /Gov Rep GOLDENROD - Driver keep in truck Looks � 1 0 Great Services = • 003928 IKA!LtK IYIt1A3UKtIVItIVIS LENGTH: TRUCK CAPACITY CERTIFICATION CLIENT NAME: TIME: DEDUCTIONS: ti d1 U f DISASTER NO: CONTRACTOR NAME: yy GROSS CY: 14-1 f (PLEASEPRINTCLEARLY) ,i i TRUCK OWNER NAME: DRIVER NAME: t . � n DROVER'S LICEN5E k: ., TRUCK /TRAILER FT MAKE: ASSIGNED TRUCK/ LICENSE NO: STATE: MODEL: TRAILER NO: IKA!LtK IYIt1A3UKtIVItIVIS LENGTH: WIDTH: HEIGHT: TIME: DEDUCTIONS: FEDERAL INSPECTOR: (INSIDE DIMENSION) (INSIDE DIMENSION) (INSIDE DIMENSION ) GROSS CY: (IFAPPLICABLE) NET CY: FT FT FT INI IN IN CY CY CY SIDEBOARDS: YES /NO Are the following in HEADLIGHTS: YES /NO SIGNAL LIGHTS; YES /NO LOADER SEAT: YES /NO acceptable working - TAILGATE: YES /NO condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: 0 0 DESCRIPTION OF DEDUCTIONS: (JFANY) . DATE: PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: MONITOR /INSPECTOR: FEDERAL INSPECTOR: - ^ -- --l- 111- -l•r, —M, ;GLv -a. ....... ur vINA- AVOrorar/aovHep GOLD €NRUD3Dnverkeep in truck Looks ` 1 Great Services, 00392y TRAILER MEASUREMENTS LENGTH: ( INSfDE DIMENSION TRUCK CAPACITY CERTIFICATION CLIENT NAME: GROSS CY: DEDUCTIONS: (IFAPPUCABLE) NET CY: FT FT Z%r CY DISASTER NO: CY CONTRACTOR NAME: C IN PL-UNDH (PLEASE PMNT CLEARLY) J TRUCK OWNER NAME: TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO , I : _I DRIVER NAME; 1 1 ,'� I DRIVER'S LICENSE q: - TRUCK /TRAILER MAKE: ASSIGNED TRUCK/ LICENSE NO: STATE: MODEL TRAILER NO:y TRAILER MEASUREMENTS LENGTH: ( INSfDE DIMENSION WIDTH: (1NSME DIMENSION) HEIGHT: (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: (IFAPPUCABLE) NET CY: FT FT FT CY CY CY IN IN IN SIDEBOARDS: YES /NO Are the following in acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) wrnec- rnmeLontrncior (aK&kN- t:nent(at),countystetel YELLOW - Contractor PINK- MonitorfGDvRep GOLDENROD - Driver keep In truck PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: DATE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: wrnec- rnmeLontrncior (aK&kN- t:nent(at),countystetel YELLOW - Contractor PINK- MonitorfGDvRep GOLDENROD - Driver keep In truck Looks / Great Services = 003930 I RAILER MEASUREMENTS LENGTH: WIDTH: TRUCK CAPACITY CERTIFICATION CLIENT NAME: DEDUCTIONS: MONITOR /INSPECTOR: "'v i i LukA (INSIDE DIMENSION I � DISASTER N0; CONTRACTOR NAME. (If APPLICABLE} NET CY: (PLEASE PR)NPCi£ARLY) _ l TRUCK OWNER NAME- 4 V FT DRIVER NAME: .. CY DRIVER'S LICENSE #: , } TRUCK /TRAILER V IN IN .� MAKE: ASSIGNED TRUCK/ LICENSE NO: SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO STATE: I MODEL:Nt ct ITRAILER NO: I RAILER MEASUREMENTS LENGTH: WIDTH: HEIGHT: DEDUCTIONS: MONITOR /INSPECTOR: INSIDE DIMENSION (INSIDE DIMENSION (INSIDE DIMENSION J GROSS CY: (If APPLICABLE} NET CY: FT FT FT CY CY +/ CY IN IN IN SIDEBOARDS: YES /NO Are the following in acceptable working HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DLSCRIPTION OF DEDUCTIONS: (IEANY) DATE: PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: MONITOR /INSPECTOR: FEDERAL INSPECTOR: ...,... ..,".. VriEEiV-r.nengrary,counry,srarel "LLVw- contractor PINK- Mooltor /Gov Rep GOLDENROD - Driver keep In truck Looks Great Services 003931 1 TRUCK CAPACITY CERTIFICATION CLIENT NAME; [DISASTER NO: CONTRACTOR NAME: (PLEASE PRINT CLEARLY) 1 _ l TRUCK OWNER NAME: .�•.