MSV TRUCKS 10.10 LOADSLoad Ticket Ticket No.
Municipality (Applicant) f p
JA 9 AM 4 C tfeef4 i, I i�
4
I AM Sub-CC
Aj 4mt S 40�Si riR 33135 ■�1
Truck No
wt I ► Id
Truck Driver (print legibly)
EmaV) Ue 1 Lv1,S
. •
Loading - ....._...._.
�.d0 � �UJiO' UY1 YID'
Location (Address or Cross Streets)
N5 loose
NE , d AV e K G- i OAS
N I
.K Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other' See Below
Time
Date Ins ector /Mon
Unloading
DMS Name and Location
1 '701 IJ(-) 103'4 -57-1
AAme *:7Wg3c, 39/47
f
Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket I 4TIcket . A-4 S V
Municipality (App licant) Co ra r fviiAati SH ®2es V� {i106.5°0 r 6 c9,a !U9 Contr cto ` /
Truck No j (/ n K Capacity
d-
Truck Driver (print legibly)
.K Vegetation
❑ C &D
❑ White Goods
/
❑ HHW
❑ Other' See Below
Time
Date Inspector/Mop
Unloading � / S0
�U
/O t
7
DMS Name and Location
not foo 103' Sri
AAAiif 39 /Lf7
Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No. S
MunicipalitP im Co rac r tOD6sO ! Sub- Contractor
Migat: s HB/dw�, ►'tom 69.3e pit
K No Capacity
t� 10 l () I Q(
Oncfr
ime Date Inspector/Monitor
Loading
w.(A 1 p1 i o, scan motn�
Location (Address or Cross Streets)
o� st
N 1W
estimated /a, CYs, or Actual Weight
Vegetation
❑ C&D
it ��
❑ White Goods (� /"
ED] HHW
❑ Other* See Below
me Date Ins ector /Monitor
L loading S Name and Location
ot n'u ao3'c .5� #&4sAma ccaraJe, 3stg7
her Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
I_'�t!a /.� ss l� y � �A�✓S
Load Ticket Ticket No. S Y
Municipality (Applicant) P im Co rac r
JA l AOA*t f faeevw l, 1 t 4C 14,
10VS70 p%f ® d AJs Sub -Contr cto
tliia.u9: {, aFeoty, r=(0- 3311T W' ,
Truck No Qyr /! u/C V I Capacity
Truck Driver (print legibly)
Loading
Location (Address or Cross Streets)
A/ i%C
Vegetation
csurnatea io, I; YS, or Actual V
❑ C&D
[I White Goods
❑ HHW
HW
❑ Other See Below
Time
Date Ins ector /Mon
Unloading !/
DMS Name and Location
1'101 Ivu 003 °4 s,
A9rAm N(®naG. $3«47
,
,
Other Debris F� planation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket "TicketNo. Municipality (Applicant) P4IAtAl C Koef4 10CSO e06 e0 /b;AMa 6 PI9R4�i
Truck No
my# 10) 0
Truck Driver (print legibly)
Loading I I G
Location (Address or Cro
vr' w {h Avc
in
❑
C &D
❑
White Goods
❑
HHW
❑
Other* See Below
Capacity
A(;
D I 1611 o-L'I�
reets)
as. g6_
Z6 i P
W
iatetl %, CYs, or Actual
7e
Unloading _._..._.
DIMS Name and Location
I"%®I of) 103'4 .SYr av8o�ct'c� t% {�rad� $3/cf7
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Loan! Ticket Ticket No.
Municipality (Applicant) p
P4 i AA41 C (¢0,2:,&
100SO N6 �o AJE Su
M 4M; S cf® mi F(0- 3135
Truck No Capacity
"S $ os a -� I a G
Truck Driver (print legibly) 1
1_I) IS hp)rVlrlY\A.,;,
sl
Loading _.._.
a�30 �01 Seal V�lorr�l'
Location (Address or Cross Streets)
hf E (� o t �
Ya{\U -e
N I
❑
C &D
❑
White Goods
❑
HHW
7
Other* See Below
/I
Unloading - --- ..---- ...._.
/,:)/' �'
DMS Name and Location
j -10 B Pj ;i to 3'G Sr , MiAml, P(mils. 83147
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No' , ,1
Municipality (Applicant) I' im Ca rac r
Sh
106SO , f "s Sub- Contractor
1
Truck No Capacity
Truck Driver (print I ibly)
Time Date fns ector /M-o ftor
Loading
LOGation (Address or Cross Streets)
I MAN
�.. —
e- ris Ciass;;; mated %, CYs, or Actual Weigh
Vegeta
❑ C &D
❑ White
❑ HHW
❑ Other*
fnspector /Mcnitor
�it1fUCidi 1
DMS Name and Location
'Other Debris Explanation
TCoppyy3: riginal: Applicant
opy is
o 2:
i��� IS kL F`•VArS
Load Ticket Ticket No, 10 S
Municipality (Applicant) tSub-Contr rac r,
10 a Ago t C Na��s VI 0 t � �l
100.8v p 4
� AJr cto
1Mi�r�; g rt ®¢-4 <t N(0. $3 IM �I
Truck No C-7 1/ e Capacity
� 170 i v
Truck Driver (print legibly)
h} ,J &)F, L cpvc -F ,
Loading
p : i�- )i0- LOLr�A,�ISk�
or Cross Streets
f I
fd7 r Ja i xm s
LCFt
-'- - - cow neteu %a, VY5, Or HCLU811
Vegetation
❑ C &D /
❑ White Goods
❑ HHW
❑ Other* See Below
11 Time Date Ins ector /Mon
Unloading -51 /� i0 X71
DMS Name and Location
1 ?01 1>D<J 10$1c Si 1�aAH�, Ffa�+d�. $3Jy7
'Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) P im Co rac r
►1iaAMi CHoe:s Vtvia��
100 ro Na '9", Am Sub -Contr cI
M�aat: g cFBg Sr rlat 83138' M1 I
GTRA-M IMF
Truck No Capacity
3161 31
Truck Driver (print legibly)
C—IL C
Loading I j -lc' >
Location (Address or Cross Streets)
Nw ?�� AVe,
N IW
�aurnatea /o, GYs, or Actual Weight
Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other* See Below
Unloading
DMS Name and Location
1-701 h7U IOg�a Si ieAaa�� cs(iP $3/f47
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Tickei
Ticket No. A/, > y
Municipality (Applicant) P� rac r
jv4 ! 640A C qo ea V�
1006'0 Nis ® a Am Sub -Contr to
❑ HHW
Truck Information
Truck No C_ i y 5Z J C IL Capacity
I�
Truck Driver (print legibly)
v i LY Y/�Trn/'lSk
Loading
Time
Information
Date
�K
Inspector/Monitor
Loading
��
10
>I1 Skt ! vjl) l
Location (Address or Cross Streets)
r— RAr.11) r,,..if , n tf- ei e i1 /I r7-
Debris Classification
Estimated %, CYs, or Actual Weight
Vegetation
❑ C &D
❑ White Goods
�l
❑ HHW
111
❑ Other* See Below
Time
Date Inspector /Monitor
J'" is I
Unloading
DMS Name and Location
i'10t nDsJ 9o3�G Si ,
l�sAm�, c%croPod�.
B3 /y7
*Other Debris Explanation
Original:
Applicant
Copy 1:
Copy 2:
Copy 3:
I5
Fs
Load Ticket Ticket No.
Municipality (Applicant) {{ p
rA I stems i C 00,e f4 i/t I i t
IOOSO N6 0 3 AJZ Su
rH,4.K; b cf ®aG:, GCh 331$
Truck No I Capac' y
ms i � i� a
anUell Wl
Loading I.30 10, Seas Yv161�(I
Location (Address or Cross Streets)
NA'� 4q1"s� as. �6Gt1:
IV� �r' AVC $0. l q � i1 ..
N I
vc�uJ INQJJ11;Blefow CSil matad Or Actual
Vegetati
❑ C &D C/
❑
White G
❑ HHW
❑ Other' Sime Date Ins ector / Mon
Unloading S? 14
DMS Name and Location
11101 hict 103'c S3' g.4sAwa, a= (a�ada, 39/47
Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No. �
A;.(
Municipality (Applicant) Co rao r
4 a .-r� � g V, I J J4ffT",F
joa o �Jf- Aj� Sub - Contractor ~ T
i� 0�:tX- 6S uff in AS
Truck No
Truck Driver(p}rint legibly)
Time
Loading Y ,
Location (Address or Cross Streets)
Capacti r
Hate Ins
onitor
N v
r .. ,
Debris Classification Estimated °f , C--Ys, or Actual Wei
Vegetation
❑ G &D
❑ White Goods
❑ HHW
❑ Other* See Below
Time Date InspectorlManitor
Unloading
DMS Name and Location
1'?0 101 "e- Ss°1 AMI-I k ;:(staj 39/4-7
*Other Debris Explanation
TOriginaf: Applicant
.
:
:
Load Ticket
Ticket No.
A t L{dill ffAP.w�S
B' ' i 4
li "i
S
10050 eJe±
t8ic4 at: S uFB vi
d f1rM
o- to S? 1 .3S
Sub -Contr cto
f ,
i rucK NO Capacity
I
Truck Driver (print legibly)
L u i'f hern a n dfz,
I I]me I Date I Inspector /Monitor
Loading IQ'05 IU /)O' S-Mrl Moyn
Location (Address or Cross Streets)
Sf
is" 466 -
N I
cbnrnaiep %o, GYs, or Actual Wel ht
Vegetation
❑ White Goods l/
❑ HHW
❑ Other" See Below
Time Date Ins ector/ onitor
Unloading
1101 rJ&i 10Z�4 S7f— OAa Ntrr�a X8147
`Other Debris Explanation
)4p)OSY" ko"kls
Load Ticket I Ticket No. T�
pA1Qs<At jCtfae.C4 V�j'6z 't i
i 0OS0 NC � °4a Sub -Contr cto
r4liAat: 6 (419 v', Uf 1s'S
Truck No C j \I + v _iQ Capacity
I'S al L
Truck Driver (print legibly)
Loading
�,30 to l� 1"y I�A�ISI�t� f \(r�tyS
Location (Address or Cross Streets)
(-74013 Co1iCvj/ISe ��, r �i AV r--
W
W
--- - - caw ndiea 70, l,Ts, or HCtUal V
Vegetation
❑ C&D /} /! %/�/J,/
❑ White Goods %S L(/
❑ HHW ((( 7
❑ Other* See Below
Time Date Inspector/ n
Unloading 1711 4
DMS Name and Location
1 ?01 04) 103'G ST-1 AA" F ( ®rya 83/47
Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket Ticket No. f U
Municipality (Applicant) P im Co ra r
p4IAAti Cffee .S R/c�S L f "l Sim*
afl��o N a AJs SuC acto i
ttii4at: 6 oEB si I=fo- $3IM
Truck No
m% III
Location (Addre!
r(G' loo
3rd
N
Capacity
1;5D )0 %ro-
Cross Streets)
in
61a
9 I5 ._
Vegetation
❑ C &D
❑
White HHW Goods
HHW
❑ l
❑ Other" See Below
Unloading '
lime Date Inspector /Monitor
`�,/$ I %o " 7 1
DIMS Name and Location
noa foo l03`G S. P3vacaa, a%tarw3a. 39IL(7
"Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3: