HomeMy WebLinkAbout10/2024 SITE TICKET GRID WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01919277 Steph
PO Box 962/6155 Cox Lane
Cutchogue, rY 11935 DATE IN DATE OUT TIME IN,.TIME•OUT, VEHICLE ROLLOFF,
10/01/24 10/01/2 07:2 07:46 19606TC
9316 Town of Babylon
SCALE 2 GROSS WT 71440 LB Outbound Ticket
SCALE 117ARE WT 34960 LB
NET WEIGHT 36480 LB
QTY.- UNIT... DESCRIPTION,-: RATE EXTENSION, FEE . TOTAL
18.24 OUTGO.MSW 0.000 0.00 0.00 0.0e
—)
)elc_
Operating hours 7:00 AM to 5:00 PM 7 days a week ,; ,'��N f,;,. Me
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - CO�LMBUS
8 O TENDERED
DAY
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET' GRID_ WEIGHMASTER '
SOUTHOLD TOWN DEPT SOLID WASTE ep
PO Box 962/6155 Cox Lane
Cutchogue, NY 1.1935 D TE IN D T OU T ME I ]Tm Abyj VE I ROLL OFF
9316 Town of Babylon
REFERENCE
•-
Uut0ouna Ticket
FSCALE 1 TARE WT 34960 LB
WEIGHT 36480 LB
QTY UNIT _ DESCRIPTION _ RATE', EXTENSION FEE'_; TOTAL"'`'-
18.24 OUTGO.MSW 0. 0.
Operating hours 7:00 AM to 5:00 PM 7 days a"Veek,k' .' •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - CQLUMU moo,
DAY TENDERED
V
CHANGE
CHECK NO..
cr_�n•r roc
- ' NO. 2565
s
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER_:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER_
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET.NO.
DUPLICATE TICKET SITE I TICKET GRID I - WEIGHMASTER
,
SOUTHOLD TOWN DEPT SOLID WASTE 001 01919360 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
10/01/24 10/01/24 11:30 11:43 19606TC
9316 i.• Town of Babylon
L •.
SCALE 2 GROSS WT 73980 LB Outbound Ticket
SCALE 1 TARE WT 34460 LB
NET WEIGHT 39520 LB
QTY UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
19.76 OUTGO.MSW 0.000 0.00 0.00 0.0e
�. t!;�3
Operating hours 7:00 AM to 5:00 PM 7 days a week. ''`- 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COLUIBUS DAY TENDERED;
� � � ti
CHANGE
CHEC NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID WEIGHMASTER --
SOUTHOLD TOWN DEPT SOLID WASTE 001 01919360 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE` ROLL OFF
9316 Town of Babylon
REFERENCE
•.
CALE 2 GROSS WT 73980 LB Outbound Ticket
SCALE 1 TARE WT 34460 LB
NET WEIGHT 39520 LB
QTY. "UNIT DESCRIPTION RATE- EXTENSION "FEE TOTAL
19.76 OUTGO.MSW 0.000 0.00 0.00 6.0e
r
Operating hours 7:00 AM to 5:00 PM 7 days,a,week:�' `--� ` 9 •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 COLUMBUS�•.:�e.
DAY ` TENDERED
CHANGE
CHECK NO:::::l
NO. 2566
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
i HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING.TCQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION%FREIGHT CO.
TRUCK NO. - LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW:
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL,HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR . DISPOSAL LOCATION TICKET NO:
DUPLICATE TICKET SITE I TICKET GRID I WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01919550 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN. DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
10/02/2 10/02/2 11"1406TC
9316 'Town of Babylon
REFERENCE
-
SCALE 2 GROSS WT 74980 LB Outbound Ticket
SCALE•1 TARE WT 34620 LB
NET WEIGHT 40360 LB
QTY.' UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
20.18 OUTGO.MSW 0.000 0.00 0.00 me
tt fl
Operating hours 7:00 AM to 5:00 PM 7 da3is9,a ,week.'^. � '',.. ' Cl' Foe
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14�'- LU COMBUS':, '
TENDERED
DAYS
ez �= 'yX�;•, CHANGE
CHECK NO:::::j
SIGNATURE
DUPLICATE TICKET SITE I TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01919550 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN. DATE OUT TIME IN-TIME OUT - VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 74980 LB Outbound Ticket
SCALE 1 TARE WT 34620 LB
NET WEIGHT 40360 LB
QTY.: 'UNIT— DESCRIPTION" RATE EXTENSION FEE TOTAL
20.18 OUTGO.MSW 0.000 0.00 0.00 0.0e
ul
v. t 0 1
t
Operating hours 7:00 AM to 5:00 PM 7 days a�weeka...�:,'.--``�-�'1���''�� ' •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT.
DAY c 1;vJtr f r r ° TENDERED
t I U�(�la q
1 CHANGE
CHECK NO.
-::j
RIMMATI IRF
41, NO. 2568
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE_ LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE' TICKET SITE I TICKET , I GRID I WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01919485 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN - DATE OUT TIME IN TIME OUT , VEHICLE ROLL OFF
10/02/24 10/02/2 07:3 07:50 19606TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 66640 LB Outbound Ticket
SCALE 1 TARE WT 35300 LB
NET WEIGHT 31340 LB
CITY. UNIT DESCRIPTION RATE- EXTENSION FEE TOTAL ,
15.67 OUTGO.MSW 0.000 0.00 0.90 0.0e
> Cdl lf.�. �t8 a•(
q e'•�, ram_ //��'��°-, C�iq"�°y> ``
as
Operating hours 7:00 AM to 5:00 PM 7 days�,a week.``
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COLUMBUS �� g{ `TENDERED'
DAY
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID WEIGHMASTER-
SOUTHOLD TOWN DEPT SOLID WASTE 00 01919481 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN' DATE OUT TIME IN TIME OUT. VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 66640 LB Outbound Ticket
SCALE 1 TARE WT 35300 LB
NET WEIGHT 31340 LB
ITY UNIT DESCRIPTION RATE - EXTENSION FEE TOTAL
15.67 OUTGO.MSW .0.000 0.00 0.00 0.0e
r
Operating hours 7:00 AM to 5:00 PM 7 days a,«weeks
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 COL'�UMBUS---- ----' pN a�'
DAY ` � I€'t� v � ��# TENDERED`
q fd CHANGE
CHECK NO.
SIGNATURE
NO. 2567
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED;CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION-ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO'DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE TICKET GRID WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01919667 Steph
PO Box 962/6155 Cox Lane
Cu cholue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
10/03/2 10/.03/2 07:3 07:4 19606TC
9316 Town of Babylon t t t
REFERENCE ORIGIN
SCALE 2 GROSS WT 74380 LB Outbound Ticket
SCALE 1 TARE WT 35940 LB
NET WEIGHT 38440 LB
QTY. UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
19.22 OUTGO.MSW 0.000 0.00 0.00 0.0e
rw
Operating hours 7:00 AM to 5:00 PM 7 days"a eeek.�' ' 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 -\COLUMBUS f TENDERED
DAY
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID WEIGHMASTEW
SOUTHOLD TOWN- DEPT SOLID WASTE 00 01919667 Step
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 7 DATE IN 'DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 74380 LB Outbound Ticket
SCALE 1 TARE WT 35940 LB
NET WEIGHT• 38440 LB
QTY. UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
19.22 OUTGO.MSW 0.000 0.00 0.00 0.0e
r
} l ~
14.
Operating hours 7:00 AM to 5:00 PM 7 days &,week`.— Fj' •
CLOSED HOLIDAYS - NEXT: , MONDAY, OCT. 1CL COLUMBUS- -__.w..---`'
DAY � �� p C _TENDERED
CHANGE
CHECK NO.
&1lANATI IRF
•s
NO. 2569
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS_
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED�AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE I TICKET I GRID I WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01919736 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
10/03/2 10/03/2 11:2 11:4 19606TC
9316 Town of Babylon t - I
REFERENCE
•-
SCALE 2 GROSS WT 78660 LB Outbound Ticket
,SCALE 1 TARE WT 33940 LB
NET WEIGHT 44720 LB
QTY.. UNIT DESCRIPTION' RATE EXTENSION FEE` TOTAL
22.36 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 dayy q'a eek``� d � y ' . • 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14 SCOLUMBUS,� a:
DAY , - .. #. �+� ,� � ��`�� ,.(fir TENDERED
14
r> U CHANGE,
CHECK NO..