- DRIVER NAME: I — _ DRIVER'S LICENSE #: TRUCK /TRAILER / LICENSE NO: STATE: 1 MAKE: MODEL:f►7)4i ASSIGNED TRUCK/ I J' TRAILER NO: I4 ia_IIRa:a16TAIWi .191IN a1►Al2,11W LENGTH: WIDTH: HEIGHT: DEDUCTIONS: (INSIDE DIMENSION) ((NSIDE DIMENSION) (INSIDE DIMENSION) GROSS CY: (IF APPLICABLE) NET CY; FT FT FT CY CY CY IN IN INI SIDEBOARDS: YES /NO Are the following In acceptable working HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: MONITOR /INSPECTOR: FEDERAL INSPECTOR: .... ..... «.........,4 -. vn uty,—Unlysra[e/ ft[ww- LOnrrottor VINK- Monitor Gav Rep GOLDENROD-Driver keep In truck Es GJ395� TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION) TRICK CAPACITY CERTIFICATION HEIGHT: (INSIDE DIMENSION) CLIENT NAME: / ] I I �� �`�. - -�,; DISASTER NO: 7 CONTRACTOR NAME: fPLEASE PRINT CLEARLY) l '� Y TRUCK OWNER NAME: CY DRIVER NAME: It r, ;' I. � 1 ( DRIVER'S LICENSE #: / -� � 1 "►, _ TRUCK/TRAILER * LICENSE NO: SIDEBOARDS: YES /NO , STATE: MAKE: yy MODEL: V ASSIGNED TRUCK/ ++ TRAILER NO: TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION) WIDTH: ()NSIDE DIMENSION) HEIGHT: (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: (IFAPPLICABLE) NET CY: FT FT FT CY CY CY IN INI IN SIDEBOARDS: YES /NO Are the following in acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE; YES /NO - BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO IDESCRIPTPON OF DEDUCTIONS: (IFANY) DATE: PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: WN)TE -Prime Contractor GREEN- CHent(ciMcounry state) YELLOW-Contractor PINK- Monitor /Gov Rep GOLDENROD- Driver keep in truck Looks 1 i Great Services • TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION) TRUCK CAPACITY CERTIFICATION CLIENT NAME: GROSS CY: NET CY: FT DISASTER NO: CONTRACTOR NAME: CY (PLEASEPRiNTCLEARLYJ A TRUCK OWNER NAME: 22-Alf r-P t IN DRIVER NAME: J DRIVER'S LICENSE #: ! ?. TRUCK /TRAILER LOADER SEAT: YES /NO TAILGATE: YES /NO MAKE: ASSIGNED TRUCK/ LICENSE NO: DESCRIPTION OF DEDUCTIONS: (1FANY) STATE: MODEL: TRAILER NO: TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION) WIDTH: (fNSfdE DIMENSION) HEIGHT; (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: (fF APPLICABLE) NET CY: FT FT FT CY CY CY INI INI IN SIDEBOARDS: YES /NO Are the following in acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: Y ES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (1FANY) WHITE -Prime Contractor GREEN- Client(eity,couriMstate) YELLOW- Contractor PINK- Monitor /Gov Rep GOLDENROD- Driver keep In truck PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: DATE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: WHITE -Prime Contractor GREEN- Client(eity,couriMstate) YELLOW- Contractor PINK- Monitor /Gov Rep GOLDENROD- Driver keep In truck Looks .1 # 1 1 4 4 a Great... s Services TRAILER MEASUREMENTS LENGTH: (IN51DE D)MENSION) WIDTH: INSIDE DIMENSION) TRUCK CAPACITY CERTIFICATION CLIENT NAME: N, ., �y NET CY: FT FT ` An) — + I DISASTER NO: CONTRACTOR NAME: IN (PLEASE PRINT CLEARLY) LIF I TRUCK OWNER NAME: Are the following In acceptable working condition? � Ii lI rI �' t 4 DRIVER NAME: , V �+1 DRIVER'S LICENSE #: TRUCK /TRAILER MAKE: I)t e ASSIGNED TRUCK/ LICENSE NO: 6 9 L4 L4 STATE: MODEL: TRAILER NO: TRAILER MEASUREMENTS LENGTH: (IN51DE D)MENSION) WIDTH: INSIDE DIMENSION) HEIGHT: (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: IF APPLICABLE NET CY: FT FT FT CY' CY CY IN INI IN, SIDEBOARDS: YES /NO Are the following In acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) WHITE -Prime Contractor GREEN- Client(city,county,state) YELLOW-Contractor PINK-Monitor /Gov Rep GOLDENROD - Driver keep in truck PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: DATE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: WHITE -Prime Contractor GREEN- Client(city,county,state) YELLOW-Contractor PINK-Monitor /Gov Rep GOLDENROD - Driver keep in truck Looks ,� 1 Great Services 003963 ' " -4 'I, ., � f-, TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION) WIDTH: (INSIDE DIMENSION) TRUCK CAPACITY CERTIFICATION GROSS CY: CLIENT NAME: NET CY: re �' FT FT Cyl Cy Cy DISASTER NO: IN CONTRACTOR NAME: SIDEBOARDS: YES /NO Are the following in acceptable working Condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO (PLEASE PRINT CLEARLY) TAILGATE: YES /NO _ TRUCK OWNER NAME: TIRES: YES /NO DRIVE DRIVER NAME: F }' DRIVER'S LICENSE i#:� `�cj J ti �� co- TRUCK/TRAMER MAKE: ASSIGNED TRUCK/ LICENSE NO: STATE: # MODEL: l TRAILER NO: 7- ' " -4 'I, ., � f-, TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION) WIDTH: (INSIDE DIMENSION) HEIGHT: (INSIDE DIMENSION ) GROSS CY: DEDUCTIONS: (1F APPLICABLE) NET CY: FT FT FT Cyl Cy Cy IN IN IN SIDEBOARDS: YES /NO Are the following in acceptable working Condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) writ- prime [.ontructor GREEN- Chent(clty,countystate) YELLOW- Contractor PINK- Monitor /Gov Rep GOLDENROD - Driver keep In truck PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: DATE: � ` I � C � ! q_ MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: writ- prime [.ontructor GREEN- Chent(clty,countystate) YELLOW- Contractor PINK- Monitor /Gov Rep GOLDENROD - Driver keep In truck woks ` 1 Great,. ► Services - 003932 TRAILER MEASUREMENTS LENGTH: TRUCK CAPACITY CERTIFICATION HEIGHT: CLIENT NAME: DEDUCTIONS: (INSIDE DIMENSION) (INSIDE DIMENSION ) (INSIDE DIMENSION) GROSS CY: DISASTER NO:�� NET CY: CONTRACTOR NAME: Irk `, t' �{ Yl� rt j (PLEASE PRINT CLEARLY) Y TRUCK OWNER NAME: FT FT DRIVER NAME: IN DRIVER'S LICENSE iF: IN !! CY TRUCK/TRAILER CY SIDEBOARDS: YES /NO MAKE: ASSIGNED TRUCK/ ,SIGNAL LIGHTS: YES /NO LICENSE NO: _� STATE: MODEL: TRAILER NO: TRAILER MEASUREMENTS LENGTH: WIDTH: HEIGHT: DEDUCTIONS: (INSIDE DIMENSION) (INSIDE DIMENSION ) (INSIDE DIMENSION) GROSS CY: (IF APPLICABLE) NET CY: FT FT FT IN IN IN !! CY 1✓ CY CY SIDEBOARDS: YES /NO Are the following In V_ ✓ HEADLIGHTS: YES /NO ,SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO acceptable working TAILGATE: YES /No condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: 4/y "� PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: y� (> 1A,► I MONITOR /INSPECTOR: FEDERAL INSPECTOR: wrrrrr -Prime Lonrracror (2KttN- cnen[Iury,countysrote) YELLOW - Contractor PINK- MonitorlGov Rep GOLDENROD - Driver keep in truck Looks ` 1 Great Services 00;,959 TRAILER MEASUREMENIS LENGTH: INSIDE DIMENSION TRUCK CAPACITY CERTIFICATION HEIGHT: (INSIDE DIMENSION) CLIENT NAME: DEDUCTIONS: (IFAPPLICABLE WASTE NO: FT CONTRACTOR NAME: (PLEASE PRINT CLEARLY) TRUCK OWNER NAME: t DRIVER NAME: A(� r� % 7 . U ;• L L DRIVER'S LICENSE #: � � �l '{ ' 10� r TRUCK /TRAILER LICENSE NO: ✓ STATE: MAKE: MODEL: ASSIGNED TRUCK/ r TRAILER NO: TRAILER MEASUREMENIS LENGTH: INSIDE DIMENSION WIDTH: (INSIDE DIMENSION) HEIGHT: (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: (IFAPPLICABLE NET CY: FT FT FT �J ' �( CY 0 CY r CY IN INI IN SIDEBOARDS: YES /NO Are the following In acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IF ANY) DATE: �/� � PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: _ , �'°'� MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: WHITE -Prime Contractor GREEN- Client(city,count)o,state) YELLOW- Contractor PINK- Monitar /Gov Rep GOLDENROD- Driver keep In truck Looks 40 00. TRUCK CAPACITY CERTIFICATION CLIENT NAME: .I ( A V5 Q S/ 4 L 1 (jam 7DISASTER ND; .{5y6 y�y` e L j,/�+Q (' CONTRACTOR fNA ME: I n yyi +` S ft (L6E \1 11 (Y TRUCK OWNER NAME: 1 ! )A � nk 1 T` O CC5, j ti(� (? DRIVER NAME: h ARD\ V M LIL DRIVER'S LICENSE #: ' 00 r' 67 - 1'37- V TRUCK /TRAILER k t(r RUCK/ LICENSE NO: � � � { � STATE: MODEL:' �0 1� ITRAIGLER NO L TRAII FR MFACIIRFMFNTS fl- LENGTH: (INSIDE DIMENSION) WIDTH: (INSIDE DIMENSION HEIGHT: (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: (IFAPPLICABLE NET CY, FT FT FT �� CY CY CY IN IN IN SIDEBOARDS: YES /NO Are the following In acceptable working Condition.? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANV) WHI iE -Prime Lanrru"Or UNE krV- raiengnry,caunry,smrrf rLLLI/W-LU,niuUU. �.,,n . ............�.,... .,4r .............,.. ........ .. ,. .. .. _.,.. PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: BATE: 6 / F f � �� MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: WHI iE -Prime Lanrru"Or UNE krV- raiengnry,caunry,smrrf rLLLI/W-LU,niuUU. �.,,n . ............�.,... .,4r .............,.. ........ .. ,. .. .. _.,.. Looks, ` 1 Great . Services 003'03 TRUCK CAPACITY CERTIFICATION CLIENT NAME: 1. HEIGHT: INSIDE DIMENSION) 1 DISASTER NO: J M lArm � PLEASEPRiNOR LEARLYE \ �J TRUCK OWNER NAME: V MA A U � � C'!.9 l � � �t.��1 � � � � �~ DRIVER NAME: e- r _ DRIVER'S LICENSE #; TRUCK /TRAILER _ f INI MAKE: ASSIGNED TRUCK / LICENSE NO: STATE: MODEL TRAILER NO: TRAILER MEASUREMENTS LENGTH: INSIDE DIMENSION WIDTH: (INSIDE DIMENSION) HEIGHT: INSIDE DIMENSION) GROSS CY: DEDUCTIONS: (IFAPPLICABLE NETCY: FT FT FT 67 Cy Cyl r( . Cy INI INI IN SIDEBOARDS: YES /NO Are the following in acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YESJNO LOADER SEAT: YES NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS. (IFANY) / ) J DATE: '"/ /t ...� �, F �� 1.L i PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: !{: WHITE -Prime Contractor GREEN- Client(city;county state) YELLOW - Contractor IF PINK - Monitor /Gov Rep GOLDENRO" fiver keep In truck Looks ,� 1 Great Services 003955 (RAILER MEASUREMENTS LENGTH: TRUCK CAPACITY CERTIFICATION HEIGHT: CLIENT NAME: DEDUCTIONS: NET CY: (INSIDE DIMENSION) DISASTER NO: (INSIDE DIMENSION) CONTRACTOR NAME: t r (PLEASEPRINTCLEARLY) - TRUCK OWNER NAME: - l 7 'e DRIVER NAME: } 0 DRIVER'S LICENSE #: TRUCK /TRAILER "L IN MAKE: A Cy LICENSE NO: Cy STATE: MODEL: TRAILER NO: (.r (RAILER MEASUREMENTS LENGTH: WIDTH: HEIGHT: GROSS CY: DEDUCTIONS: NET CY: (INSIDE DIMENSION) (INSIDE DIMENSION) (INSIDE DIMENSION) MONITOR /INSPECTOR: (IFAPPLICABLE TIME: FT F7 F7 Ro , 0 r "L IN INI IN Cy Cy Cy SIDEBOARDS: YES /NO Are the following in HEADLIGHTS: YES /NO SIGNALLIGHTS: YESJNO LOADER SEAT: YES /NO acceptable working TAILGATE: YES /NO condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) WHITE -Prime Contractor GREEN- Ciient(ciMcount)Gstate) YELLOW- Contractor PINK- Monitor /Gov Rep GOLDENROD- Driver keep in truck PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: DATE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: WHITE -Prime Contractor GREEN- Ciient(ciMcount)Gstate) YELLOW- Contractor PINK- Monitor /Gov Rep GOLDENROD- Driver keep in truck Looks 1. 4 1 I Great .. Services 009954 TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION TRUCK CAPACITY CERTIFICATION HEIGHT: tINS1DfDIMENSIONJ CLIENT NAME: f w l C f I o e� DISASTER NO: b FT CONTRACTOR NAME: (PtfASEPIxINTCLfARlY) M�1 � r" I /�It / Cy TRUCK OWNER NAME: Cy DRIVER NAME: !! 6 t_) T � / DRIVER'S LICENSE #: y TRUCK /TRAILER LICENSE NO: 6 y�� STATE: q MAKE: K MODEL: �i v ASSIGNED TRUCK/ TRAILER NO: - TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION WIDTH: INSIDE DIMENSION) HEIGHT: tINS1DfDIMENSIONJ GROSSCY: DEDUCTIONS: (IFAPPLICABLE NIETCY: FT FT FT / Cy Cy Cy IN INI IN SIDEBOARDS: YES/NO Are the following In acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) wrart -creme Lonrractor Grttm- cnenrfomcounty srate) VaLow- Contractor PINK- MunfMr/GOvRep GOLDENROD- Driver keep In truck PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE:. DATE: 14 MONITOR /INSPECTOR: * FEDERAL INSPECTOR: TIME: Z` � wrart -creme Lonrractor Grttm- cnenrfomcounty srate) VaLow- Contractor PINK- MunfMr/GOvRep GOLDENROD- Driver keep In truck Looks 00996 Servicesloft 1 TRUCK CAPACITY CERTIFICATION CLIENT NAME: DISASTER NO: CONTRACTOR NAME: (PLEASE PRINT CLEARLY) y j TRUCK OWNER NAME: DRIVER NAME: --)? NX Y; C-kA 6 -(�or� DRIVER'S LICENSE #: TRUCK /TRAILER MAKE: ASSIGNED TRUCK/ LICENSE NO: STATE: MODEL: TRAILER NO.- TRAILER MEASUREMENTS LENGTH: WIDTH: HEIGHT: GROSS CY: DEDUCTIONS: (INSIDE DIMFN90N) INSIDE DIMENSION) ( JNSIDE DIMENSION) RE APPLICABLE NET CY: FT FT PT /! IN INI IN CY CY CY SIDEBOARDS: YES /NO Are the following In .HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO acceptable working TAILGATE: Y ES /NO condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: ATE: :. PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: � .A l I I TIME: MOMTOR /INSPECTOR: FEDERAL INSPECTOR: WHITE -Prime Contractor GREEN- Client(citycounty,state) YELLOW- Contractor PINK - Monitor /Gov Rep GOLDENROD - Driver keep in truck rt 003966 Services TRUCK CAPACITY CERTIFICATION CLIENT NAME: ! } DISASTER NO: CONTRACTOR NAME: (PLEASE PR1NrCLEARLY) TRUCK OWNER NAME: DRIVER NAME: } DRIVER'S LICENSE #: *' 4� +� ✓_ } 3" - TRUCK /TRAILER t y MAKE: ASSIGNED TRUCK/ z LICENSE NO: ' t STATE:{ MODEL: ITRAILER NO: TRAILER MEASUREMENTS LENGTH: WIDTH: HEIGHT: GROSS Cy: DEDUCTIONS: (INSIDE DIMENSION) (INSIDE DIMENSION) (INSIDE DIMENSION) (IF APPLICABLF) NET CY: FT FT FT V7 LJ IN INI IN Cyl Cy Cy SIDEBOARDS: YES /NO Are the fallowing in HEADLIGHTS: Y €S /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO acceptable working TAILGATE: YES /NO condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: , '� � TIME: MONITOR /INSPECTOR: FEDERAL INSPECTOR; WHITE -Prime Contractor GREEN- Client(citgcountgstate) YELLOW- Contractor PINY- Monitor /Gov Rep GOLDENROD - Driver keep In truck Looks ` 1 G rest • Services_ # TRUCK CAPACITY CERTIFICATION CLIENT NAME: D ' {+ • ' 1 C (�+ IDISASTER NO: CONTRACTOR NAME: r �_ (PLEASE PRiNT CLEARLY) - ,' TRUCK OWNER NAME: DRIVER NAME: Yl ci � i� S I 1 /�, DRIVER'S LICENSE #: 4 J TRUCK /TRAILER I /� LICENSE NO: L r +.'i 1'/ JSTATE- MAKE: MODEL: ASSIGNED TRUCK/ TRAILER NO: a �— I KAILEK MEASUREMENTS LENGTH: (INSIDE DIMENSION WIDTH: (INSIDE DWENSION) HEIGHT: (INSIDE DIMENSION ) GROSS CY: DEDUCTIONS: (fFAFPClCAHCE) NET CY: FT FT FT CY CY 7� CY IN IN IN SIDEBOARDS: YES /NO Are the following in acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES/No LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS; YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) ...,,, c—u„c ..w,uuuur unccm- wnenrtory,cuun rysrarej rtLLUW- Lonrractor PINK- Manitor/Gav Rep GOLDENROD - Driver keep in truck PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: DATE: MONITOR /INSPECTOR: FEDERAL INSPECTOR: TIME: ...,,, c—u„c ..w,uuuur unccm- wnenrtory,cuun rysrarej rtLLUW- Lonrractor PINK- Manitor/Gav Rep GOLDENROD - Driver keep in truck looks ,, 1 Great Services@ CERTIFICATION TRUCK CAPACITY CLIENT NAME: PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: MONITOR /INSPECTOR: ;A FEDERAL INSPECTOR: DISASTER NO: I- 1 CONTRACTOR NAME- Ir a (PLEASE PRINT CLEARLY) �{ TRUCK OWNER NAME: Her- r'' - DRIVER'S LICENSE #: } DRIVER NAME: TRUCK /TRAILER i� F d MAKE; ASSIGNED TRUCK/ /„r LICENSE NO: / STATE: MODEL: TRAILER NO: TRAILER MEASUREMENTS LENGTH: WIDTH: HEIGHT: GROSS CY: DEDUCTIONS: NET CY: (INSIDEMMENSION) (INSIDE DIMENSION) (INSIDE DIMENSION) (IFAPPLICABLE FT FT __ FT CY CY CY IN INI INJ SIDEBOARDS: YESMO Are the following in HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO tab tab acceple working TAILGATE: YES /NO ltl BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: MONITOR /INSPECTOR: ;A FEDERAL INSPECTOR: wma. -Prime conrratror ...cr ...... ........._.,---..-r -_- --.....__---- - - - - -- woks wk # , Great ,� �' Services�'f' TRUCK CAPACITY x CLIENT NAME: DISASTER NO: CONTRACTOR NAME: (PLEASEPRINTCLFARLY) TRUCK OWNER NAME: _ DRIVER NAME: DRIVER'S LICENSE t7: TRUCK /TRAILER MAKE: )� ASSIGNED TRUCK/ LICENSE NO: STATE: MODEL: ! C r TRAILER NO: — TRAILER MEASUREMENTS LENGTH: WIDTH: HEIGHT: GROSS CY: DEDUCTIONS: NET CY: (INS IDEDIMFNSION ) (INSIDFDIMENSION) (INSIDE DIMENSION ) (IFAPPLICABLE FT FT FT IN IN [NJ CV CV CV SIDEBOARDS: YES /NO Are the following in HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO acceptable working TAILGATE: YES /NO condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: DATE: �\ 1 ` (I(IFANY) /�� PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: MONITOR /INSPECTOR: FEDERAL INSPECTOR: WHITE -Prime Contractor GREEN - Client city counMstate) YELLOW- contractor PINK- Manitor /Gov Rep GOLDENROD - Driver keep In truck Looks ` / / 1 r • Great Services TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION ) TRUCK CAPACITY CERTIFICATION . CLIENT NAME: �� A ,„„� �^�to� � (�` ` NET CY: ���f ,DISASTER NO: / CONTRACTOR NAME: CY (PLEASE PRINT CLEARLr) RUCK OWNER NAME: - A INI DRIVER NAME: SIDEBOARDS: YES /NO DRIVER'S LICENSE #: TRUCK /TRAILER SIGNAL LIGHTS: YES /No LOADER SEAT: YES /NO MAKE: f 1 ASSIGNED TRUCK/ LICENSE NO: TIRES: YES /NO STATE: MODEL: f}.`(: TRAILER NO:� TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION ) WIDTH: (INSIDE DIMENSION) HEIGHT: (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: (fF APPLICABLE NET CY: FT FT FT CY CY CY IN INI IN SIDEBOARDS: YES /NO Are the following in acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /No LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS:. (fFANY) DATE: c ` �{ 1f 3 CJ PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: A TIME: 91,00 ,!� i'Y MONITOR /INSPECTOR: FEDERAL INSPECTOR: YYMFTE -FWme Contractor GREEN- Client(cityicount)ostate) YELLOW - Contractor PINK - Monitar /Gov Rep GOLDENROD - Driver keep In truck NAME: CONTRACTOR NAME: (PLEASE PRINT CLEARLY) DRIVER NAME: TRUCK/TRAILER LICENSE NO: F oks reat Services 4` TRUCK CAPACITY CERTIFICATION DISASTER NO: TRUCK OWNER NAME: IVER'S LICENSE #: STATE: MODEL: TRell FR MFAC%HRFMF ASSIGNED TF TRAILER NO: 003971 DATE PRIME CONTRACTOR REPRESENTATIVE: (CLIENT REPRESENTATIVE: R /INSPECTOR: FEDERALINSPECTOR: ME: WHITE -Prime Contractor GREEN- Client(city,countMtatE) YELLOW - Contractor PINK- MonitorJGov Rep GOLDENROD - Driver keep In truck Looks ! 1 / 1 } Great,. loft � Servicev TRAILER MEASUREMENTS LENGTH: (1NSIDEDIMENSION) TRUCK CAPACITY CERTIFICATION CLIENT NAME: }/�,p GROSS CY: DEDUCTIONS: (IFAPPLICABLE NET CY: " / t! i/�'f , FT FT DISASTER NO: 4. CONTRACTOR NAME: C� /. I )V CA f "r (PLEASE PRINT CLEARLY) - kjJ i TRUCK OWNER NAME: Are the following in acceptable working condition? 4 t� SIGNAL LIGHTS: YES %NO LOADER SEAT: YES /NO DRIVER NAME: G .YJ ry BACKUP ALARM: YES /NO DRIVER'S LICENSE ft: TRUCK /TRAILER MAKE: .r` ASSIGNED TRUCK/ LICENSE NO: STATE: MODEL: t' TRAILER NO: TRAILER MEASUREMENTS LENGTH: (1NSIDEDIMENSION) WIDTH: (INSIDE DIMENSION) HEIGHT: (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: (IFAPPLICABLE NET CY: FT FT FT Cy Cy Cy INI INI INI SIDEBOARDS: YES /NO Are the following in acceptable working condition? HEADLIGHTS: YES NO SIGNAL LIGHTS: YES %NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) GATE: / i! PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: MONITOR /INSPECTOR: p!, 1 I' FEDERAL INSPECTOR: WHITE -Prime Contractor GREEN- Client(ci[y,county,state) YELLOW - Contractor PINK- Monitor /Gov Rep GOLDENROD - Driver keep in truck Looks 1 1 1 Great �' Services- TRUCK CAPACITY CLIENT NAME: —7 11 y j , � —', DISASTER NO: ..� I CONTRACTOR NAME: .r (PLEASE PRINT CLEARLV) TRUCK OWNER NAME: DRIVER NAME: 1 + DRIVER'S LICENSE #: TRUCK/TRAILER MAKE: ASSIGNED TRUCK/ LICENSE NO: STATE: MODEL: TRAILER NO: t.J TRAIT FR MFACI IRFMFNTS LENGTH: (INSIDE DIMENSION) WIDTH: (INSIDED7MENSION HEIGHT: (INSIDEDYMENSIONJ GROSS CY: DEDUCTIONS: (IFAPPLILABLE) NET CY: FT FT FT Cy. Cy CV IN IN IN SIDEBOARDS: YES /NO Are the following In -, acceptable working = condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES %NO LOADER5EAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YESMO BACKUP ALARM: YES /NO .TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: /] +✓ PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: ' MONITOR /INSPECTOR:, FEDERAL INSPECTOR: wrrrrt-PrIME Lonrrocror ancc r- �r +rrrysny wu ++ y,,.u.�r Looks Great • Services" 003993 19.11±1I12:4I+►r7!ulllII ] If aL*AEa►•I W LENGTH: (INSIDE DIMENSION) WIDTH: (INSIDE DIMENSION) HEIGHT: (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: fIFAPPLICAME NET CY: FT FT FT CY CY CY IN INI INI SIDEBOARDS: YES /NO Are the following in ple o working acceptab tab I HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) 1 DATE: 1� ,,. � � /� 1 PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: , / � J�^ �7/f� 1,111" {�y�y� (/ MONITOR /INSPECTOR: /`-fir FEDERAL INSPECTOR: WHITE -Prime Contractor GREEN- Chent(city,countystote/ YcLLVW- Lonrrocrar rrrvn- munirorravRrp =, •^ Looks ,. I / 1 11 Great... Services TRAILER MEASUREMENT5 LENGTH: (INSIDE DIMENSION) TRUCK CAPACITY CERTIFICATION CLIENT NAME: No � 4--S37 NET CY: 1`"� � DISASTER NO: CONTRACTOR NAME: CY CY (PLEASE PRINT CLEARLY) IN TRUCK OWNER NAME- ` r (� /�] ��v / p p" 1, 'T 7g0 - g ' DRIVER DRIVER NAME: ! d% f { DRIVER'S LICENSE q: • ! n TRUCK /TRAILER y� BRAKE LIGHTS: YES /NO MAKE: ASSIGNED TRUCK/ LICENSE NO: STATE; MODEL: TRAILER NO: .� TRAILER MEASUREMENT5 LENGTH: (INSIDE DIMENSION) WIDTH: (INSIDE DIMENSION) HEIGHT: (INSIDE DIMENSION GROSS CY: DEDUCTIONS; (IFAPPLICASLE) NET CY: FT FT FT CY CY CY IN INI IN SIDEBOARDS: YES /NO Are the following ICI acceptable working condition? HEADLIGHTS: YESINO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YESINO TIRES: YESINO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: � f JJ / f / PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: r MONITOR /INSPECTOR: / ' FEDERAL INSPECTOR: TIME: WRITE -Prime Contractor GREEN- CNent(ft county,state) YELLOW- Contractor PINY- Monitor /Gov Rep GOLDENROD- Driver keep in truck Looks ` I I Great �, Services ON 003956 TRUCK CAPACITY CERTIFICATION NO: CONTRACTOR NAME: ) [� (PLEASE PRINT CLEARLY) TRUCK OWNER NAME: 1I f yr L/ ( -, DRIVER NAME: f (, DRIVER'S LICENSE TRUCK /TRAILER MAKE: ASSIGNED TRUCK/ LICENSE NO: 15TATE: MODEL: TRAILER NO: TRAII FR MFACI IRFTAFNTS LENGTH: (WIDE DIMENSION) WIDTH: (INSIDE DIMENSION ) HEIGHT: (INSIDE DIMENSION) GROSS CY: DEDUCTIONS: (IFAPPLICABLE NET CY: FT FT FT i) - f !\ l V��• CY %r) !1. Cyl � (' CY IN IN IN SIDEBOARDS: YES /NO - Are the following in acceptable working acceptable HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES /NO TAILGATE: YES/NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: TIME: % MONITOR /INSPECTOR: FEDERAL INSPECTOR: WHfTF-Prlme Cantru[tOr c t(ttrv- uienrinry,counrysrarel ...... �,,.n- ,..•.,.•....i.,,.. .•ter �•- �� -•••• -- -••- • - - -r ••• -•__.. F ices~' TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION TRUCK CAPACITY CERTIFICATION CLIENT NAME: GRASS CY: DEDUCTIONS: (IFAPPLICA &LE) DISASTER NO: CONTRACTOR NAME: y� -BOA' .,. (PLEASE PRINF CLEARLY) TRUCK OWNER NAME: 1A f ii, ii o DRIVER NAME: 44AILIEL L.A VIC 1 DRIVER'S LICENSE #:mot -I I I-Yi' - TRUCK /TRAILER r (.0 /� MAKE: ASSIGNED TRUCK/ • -'` A LICENSE NO: STATE: MODEL: TRAILER NO: TRAILER MEASUREMENTS LENGTH: (INSIDE DIMENSION WIDTH: (INSIDE DIMENSION) HEIGHT: (INSfOE DIMENSION) GRASS CY: DEDUCTIONS: (IFAPPLICA &LE) NET CY: FEDERALINSPECTOR: TIME: FT FT FT, J/ `� / � j(lJ, CY CY ).6- 6 CY IN IN IN SIDEBOARDS: YES /NO Are the following in HEADLIGHTS: YES /NO SIGNAL LIGHTS:. YES /NO LOADER SEAT: Y €SINO acceptable working TAILGATE: YES /NO condition? BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) DATE: ( _ �.�y{ _ / PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIVE: MONITOR /INSPECTOR, FEDERALINSPECTOR: TIME: wnrre- YrimeContractor GREEN- Client(ciMcountystote) YELLOW- Contractor PINK - Monitor /Gov Rep GOLDENROD - Driver keep in truck E 003912 I KAILEFL MEA51JIKEMENTS LENGTH: (INSIDE DIMENSION) WIDTH: (INSDEDIMENSION) TRUCK CAPACITY CERTIFICATION CLIENT NAME: � DEDUCTIONS: IF APPLICABLE NET CY: FT FT FT CY DISASTER NO: �433_� CONTRACTOR NAME: IN IN IN SIDEBOARDS: YES/NO (PLEASE PRINT CLEARLY) , SIGNAL LIGHTS: YES /NO TRUCK OWNER NAME: TAILGATE: YES /NO DRIVER NAME: BACKUP ALARM: YES /NO TIRES: YES /NO f DRIVER'S LICENSE M .',A r( T) TRUCK /TRAILER I MAKE: y,r,WC - "0v- ASSIGNED TRUCK] ,.... LICENSE NO: STATE: MODEL: Ct&"firUC RAILER NO: "" I KAILEFL MEA51JIKEMENTS LENGTH: (INSIDE DIMENSION) WIDTH: (INSDEDIMENSION) HEIGHT: (INSIDE DIMENSION) GROSSCY: DEDUCTIONS: IF APPLICABLE NET CY: FT FT FT CY CY CY IN IN IN SIDEBOARDS: YES/NO Are the following in acceptable working condition? HEADLIGHTS: YES /NO SIGNAL LIGHTS: YES /NO LOADER SEAT: YES/No TAILGATE: YES /NO BRAKE LIGHTS: YES /NO BACKUP ALARM: YES /NO TIRES: YES /NO DESCRIPTION OF DEDUCTIONS: (IFANY) . DATE: PRIME CONTRACTOR REPRESENTATIVE: CLIENT REPRESENTATIV€: f , TIME: MONITOR /INSPECTOR;- FEDERAL INSPECTOR: i ., OREEii -a.i —I ci[y,caunrysrocei rsLLUW- L&nrrcctor FINK- monitor /Gov Rep GOLDENROD- Urlverkeep In truck