MSV TRUCKS 10.02 LOADSLoad Ticket Ticket No.
Municipality (Applicant) P im Co rac r
aA�i SHokcs V��(a Z
106SO p16 ® d A)s' Sub -Contr cto
Neigac: 5 use, ►'la 33t�g iW
Truck No
I
Loading Time Date Ins ectorm
Y �0 I!`Z-i �i,Shord
_ocation (Address or Cross Streets)
N� 10? 2S.g, l2
120h Ave / go, 17a3
N IW
- -- - csun crs, or Actual Weight
Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other See Below U
Unloading - -
DMS Name and Location
110► h1&J (03�c Si p'1,Am'4 t%(sr.dc' 33fy7
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant)
P �Con rac r
I ` a m ,
t 0 "so tof s
,
Sub- Contrarnfnr. .
Truck No
ru Driven L� , (print legibly
CHA Q
Time Date
Loading
2,0)
Location (Address or Cross Streets)
Capacity
(23I S
Inspector/Monitor
wi,b Autr''-
ttao35— l Zq t Le.
rz
v tied. �a �e3i rtes. see e m E. E'
N Qf 66177 w -Sto. 173
Debris Classification
Estimated °/Q CYs, or Actual Wei
VeLetation
❑ C &D
❑ White Goods
❑ H
f/
Othe e
h
❑ r* See Below
Time
Date Inspector /Monitor
Unloading
'��61 Z,
DMS Name and Location
4 -701 r0o 103`4 -5 °M
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:.
t
Load Ticket Ticket No/ / S
Municipality (Applicant) P im Co rac r
JAIAA41-Cffae�"F4 MI 4C iOGSO Ni+ 4'a A E Sub -Contr cto
m 4ma S o aeu ;, ''(A. 3315'9' I1 "I
Truck No CZ %�l %Ra C.0
y
wwnaieu %o, "Ys, Or Actual vv' ht
Vegetation
❑ C &D
❑
White Goods �.
❑ HHW / /�j (' \
❑ Other' See Below Y 1
Time Date I s ector /Monitor
Unloading 6,
DMS Name and Location
J-701 IJ4! 103'C
I w4apc9i t =(rrgJa 33/(7
Other Debris Explanation
Original: Applicant
Copy 1:
COPY 2:
Copy 3:
Load Ticket Ticket No.m_ V
Municipality (Applicant) ff P n rac r
x+19Q4i! C#fa$.�5 V 1 got SI*
a00S0 Pf e044 AJi Sub -Contr to
jb IAA4: S 1190-*£, �'ix. 33138° h" f,
Truck No Capacity
MS n,a3 I X
Lui 3 h-crr�01,)
Loading
Location (Address or Cross Streets)
AS
KE -7 t" AVC„
N I
z/0; acec 7a, (,Ys, or Actual Wei ht
Vegetation
❑ CH
❑ White Goods
❑ HHW
❑ Other* See Be;"-e,
e fns ector /Monitor
Unloading
DMS Name and Location
1101 IJ=a 1036 -9 f:cWsdc. 29/47
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket
Ticket No.
41 AA4 a -046'e S
M� ,
1006® Pf /fig
M;4Ma 6 r�®�, '=(0-69 5
I Sub -Contr cto
A01011
Truck No Capacity
X161 31.
Truck Driver (print legibly)
Lc If c.
Loading I ar
Location (Addressor Cross Streets)
N I w
70FIHHW �70, GYs, or Actual Wei ht
tion
Goods See Below
rDMS ading ,
�•J � t
Name and Loca tion 1 f Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) P� rac r
jvi 14441 i OgZ64
10050 Nf- e,4 a A)J5 Sub- Conntracto
1%4441 g OOS40, rt�c 33138 / ,
Truck No Capa
mss ,ogo1 02
Truck Driver (print legibly)
(A14 SSe.( I
Loading
3- ,hJ PIY) Imo• a • I� ' Jccm� l IZ.t C!•�
_ocation (Address or Cross Streets)
N t-�5.8(nbi I W —�-O, I
Vegetation
❑ C &D
❑ White Goods �J
❑ HHW /
❑ Other* See Below
Time Date Ins ector /Mon
Unloading ti . 00
t
DMS Name and Location
1'701 foe) log's ST', AiAaa, e(stsjc. 33/y7
'Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
K J9 ,A" i sLc Y f7imW
Load Ticket Ticket No /V') S
Municipality (Applicant) P m C roc r ,
IA a A,441 C ifee s �, 11.46 4
10 06,0 NC eo -' /ui Sub- Contracto
lft .4an: 5 of®QtaI @7(4. 381.3ff ,
Truck No 2t Tt% 7t�/C-W-
/% /) 7 1 o
-)IJC-)tL
Loading
3;v0
_ocation (Address or Cross Streets
Capacity
C,
to Inspector/Monitor
�� K��JISky �Ire�.s
N . 36V 16.3 1 W (,o. 1(6 o
-
Vegetation
�auumieu io, ors, orHctuai t
El C &D
El White Goods
/�
/ G
❑ HHW
❑ Other* See Below
Gl
Time
Date Inspector /Mon
Unloading
Z/3
DMS Name and Location
1 ?01 44) 10$,e ST-1
OiAm'' t%tr sjc, 2SA0
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) P im Co rac r
rVI I A j-A i C No 1.4 e— s
00SO �� Sub- Contractor
Truck No Tc
r
i¢uc
Truck Driver (print legibly)
7
Time Date Inspector /Monitor
Loading ��.
a' 36 i �o e� r 4�ri� uC714
Location (Address or Cross Streets)
q875 N6 \7-a4�r n.►
N
De ris Classification
Vie to +e
❑
C &D
❑
White Goods
HHW
❑
Other* See Below
W - e0- Q3
mated %, CYs, or Actual
7z,�
S3�3$
i 11T1e Uate Inspecto /Monitor
:=andation
1'191 0
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket
Ticket No.
i00SO N6 e04" {&3b Mb onnr cto
M;.4.44; S 0ORZ , f;fo- 331 .3g
Truck No I Capacity
Truck Driver (print legibly)
ZMU✓1veI bur4-
Loading _
Location (Address or Cross Streets)
N I
Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other* See Below
Unloading
i ?v 1 0&) tog°c Sr, AAm'� f;;w4ja. ai3«ra
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
IA PA0 ki / E f ,9,X6
Load Ticket Ticket No.
Municipality (Applicant)
MiAOI iHae%S Vc {,
100ro N6 � 'd AJr Suet
m 4mr g "$sex/ r=tot. 331, 5
Truck No c r T l/ -v c k Capacity
i6ay a�
Truck Driver (print legibly)
8)b'JJ- a M yn(
Loading
u��%rr ►�a��r
_ocation (Address or Cross Streets)
Vegetation --
❑ C &D
❑ White Goods L_iJ
❑ HHW /
❑ Other* See Below
Time Date Ins ector /Mon
Unloading /
DMS Name and Location
11101 fvf Po*{Ic Si i�iAroi t%fPP<da. $31x(7
*Other Debris 6cplanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
AWf
Load Ticket Ticket No. SV
Municipality (Applicant) ( P n ra r
800b"0 PiE �''a fgjg Sub- Contracto
Truck No Capacity
mcsa3 �
Truck Driver (print legibly)
(.UU1 I�Prn0 �dCZ
Time Date Ins ectorimonitor
Loading
ioN� Sc -ctn r��, ti -I's
Location (Address or Cross Streets)
N I
Vegetation
❑ C &D "Datel White Goods HHW
Other` See Be nitor
Unloading
I DIMS Name and Location
01 fj s1 10 j $41A.H'4, t%otsja. ,i33,a(?
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Tick t Ticket No .
r AA4 t'� s#ae" 1 ,11ACI e- I � ' �i
10Gso mar 0", AJE Sub -Contr cto
'Truck Information
pliAat: s cia��v'� r=4R. 33138 �'
Truck No C r 7 Y r/-,/ C 1C Capacity
- 16--f / 0 1 1 a6
or
�Z9 Vegetation
❑ C &D
❑ Wh to Goods 7667 HHW �j/1 X
❑ Other` See Below
Time tor /Monitor
Unl oading 3
DMS Name and Location
1-7 0 1 ro(-) to3'4 Si eAm�, t%ta�.d0. 291(f7
'Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) p
rA I AA4 i C ffae" b4c 0 IaG
10050 A-�f: 4'03 AJs` Sub -C
adl +.q.H: s u ®ass, rta. 33135
Truck No
�ltl
Truck Driver (prin
,E-�AI` e.
Loading
:aeon (Aaaress or Cro:
N
3l .5
>> 26,1712
W
�1
Vegetation
❑ C &D
❑ Whfte Goods C1 /f
❑ H Z
❑ Other* See Below
Time Date Inspect r /Monitor
Unloading
DMS Name and Location
1?01 foo 103,4 .5-11 4aARna, f- (ar,aG, 83/47
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket I Ticket No.
naAroti iH ®Qc5 v�1ia��
1005'0 p'fE 8,6 A46 Sub -Contr cto
6z IM / tL
1,111561
M) yioaol
ck Driver (print legibly)
N aaea l , -)n r>
Loading
_ocation (Address or Cross Streets)
N
W 8v. x az,1
WName - - �muimi�a 70, UYS, or Actuai Wel ht
ion
White oods
ee Below
Time Date �.15 �i r� id Location
103'c Si 1�1AMii ec®/'.jai 83/s(7
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) P C rac r r
M I A#01 S ifae" !✓c I I
I®O.sO NE �,b Am Su�ntracto
Mi.�aa: 5 cta�� r'f�c. 3315
Truck No Capacity
ros '�- bl
Truck Driver (print legibly)
Time Date Ins ector /Monitor
Loading
1.3j Pm I0a i)
Location (Address or Cross Streets)
N a y. eVI, I w
"uts,,maec"/a, t CYs, or Actual Wei ht
Vegetation
❑ C &D
❑ HHW Goods
❑ HHW Z/
❑ Other' See B
I eUnloading1
DMS Name and Location
(101 f0o 103 °° Si IS9ega9a, e(arIJa 33iK7
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Appiicant) Prime Contractor
100SO .06 Sub C°`ontra �
�cttor
/
Truck No
',c,ir 3r 3
Truck Driver (print legibly)
Z&HP, RrJ
Time Date
Loading
il� � �� � toZ•Zoj
Location (Address or Cross Streets)
Capacity
5i 5
Inspector/Monitor
Aug i l") Auctl
i
2s sS f VV
Debris Classification Estimated %, CYs, or Actual Weight
Vegetation
❑ C &Q
❑ White Goods
Q HHW
❑ Other* See Below
Unloading
Time Da #e nspector /Monitor
r
t
DMS Name and Location
r
*Other Debris Explanation
Original; Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) 104
f4iAA41( ifgec4 Vc iii
1006,0 N1^ ®'a AJE Sub-C
Al 4wi: IS ua/ae.s, r'(0- 831 .3$' 1 ft
CJ
Truck No Capacity
a�
Truck Driver (print legibly)
ENEEI -M
Time I ' Date I ------------
U
C &D
❑
White Goods
❑
HHW
❑
Other* See Below
1 10, a,,", .
W -W,
me Date Ins ector /Monitor
Unloading
S I
DMS Name and Location
11101 0") 103'4 Sri p;4iA&,,,t F(a/'lda. 23,47
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality
i (Applcat) Prime Contractor
-W g*sTf p116abA �NaQcS 4c{ t
006O E ,
N®
fits Sub- Contractor �vT
Truck No Capacity
M5# 053'3 a
Truck Driver (print legibly)
Loading ime 11 Date Inspector/Monitor
0 Ib; I S!O n v►'I�Y;
Location (Address or Cross Streets)
NVP 64 hs f�L-).1Iq
N
W
— umaiea /o, t:Ys, or Actin
17ZI
Date Inspector/N/____
Unloading
�� A/ 7(
DMS Name and Location
(101 IJO 103'4 Si l w(eAm',, e('t.de, a3 /47
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Vegetation
❑
C &D
❑
White Goods
❑
HHW
❑
Other` See Below
W
— umaiea /o, t:Ys, or Actin
17ZI
Date Inspector/N/____
Unloading
�� A/ 7(
DMS Name and Location
(101 IJO 103'4 Si l w(eAm',, e('t.de, a3 /47
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
t /t �l %��1
Load Ticke Ticket No. S v
Municipality (Applicant) Jim rac r
loos® NE
® a AJz Sub -Contr cto
K No , / r/� v Capacity
Lets VAs W u t-
Loading
Location (Address or Gross Streets)
.97= s%, /,J.�C. ice.
Na-58GJd(b I _Q1 (6
,Q9 Vegetation
❑ C &D
❑ White Goods C��
❑ HHW !/
❑ Other* See Below
Time Date Inspector/Mon
Unloading
d - �� /d' /)l
CMS Name and Location
('701 00 103e4 -ST-1 ►rlcAwn�, Ft,r.d�, B3f6f7
Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No. M S V
Municipality (Applicant) Prime Contractor
MiAoAl.01oe64 �,9f 4 AV4 +3a�Tr
100so A- ®,a A) Sub- Contractor / 4:' c
No Capacity
#0q0
/ .....1 — .- ,Y.a i. ivy.— I
Loading Information
Time Date Ins actor /Monitor
Loading
SPC�,1'1 Y71Gfrl
Location (Address or Cross Streets)
(,1 Dry V-r
iV.- QG fh' :•
N I
�eun� �.iessuica noZ-3/0 ated %, CYs, or Actual Weight
Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other` See Be
Unloading i1
(701 r%U 103'4 S-11 AAm, t%l®t.de, 33A(7
'Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket
Ticket No.
a adwe
Harts
v� ! fa 4�%
❑ White Goods
10050
,a9 �
®
d AJs
Sub -Cont r
4A
Truck No Capacity
3161 31.5
'truck Driver (print legibly)
r-_AI1(�
Loading 11 I Date {� Inspector /Mi
11 2-1
1�1, "Sha_ ra
Location (Address or Cross,Streets) A
y
N 10H h Si
m,
W
K Vegetation
❑ C &D
❑ White Goods
1;7
❑ HHW
❑ Other' See Below
Time
Unloading .�
Date Inspector /Mon
//
�0 `
DMS Name and Location
sI
Aa„�, as /q7
,
`Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No. M
I
Municipality (Applicant) Prime Contractor
1006,0 OFD'' .Jr Sub- Contractor
i!u !ice
Truck No
Truck Driver (print le ibly)
ze-HA4a
MIFM
firma Gate
Loading
�•ss,4" ,e•z• 209_�
Location (Address or Cross Streets)
Capacity
&6
IZ79 rd� q�6+ A"4*q &Mpae b313'8
�J1�
Inspector /Monitor
AA b Auer
N S� - �a W - moo. t7 ►q
Debris Classification Estimated %, CYs, or Actual Wei
Veq
❑ C&D
❑ White Goods
❑ HNW
❑ Other* See Below (j
Time Date Inspector /Monitor
Unloading % "0)
DMS Name and Location
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Al l S !c f , I/4.J1
Loads Tic et Ticket No. _A� S 1/
1005'0 foE 9,4 Am. Suer cto
rtii.a.av: S cdBg�vi r'CR. $3 t 8'
Truck No r1 % Capacity
Truck Driver (print legibly)
6L�CL
Loading
N 39", Stiff,.
7 ; 0 <- I/ 0)0a/
or Cross Streets)
_ TN
A'. t - / U--
W f3 v.
K %IA! s k / ., i /.AAef
a
Vegetation
❑ C &D i C%
E] White Goods
r
❑ HHW
❑ Other' See Below l ' ( f
Time Date Ins ector/ onitor
Unloading
clot 104) ro3 "e ST- #IiAml,FtPr.dc, ,83(7
'Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket tTicket g Municipalit y (Applicant) e Contractor
if+7tL," F✓c {� e- 4 gieTr 10050 tier �,`t AJJE Contractor A&—r M44m� 6 u®a�, Ftn SS 137 ka 141'1
Information
Truck No Capacity
I0 U1/
Truck Driver (print legibly)
�ry)AI�V bU) S
Loading Information
Time I Date Ins ector /Monit
Loading
��d3 �►v -�-i� �`'t��n �orv�
Location (Actor Cross Streets)
Ne Clot) oil"k S,SCdS
V 9s g4. 14�
IN Iw
csunidiea io, urs, orACtuai
Vegetation
❑ C &D
❑ White Goods
❑ HHW 7
❑ Other* See Below
Time Date Ins ector /Mon
Unloading (�2
DIMS Name and Location
I ?01 fjo 10316 Si l 04oAMCi *; ;CstJa. B3 /y7
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
1<
Load Ticket
Ticket No.
41Ao tt
Cifse,"
v,{fa L
�� I
100.50
NC ;9 ✓d A
Sub -Contr cto
Truck No Capacity
Truck Driver (print legibly) I
EJd1 �,
Time Date Inspector /Monitor
Loading —
Location (Address or Cross Streets)
iUk lotiTti s +/ 2r,25 9/2-
N IW
LJ C &D
❑ White Goods
❑ HHW
❑ Other' See Below
1191X
me Date Ins ector /Monitor
Unloading
DMS Name and Location
1"101 rjo 103 4- Si P4 14"',l (= (Se4je, 83/y7
"Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
KPA , ( 15 lc y It vow 1
Load Tiekbt Ticket No. M 5 v
Municipality (Applicant) P� n roc r,
P4 iaA41 -C oae -F4 v,9i
100 SO fJf- eO d AAE Sub -Contr cto
Truck No c -r 2 v� Capacity
Truck Driver (print legibly)
�/'�T�l JLL�6L
Loading
Time Date Inspector/Monitor
,
`d,u A)a,
Location (Address or Cross Streets)
Na .X6`6 35
Vegetation - --
❑ H
❑ White Goods
❑ HHW
❑ Other* See Below
Time Date Inspector /Mon
:Unloading
DMS Name and Location
( -101 niw rah'° s. e�van�, Fl�P.aa as:y7
Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) Prime Contractor
P41 Anal -C Ose44 v+ 6 i • e— Asia 3+x"O r
TORSO N`r A),E Sub - Contractor 4& a
Mina+: 6 ao , Ftn $31 .3g 67 ka i'da +^>t+
Truck No Capacity
M3495 .�
Truck Driver (print legibly)
L-�; i S N(- v nct n d-m
I i ime I uate I Inspector /Monit
Loading
:So �i0 -a -�� S' «ri (Yloyrl
Location (Address or Cross Streets)
(Ile 1 4 h fVe h a5 6"
N IW
uGUna indabwuduuri tstlmated %, CYS, or Actual Weight
Vegetation
❑ C &D
❑ White Goods
❑ HHW Jl
❑ Other* See Below
Time Date Ins ector /Monitor
Unloading
DMS Name and Location
1-701 foo 10.3,4 Si P1+Aro�i+ t (!Pala. 83/47
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Wicket Ticket No.
Municipality (Applicant) Aim Can rac' r
V1 11�711 S1*
1006-0 Pf- Sub- Contracto
Truck No Capacity
Truck Driver (print legibly)
Time Date Inspector /Monitor
Loading �.
Location (Address or Cross Streets)
VV ee
Debr°rs Classification Estimated %, CYs, or Actual Weight
1/eg etatic n
❑ C &D G'
❑ White Goods
Q HHW
❑ Other* See Below
Time Date Inspector /Monitor
Unloading $ ; �:, /0,11 i } —)j
DMS Name and Location
*Other Debris Explanation
Original: Applicant
Copy 9:
Copy 2:
Copy 3: