MSV TRUCKS 10.16 LOADSLoad Ti"(Applicant)p et No. r� (�
Municipality P im Con rac r 9A d � _100.57 ° ub - Contracto t�iarAR: IWI
Truck No Capacity
31 o1 I 3% f
Truck Driver (print legibly)
Vegetation
❑ C &D
❑ White Goods
❑ HHW
❑ Other* See Below
Unloading 3
DMS Name and Location
d¢?3`4- fa r 04 & A fAI 33/g7
Original: Applicant
Copy 1:
Copy Z:
Copy 3:
Load Ticket Ticket fro.
Municipality (Applicant) P im Contra r
V, .
sr aso A; f- '0 O Sub- Contractor `
Truck 4o Capacity
Truck Driver (print legibiy)
Time Date fnspec r /Monitor
Loading '
\9-,( t I \9- ���
Location (Address or Cross Streets)
N —901
Debris Classification Estimated.% CYs, orActuaf Wei ht
Vegetation
❑ G &D
❑ White Goods
❑ HHW
❑ Other{ See Below
Unloading T1rne Date inspector /Monitor
DMS Name and Location
( '701 fir) Qox� ,�°� P404m e'(0 ,'gJr, 9.ig7
'Other Debris Explanation
Original: Applicant
Copy 1
Copy 2.-
Copy I
Load Ticket Ticket No,
Municipality (Applicant) Prime Contract-or
A4 a AM fiae6,�, Ago
Sub-Contra cto rA&
1006 y,,
6z 1.i6,0 67 i4o i' A, *it
Truck No Capacity
Truck fiver (print legib,
vy)
Time Date inspector/Monitor
Loading
7Location (Address or Cross Street
01-01? 4V(4--;�2j
N w
Debris Classification
Estimated CYs, or Actual Weight
Vegetation
❑ C&D
White Goods
G
Vegetation
Classification
on
0
at
Goods s
F-1 HHW on LE Estimated
Se JS io /0
❑ Other* See Beiow
Time Date I Inspector/Monitor
Ig 1C), .
Unloadin a
DMS Name and Location
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy Fpy 2.
Copy 3:
Tu\V ie��r 0\<-(�urkz)
Load Ticket Ticket Igo.
Municipality (Applicant) P im Con rac r
FA i AA41 1.5 ijeoz4�4 Vt 1,4 - 4 RWVWI S1
z;m,�ro � e 69 ,�, JE Sub- Coritractar
� 6 691 .39P
Truck No Capacity
Truck Driver (print legibly)
V \) SSc�I
Time Date lnspertor /Monit
Loading ,
Location (Address or Cross Streets)
1'9 a 1
Debris Classification ' Estimated %, CYs, c Actual Wei
Vegetation
C &D
❑ White Goods .�
❑ HHW
❑
Other* See Below `��� ✓✓/
Time Date Inspector /Monitor
Unloading I---, �� c
DMS Name and Location
'Other Debris e=xplanation
Original; Applicant
Copy 1.
Copy 2:
Copy 3:
ht
Load Ticket Ticket No.
Municipality (Applicant) Pr'liiime Contractor
10 O'STO A- 44 AiE Sub - Contractor, d ;g -i
6z 67 i4a
Truck No Capacity
Z
Truck Driver (print legi y)
4A6,
T�mo
oading Gate ins ector /Monitor
L
Location (Address or Cross Streets)
/V
Debris Classification Estimated ° /a, CYs, or Actual Wei
Vegetation
❑ C &D
❑ White Goods
HHW
r
[� Other* See Below 9
Unloading
Time ate Inspector /Monitor
DMS Name and Location }
i -7 0 d f0 &) 103'4-
*Other Debris Explanation
Original: Applicant
Copy 1:
copy 2:
Copy 3:
Load Ticket Ticket No.
Municipality (Applicant) #P,4,-n Contrac r
S
a00so '04 � Sub- Contractor
T No
' .31 .
Truck Driv (print legibly)
�.0 �\
Time Date
Loading q` ,fir►
Location (Address or Cross Streets)
Capacity
�r5
Inspector /Monitor
Gy-Sor1.S
7
Debris Classirication Estimated %, CYsr or Actual Weis
Vegetation
C &D J
❑ White Goads �✓
❑ HHW
❑ Other* See Below
Time Kff Inspector /Monitor
Unloading j C ++
l
DMS Name and Location
1-701 INJO
'Other Debris Explenation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
Load Ticket
Ticket No.
Municipality (Applicant) Prime Contractor
PA r A a � � b-
ioo-�rO A�Pi: c9'+� s Sub - Contractor 6� m'
_ t
Truck No Capacity
Truck Driver (print legibly)
Loading ,
lime I Date I ins
Loading
Location (Address or Cross Streets)
i U jr ' " o t
e. ris Classification Estimated °fa, CYs, or Actual Weight
Vegetation
F] C &D
0 White Goods .
[] HHW
D Other* See Below
Unloading
Time Date Inspector/Monitor
DMS Name and Location
*Other Debris Expianation
Original: Applicant
Copy 1:
Copy 2:
Copy 3:
.a
Load Ticket Ticket No.
Municipality (Applicant) Prime Contractor
r;:irA- 611 $' (,;P -7 ko i, oo Je
s
Truck No Capacity
Truck Dry (print legibly)
Loading ;,,,,
Time Date lns,oector /Mcnitor
Loading
Location (Address or Crass Streets)
` X 1,—, 41s"r-
N
Il' WOR
Debris Classification Estimated %, CYs, or Actual Weight
Vegetation
Q G &D
Q White Goods c
Q HHW d
Q Other* See Below
Time Date inspector/Monitor
Unloading ��A
DMS Name and Location / l /
*Other Debris Explanation
Original: Applicant
Copy 1:
Copy 2:
Copy 3: