MSV TRUCKS 10.01 LOADS'Load rIC{C @t I Ticket
Municipality (Applicant) Prime Contractor
y�IaA4a C (40 ,e.
IOGSO Ne; r9 "d Air
69 1,3S
Truck No
Truck Driver
Loading
2
Location (Address or Cross Street:
N
41/ %
M
(� (d
mtractor
1�1
acity
15 (1 31.
4C1 .
v /`S M / k;,
�aurnaceo 70,
El White or Actual Wei ht
Vegetation
❑ D
White Goods
❑ HHW
❑ Other* See Below
Time Date Ins ector /Monitor
Unloading a
DMS Name and Location ' �,,
Ile *Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
j Copy 3:
Load Ticket
Ticket No.
Truck No Capacity
.31 1 MSy!
Truck Driver (onnt leaih)vl
Loading //:/V 1/1 ���tii sl
Location (Address or Cross Streets)
ivy
N ')-� _ ai -'� I W -
---••- -•- °- °•�� °� cmw mteu 70, 1.T3, Or Actual 1
Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other' See Below
Time Date Inspector /Mon
Unloading
DMS Name and Location
ii®► new 103'G Sr, j4iAm i'(Mj&. 23/1(7
Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
1005°0 ,off ®'`� AJ€
r�t)oAn: 6 ctmg i �!a 69 IM
Sub -Contr tot
1�1f/'I�
1!�
Truck No Capacity
.31 1 MSy!
Truck Driver (onnt leaih)vl
Loading //:/V 1/1 ���tii sl
Location (Address or Cross Streets)
ivy
N ')-� _ ai -'� I W -
---••- -•- °- °•�� °� cmw mteu 70, 1.T3, Or Actual 1
Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other' See Below
Time Date Inspector /Mon
Unloading
DMS Name and Location
ii®► new 103'G Sr, j4iAm i'(Mj&. 23/1(7
Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) P im Co roc r
0d 14A+4! jC 4#a$��S !�c 01� 4 i t S
10050 p7� �°6 AME Sub -Contr cto
(40a4<1 Pro- 39X38 MI
Truck No Capacity
Truck Driver (print legibly)
Time Date Ins ector /Monitor �y
Loading ba iG�i II``� ��f,G�
Location (Address or Cross Streets)
N
N 1W c
Debris Classification Estimated %
K Vegetation
❑ C &D
❑ White Goods
❑ HHW
/
El Other* See Below
Time
Date
Inspector /Mon
Unloading
DMS Name and Location
I ?01 iJw /o3'° Si/
04IAmw
t (rrw3a ,331%{7
/
`Other Debris Explanation —7
Original:
Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) p
FAtA0A't ijfVe" 1,IJAC,�
100so Nf s'a A)g Sub -C
Truck No
(print
Loading
Location (Address or Cross
ID 01 f) 0I. )5
N
,K Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other' See Below
�A
I ime Date Ins ector /Monitor
Unloading
DMS Name and Location
no 0 tom 10 r AAM<r PCs 33/47
'Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket
Ticket No.
to12SO Aar :.4'
`;' AJb Sub -Contr cto
r1liAat: 5 cfB%�rws'� Flel. $31�$' �f ,
Truck No Capacity
jIbl ISM 31.x'
Truck Driver (print IeQJoIV)
Time Date Ins ectoTj itor
Loading 74'SLI y® .N P7 A-k,�V, "M (J .S
Location (Address or Cross Streets)
5 NG c4q h 51
N ?.5.bbl W10,
or
fig, Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other' See Below
Unloading Time Date Inspector /Monitor
1
1-701 0) 1034 S-11 AANIi� t !®r.dr, 23/47
`Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket
Ticket No.
41 Am i C d$oec'S IJc 0 i�� G
rooi'o a6 e4 04 Arr
33 138°
Truck No
Truck Driver (pr
Loading % , DI, 10 11 q
Location (Address or Cross
N 'LS .
Ms ,v S
Wvvv 5-T
W �Q
or
K Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other* See Below
Time Date Ins ector /Monitor
Unloading
not 04) AAmt 29/47
'Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
i
Load socket
Ticket No.
�ooSa NG B'°a AJz
M�4as: s cr!B/��f r'-lx. ,3g 138'
Truck No
3161
Truck Driver (prini
Capacity
S/S
Loading LU
_ocation (Address or Cross Streets)
N ZS .�bh6 I W
or
❑
C &D
❑
White Goods
❑
HHW
❑
Other' See Below
Time Date Inspector /Monitor
Unloading
DMS Name and Location
1101 (04) /03'6 Si W1oAata, t (,rad� X3/4/7
`Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) Mub-C
pA AeW d C ffse ,S �c � � �
10050 pai5 e9oa. A)i
Truck No Ca
311
Truck Driver (print legibly)
Loading
Location (Ad
�Km
�7v 1 1O/' 11 T
or Cross Streets)
"
W
sl
A Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other* See Below
Time Date
Unloading Inspector /Monitor
. r
1'101 04) log "G sr, F(♦Pada. as A(7
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket
$4 I AeA i Clive" V41(ac �
e0iis°O n1 eO-q AJi
Truck No V i
�) 61
Truck Driver (print legibly)
Loading
Location (Address or Cross
i
Ticket No.
I fill
M
�l
Capacity
mSv 3.
Vegetation
"aLll I Jd LUU 7u, i,rs, or Actual
❑ C &D
❑ White Goods
❑ HHW
❑ Other* See Below
Time
Unloading
Date Ins ector /Mor
" d
DMS Name and Location
i'10 y hDw lo3'G s�
�4e.4Ra•o, Frrredc, 83sy7
'Other Debris F�cplanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket
Ticket No.
04 1AA4i C
1049510 F-�6 f,4"6 AJs` Sub -Contr to
Truck No Capacity
3l � /$ v 3
Truck Driver (print legibly)
Loading "
.'
Location (Address or Cross Streets)
N -IS. Xlnln I W
WIr - -- , I:YS, orACtual Wal I tionoods See Below
Time Date Ins ector /Monitor
g nd Location
eo3'd
��' *Other Debris 6cplanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket
Ticket No.
-6 e9 d A)i Suer tc
!d'Ii4M� G H ®ate, t*Lat 33138
Truck No Capacity
Loading
Location (Address or Cross Streets)
• ��5 OAF, ����� 5� ��. /.;
N FW
-
ation
�.uiiiaieu 70, crs, or Actual V\
Goods
See Below
7Unfoadin
Time
g
Date Inspector / Monit
DMS Name and Location
I�Oi M1i�J /0$'G Sir
AA44 �r F (vPa�a, 331,47
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
5,4-. pry