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID WEIGHMASTER' -
SOUTHOLD TOWN DEPT SOLID WASTE 00 01919736 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN. TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 78660 LB Outbound Ticket
SCALE 1 TARE WT 33940 LB
NET WEIGHT 44720 LB
OTY., - UNIT. _' ' DESCRIPTION RATE. EXTENSION FEE ;TOTAL
22.36 OUTGO.MSW 0.000 0.00 0.00 0.0e
Y 3 "! IN
' � r
eV
Operating hours 7:00 AM to 5:00 PM 7 days ao�week•:�.--.�^_,`�_ � f yA• ,
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14� , C0LUMBUS
DAY . ��� `t�( � TENDERED
CHANGE
CHECK NO.
RInNATI IRF ,
NO. 2570
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
- NET
HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBYCERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
rSITEJ TICKET GRID I 'WEIGHMASTER 1
DUPLICATE TICKET
SbU'FHOLD TOWN DEPT SOLID WASTE 001 .01919964 Liz H
PO Box 962/6155 Cox Lane DATE IN -DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
Cutchogue, NY 11935
10/04/24 10/04/24 13:11 13:25 19640TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT -71440 LB Outbound Ticket
SCALE 1 TARE WT 37260 LB
ET WEIGHT 34180 LB
QTY. - UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
17.09 OUTGO.MSW 0.000 0.00 0.00 0.0e
UP
Operating hours 7:00 AM to 5:00 PM 7 day5-'a H(ee k.. y - 0.02
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COLUMBUS TENDERED
DAY W i
CHANGE
HECK NO.
SIGNATURE
DUPLICATE TICKET SITE I TICKET-- I GRID.• I WE_IGHMASTER
SOUTHOLD.TOWN DEPT SOLID WASTE 001 01919964 1 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIMEOUT VEHICLE I ROLL OFF
9316 Town of Babylon
REFERENCE
•-
CALE 2 GROSS WT 71440 LB Outbound Ticket
SCALE 1 TARE WT -37260 LB
NET WEIGHT 34180 LB
QTY UNIT DESCRIPTION RATE EXTENSION. FEE TOTAL
17.09 OUTGO.MSW 0.000 0.00 0.00 0.02
_
Operating hours 7:00 AM to 5:00 PM 7 days a week��., "_— f t'
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 =1COLUMBUS�
DAY "¢ a TENDERED "
sue{' CHANGE
CHECK NO.
cnninTi goo _
NO. 2601
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE: `
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES- (COUNT):
TRUCK WEIGHT: - GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTEAS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW;HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
F
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO._
SITE 'TICKET GRID WEIGHMASTER
DUPLIC� TICKET
509TH(. OWN DEPT SOLID WASTE 001 01920043 Steph
PO Box 52/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
y' 10/05/24 10/05/24 07:19 07:39 19606TC
9316 Town of Babylon
SCALE 2 GROSS WT 71240 LB Outbound Ticket
SCALE 1 TARE WT 35260 LB
ET WEIGHT 35980 LB
QTY. UNIT-, DESCRIPTION RATE EXTENSION FEE TOTAL
17.99 OUTGO.MSW •0.000 0.00 0.00 me
01%
Operating hours 7:00 AM to 5:00 PM 7 day week. - _� me
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 -COLAUMBUS __ =-TENDERED
,DAY �U�I
CHANGE
CHECK NO:
SIGNATURE
DUPLICATE TICKET SITE I TICKET-- GRID_=, WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 001 01920043 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME-IN TIME OUT _ VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
•-
CALE 2 GROSS WT 71240 LB Outbound Ticket
SCALE 1 TARE WT 35260 LB
NET WEIGHT 35980 LB
QTY. - UNIT DESCRIPTION RATE, EXTENSION FEE TOTAL _-
17.99 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days a,week: ,. ,,>'° � �
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COL°UMBUS
DAY ES 'TENDERED
G! `CHANGE
CHECK NO.
• cir_nieTi�aG
NO. 2571
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET•NO.
SITE . TICKET I GRID IWEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01920551 Liz H
R`J Bc:X-)362/6155 Cox Lane DATE IN DATE OUT TIME IN TIME OUT °, VEHICLE ROLL OFF
Cutchogue, NY 11935
10/07/24 10/07/24 07:27 07:38 19606TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 75040 LB Outbound Ticket
SCALE 1 TARE WT 35680 LB
NET WEIGHT 39360 LB
QTY.' UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
19.68 OUTGO.MSW 0.000 0.00 0.00 0.0e
sails?
-71
Operating hours 7:00 AM .to 5:00 PM 7 day's>a week. 0.0e
a �. --
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - OLUMBU TENDERED'
DAY VDf 9
CHANGE
CHECK NO,
SIGNATURE
TICKET'_ GRID WEIGHMASTER
DUPLICATE TICKET SITE ..
SOUTHOLD TOWN DEPT SOLID WASTE 001 01920551 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
C.
-
CALE 2 GROSS WT 75040 LB Outbound Ticket
SCALE 1 TARE WT 35680 LB
NET WEIGHT 39360 LB
QTY. UNIT, DESCRIPTION RATE, EXTENSION FEE :TOTAL_
19.68 OUTGO.MSW 0.000 0.00 0.00 0.0e
PNv
71,
0
"ti a •
Operating hours 7:00 AM to 5:00 PM 7 days a,week:�,,- -„/ x�
CAOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COLUMB D TENDERED
CHANGE
CHECK NO. '
CI(�NATI IRF
r '►
NO. 2572
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: - GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO,APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER,
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE TICKET SITE TICKET GRID WEIGHMASTER
'
SOU HOLD TOWN DEPT SOLID WASTE 001 01920624 Liz H
PO j ox 962/6155 COX Lane DATE IN DATE OUT � TIME IN TIME OUT VEHICLE I ROLL OFF
Cutchogue, NY 11935
10/07/24 10/07/24 11:09 11:37 19606TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 67460 LB Outbound Ticket
SCALE 1 TARE WT 34760 LB
NET WEIGHT 32700 LB
OW. UNIT DESCRIPTION-_, RATE- EXTENSION: FEE`- TOTAL
16.35 OUTGO.MSW 0.000 0.00 0.00 0.02
tic S l
ED13 .:
Operating hours 7:00 AM to 5:00 PM 7 daysta week _ 0,02
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COLUMBUS � = TENDERED_
DAYa 1
CHANGE,
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET*= GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE, 001 01920624 Liz H
PO Box 962/6155 Cox Lane -
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN,TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
•.
CALE 2 GROSS WT 67460 LB Outbound Ticket
SCALE 1 TARE WT 34760 LB
NET WEIGHT 32700 LB
CITY. UNIT DESCRIPTION RATE - EXTENSION FEE,,, ,TOTAL
16.35 OUTGO.MSW 0.000 0.00 0.00 0.0e
a r
tt t j1 •
Operating hours 7:00 AM to 5:00 PM 7 day'sNxo
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - CdduI BUS`4-=-DAY /Y TENDERED
CHANGE
'CHECK NO.
SIGNATURE
` s3
NO. 2573
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
SALES: (COUNT):
TRUCK WEIGHT: - GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEWACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER_.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE TICKET I GRID WEIGHMASTER
DUPLICATE Tf KET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01920725 Steph
PO Box P62/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT I TIME IN TIME OUT VEHICLE I ROLL OFF
10/08/2 10/08/2 07:2 07:3 19606TC
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 78160 LB Outbound Ticket
SCALE 1 TARE WT 35160 LB
NET WEIGHT 43000 LB
- UNIT DESCRIPTION RATE- EXTENSION FEE dTOTAL-
QTY.
21.50 OUTGO.MSW 0.000 0.00 0.00 0.0e
�a
Operating hours 7:00 AM to 5:00 PM 7 days�a tw,eek.�, - °�° 0.02
,�
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 COLUMBUS �� %TENDERED
DAY ' , {�
CHANGE
.CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET' GRID_ WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01920725 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT . TIME IN TIME OUT. VEHICLE ROLL OFF
9316 Town of Babylon
REFEREN L
SCALE 2 GROSS WT 78160 LB Outbound`Ticket
SCALE 1 TARE WT 35160 LB
NET WEIGHT 43000 LB
QTY. UNIT` - DESCRIPTION RATE EXTENSION FEE TOTAL
21.50 OUTGO.MSW 0.000 0.00 0.00 0.0e
() h
Operating hours 7:00 AM to 5:00 PM 7 days a-1,week
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14'�1, COLUMBUS-------
TENDERED
DAY
4 �l . CHA GE
CHECK NO.
SIGNATURE
�J
i
N0. 2574
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR -
GOLD TO GENERATOR. DISPOSAL LOCATION TICKET NO.
DUPLICATE TICKET SITE TICKET I GRID WEIGHMASTER
SOUTHOLD,;TOWN DEPT SOLID WASTE OOL 01920823 Steph
PO Box 96276155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
10/08/2 10/08/2 12:2 12:3 19606TC
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 71000 LB Outbound Ticket
SCALE 1 TARE WT 34680 LB
NET WEIGHT 36320 LB
OTY. UNIT DESCRIPTION RATE' EXTENSION FEE TOTAL`
18.16 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 daysa week.' ''g 0.0e
a
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 -�NCOLUMBUS TENDERED
DAY
?L CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET - - GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01920823 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE. ROLL OFF
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 71000 LB Outbound Ticket
SCALE 1 TARE WT 34680 LB
NET WEIGHT 36320 LB
OTY UNIT DESCRIPTION _ RATE- EXTENSION FEE TOTAL
18.16 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14�N-6 uMBUS`---`-----'6 t� TENDERED
DAY t ` t'r qs•1I— °,
CHANGE '
CHECK NO3
SIGNATURE
NO. 2575
.GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
SALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY: -
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY_: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE TICKET GRID. WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01920998 Steph
PO Box 962/6155 Cox Lane DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
Cutchogue,-vNY 11935
10/09/2 10/09/2 11:1 11:2 19606TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 77340 LB Outbound Ticket
SCALE 1 TARE WT 34720 LB
NET WEIGHT 42620 LB
QTY UNIT ;: DESCRIPTION RATE EXTENSION FEE TOTAL
21.31 OUTGO.MSW 0.000 0.00 0.00 0.02
'ate
IN
a
Operating hours 7:00 AM to 5:00 PM 7 days a week. ' '. 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 = COL�UMBUS �a , TENDERED` "-
DAY
CHANGE
CHECK NO_
SIGNATURE
DUPLICATE TICKET »SITE TICKET GRID, ., `-. WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01920998 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
OIL
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 77340 LB Outbound Ticket
SCALE 1 TARE WT 34720 LB
NET WEIGHT 42620 LB
QTY. UNIT DESCRIPTION RATE EXTENSION FEE _. TOTAL
21.31 OUTGO.MSW 0.000 0.00 0.00 0.0e
NN
�. t i•
Operating hours 7:00 AM to 5:00 PM 7 daystacweek:�,
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - C6LfUMBUS`----:::�''`-
DAY Y
p�� Q TENDERED
e ��� �
CHANGE
HECK NO.
SIGNATURE
� J
NO. 2578
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,'HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. _LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:,
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL-HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE I . .TICKET GRID I WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01920937 Steph
PO Box 962/6155 Cox Lane DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
Cutchogue, NY 11935
10/09/2 10/09/2 07:3 07:4 19606TC
9316 Town of Babylon REFERENCE
SCALE 2 GROSS WT 76660 LB Outbound Ticket
SCALE 1 TARE WT 34860 LB
NET WEIGHT 41800 LB
QTY _ UNIT- DESCRIPTION - RATE. EXTENSION _ FEE TOTAL
20.90 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days a w�k.�: r w 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COLUMBUS TENDERED
DAY } �
CHANGE...
HECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID- WEIGHMASTER,
SOUTHOLD TOWN DEPT SOLID WASTE 00 01920937 1 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME'OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 76660 LB Outbound Ticket
SCALE 1 TARE WT 34860 LB
NET WEIGHT 41800 LB
QW UNIT DESCRIPTION RATE EXTENSION -- FEE - TOTAL
20.90 OUTGO.MSW 0.000 0.00 0.00 me
s. u.J
Operating hours 7:00 AM to 5:00 PM 7 days aeweek\-:::��:� ,/
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 -' LUMBUS �- 'r TENDERED
DAY
CHANGE
CHECK NO.
SIGNATURE
NO. 2576
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: _ (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO.APPLICABLE REGULATION.
t
GENERATOR AUTHORIZED AGENT(PRINT NAME) _r_(SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE. GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE I TICKET I GRID WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01921147 Steph
PO Box 962/6155 Cox Lane DATE IN DATE OUT TIME IN,TIME OUT VEHICLE ROLL OFF
Cutchogue, NY 11935
10/10/24 10/10/2 08:1 08:27 19606TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 73280 LB Outbound Ticket
SCALE 1 TARE WT 35160 LB
ET WEIGHT 38120 LB
OTY UNIT DESCRIPTION RATE" EXTENSION FEE'.- TOTAL
19.06 OUTGO.MSW 0.000 0.00 0.00 0.0e
f ° Leis]
0 eratin hours 7:00 AM to 5:00 PM 7 da spa week. a» 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 COLUMBUS TENDERED
DAY +
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE `.. TICKET ' GRID_ WEIGH_ MASTER'
SOUTHOLD TOWN DEPT SOLID WASTE 00 01921147 1 Steph
PO Box 962/6155 Cox Lane_
Cutchogue, NY 11935 DATE IN DATE OUT' TIME IN TIMEOUT VEHICLE ROLLOFF'
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT .73280 LB Outbound Ticket
SCALE 1 TARE WT 35160 LB
NET WEIGHT 38120 LB
QTY. ' ' UNIT DESCRIPTION' RATE EXTENSION FEE TOTAL
19.06 OUTGO.MSW 0.000 0.00 0.00 0.0e
�} .r az
r l `
IS4 r ` .E
F
t � �
Operating hours 7:00 AM to 5:00 PM 7 days avweek°.�
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. :W COLUMBUS—
DAY -
TENDERED
.
CHANGE
CHECK NO.
SIGNATURE
NO. 2577
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
1 HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW;HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION ,
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER. 4-
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
('SITEI TICKET . GRID I WEIGHMASTER
DUPLICATE TICKET
SOiJ",�WLD TOWN DEPT SOLID WASTE 00 01921308 Liz H
PO BOX 962/6155 Cox Lane DATE IN-'- DATE OUT TIME IN TIME OUT VEHICLE I ROLL OFF
Cutchogue, NY 11935
10/11/2 10/.11/2 07:3 07:4 19606TC
9316 Town of Babylon
REFERENCE
�.
SCALE 2 GROSS WT 70680 LB Outbound Ticket
SCALE 1 TARE WT 35380 LB
NET WEIGHT 35300 LB
QTY UNIT DESCRIPTION RATE, EXTENSION FEE TOTAL
17.65 OUTGO.MSW 0.000 0.00 0.00 0.0e
I I)4t,
Operating hours 7:00 AM to 5:00 PM 7 days a We'e , ' 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 OEUMBUS� } � � YTENDERED
DAY
CHANGE'_
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE. -' TICKET. GRID., WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01921308 1 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME--IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 70680 LB Outbound Ticket
SCALE 1 TARE WT 35380 LB
NET WEIGHT 35300 LB
QTY. UNIT _ DESCRIPTION RATE, EXTE_NSION_,. FEE '_ TOTAL
17.65 OUTGO.MSW 0.000 0.00 0.00 0.0e
so
Operating hours 7:00 AM to 5:00 PM 7 days 'a eV
�.; �.
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COLUMBUS
DAY r J TENDERED
COUN CHANGE
CHECK NO.
SIGNATURE
NO. 2579
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR.ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION-
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION'TICKET NO..
SITE TICKET GRID WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01921545 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
10/12/24 10/12/2 07:1 07:36 19606TC
9316 Town of Babylon
:.. REFERENCE •-
SCALE 2 GROSS WT 73600 LB Outbound Ticket
SCALE 1 TARE WT 35320 LB
NET WEIGHT 38280 LB
CITY = UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
19.14 OUTGO.MSW 0.000 0.00 0.00 0.02
Xv
Operating hours 7:00 AM .to 5:00 PM 7 days a week.' ;af��� 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COL�UjM jdy-
DAY '� \\ TENDERED
11
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE1 TICKET GRiD wEIGHMASTER_'�
SOUTHOLD TOWN DEPT SOLID WASTE 00 01921545 Steph
PO Box 962/6155 Cox Lane
Cut chogue, NY 11935 DATE IN DATE OUT TIME_IN TIME OUT' VEHICLE ROLL OFF
e
9316 Town of Babylon
REFERENCE
•-
GALE 2 GROSS WT 73600 LB Outbound Ticket
SCALE 1 TARE WT 35320 LB
NET WEIGHT 38280 LB
CITY. UNIT DESCRIPTION RATE _ EXTENSION = FEE _ TOTAL_
19.14 OUTGO.MSW 0.000 0.00 0.00 0.0e
a
Operating hours 7:00 AM to 5:00 PM 7 days,y week: , �� -r •
�' �..._
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14�'' COLUMBUS-,
DAY �� TENDERED
CHANGE
CHECK NO. _
SIGNATURE
NO. 2580
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
1 HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME), SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER,
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 001 01922082 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE„IN DATE OUT_. TIME IN .TIME OUTI VEHICLE I ROLL OFF
� • 10/15/24 10/15/24 07:25 07:42 19606TC
9316 l uwt,, of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 68920 LB Outbound Ticket
SCALE 1 TARE WT 35160 LB
ET WEIGHT 33760 LB
QTY. UNIT DESCRIPTION-__ - RATE EXTENSION ., FEE_- TOTAL
16.88 OUTGO.MSW 0.000 0.00 0.00 0.02
,)rz
0 eratin hours 7:00 AM to 5:00 PM 7 da s`�,a week � �~ 0.02
P g Y .._.
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - COLUMBUS_
TENDERED. .
DAYa U
�ry z s CHANGE
CHECK NO.'
SIGNATURE
SITE TICKET-_; GRID -- WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 001 01922082 Steph
PO Box 962/6155 Cox Lane
Cutchogue,' NY 11935 DATE-IN-= DATE OUT TIME IN. TIME OUT _EHI E 'ROLL OFF`
9316 Town of Babylon
REFERENCE ORIGIN
CALE 2 GROSS WT 68920 LB Outbound Ticket
SCALE 1 TARE WT 35160 LB
NET WEIGHT 33760 LB
OTY. UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
16.88 OUTGO.MSW 0.000 0.00 0.00
r
r;
1
A
Operating hours 7:00 AM to 5:00 PM 7 days a";week:`�_e ..�� - ","' % •
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14 COLUMBUS '
DAY R° TENDERED.
CHANGE_-
CHECK HECK NO..
NO. 2581
-400
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
SALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE TICKET GRID WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922208 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT,. TIMEIN ITIME OUT VEHICLE;, ROLL OFF,'
10/15/2 10/15/2 "11:1 11:3 19606TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 74240 LB Outbound Ticket
SCALE 1 TARE WT 35080 LB
NET WEIGHT 39160 LB
QTY UNIT DESCRIPTION RATE EXTENSION FEE - TOTAL
19.58 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days,a�week. • 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 COLUMBUS., TENDERED.'
DAY ; ,
CHANGE
' 1 CHECK NO_
SIGNATURE
DUPLICATE TICKET SITE TICKET_- GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922208 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT ; TIME IN TIMEOUTI VEHICLE ROLLOFF;;.,
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 74240 LB Outbound Ticket
SCALE 1 TARE WT 35080 LB
NET WEIGHT 39160 LB
CITY UNIT DESCRIPTION RATE EXTENSION FEE -r TOTAL_
19..58 OUTGO.MSW 0.000 0.00 0.00 0.0e
t
Operating hours 7:00 AM to 5:00 PM 7 day`s a.-week,:
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14�" COLUMBUS -
DAY TENDERED
s r<. CHANGE
CHECK NO.
SIGNATURE
NO. 2582
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANS PORTATIONIFREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE TICKET SITE I TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922510 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE -_ ROLL OFF
,. 10/16/2 10/16/2 13:1 13:2 19640TC
9316 Town of Babylon
REFERENCE ORIGIN
1 •
SCALE 2 GROSS WT 76780 LB Outbound Ticket
SCALE'l TARE WT -36220 LB
NET WEIGHT 40560 LB
=QTY = UNIT DESCRIPTION =_ RATE EXTENSION" FEE 'TOTALI
20.28 OUTGO.MSW 0.000 0.00 0.00 0.02
se r �_-•Y # \ Rq
Operating hours 7:00 AM to 5:00 PM 7 days; a week 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 =. COLUMBUS ;;, a ., TENDERED'
DAY V.;;
CHANGE,.,
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE I :TICKET- GRID_ WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922510 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE.IN DATE OUT TIME IN TIME OUT -VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
•.
SCALE 2 GROSS WT 76780 LB Outbound Ticket
SCALE 1 TARE WT 36220 LB
NET WEIGHT 40560 LB
,,,OTY,,, .,UNIT DESCRIPTION,,.,.;,. RATE _:,` EXTENSION" FEE` ' TOTAL--,:-,
20.28 OUTGO.MSW y 0.000 0.00 0.00 0.02
r'
Operating hours 7:00 AM to 5:00 PM 7 days, a;week`.;= -,
CLOSED HOLIDAYS - NEXT: ' MONDAY, OCT. 14�= COLUMBUS'"
0.�:: TENDERED
DAY a;r e..h t` ;",s.;, • : fi,
r t .N ,...., `•e,. . CHANGE
CHECK NO.
SIGNATURE
n "•n NO. 2602
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL'LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:_
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE TICKET .. GRID , WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922440 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE I ROLL OFF
10/16/2 10/16/2 10:5 11:1 19606TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 64820 LB Outbound Ticket
SCALE 1 TARE WT 34720 LB
NET WEIGHT 30100 LB
QTY UNIT DESCRIPTION RATE' EXTENSION FEE TOTAL
15.05 OUTGO.MSW 0.000 0.00 0.00 0.0e
VI
_ 1
Operating hours 7:00 AM to 5:00 PM 7 dajrs:a:,week. - 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 „COLUMBUS. p -_ .TENDERED
DAYr,-
'"x'
raj. CHANGE
CHECK NO.
SIGNATURE
SITE TICKET A- GRID, WEIGHMASTER`
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922440 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME•IN TIME OUT VEHICLE ,ROLL OFF
,9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 64820 LB Outbound Ticket
SCALE 1 TARE WT 34720 LB
NET WEIGHT 30100. LB
QTY UNIT,> DESCRIPTION RATE-,, ,,EXTENSION FEE TOTAL „
15.05 OUTGO.MSW 0.000 0.00 0.00 0.0e
P� tir� .i}1 �.Vj •F P
1 �1•�! �e
S
x�-P 4
Operating hours 7:00 AM to 5:00 PM 7 days aweek:i
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14'=.. CO.LUMBUS__
yjf/" ;'-. ?•- r TENDERED
DAY �" 6' �'';n�,j,.���=;� ',,�1"-'�ry fr
CHANGE
CHECK NO
SIGNATURE
NO. 2584
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIAL_S
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE- (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION- DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE I TICKET', I GRID" WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922385 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN - DATE OUT TIME IN-TIMEOUT• VEHICLE ROLLOFF
10/16/2 10/16/2 07:1 07:3 19606TC
9316 166 n of Babylon REFERENCE
SCALE 2 GROSS WT 63960 LB Outbound Ticket
SCALE 1 TARE WT 35100 LB
NET WEIGHT 28860 LB
QTY UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
,14.43 OUTGO.MSW 0.000 0.00 0.00 0.0e
(fir n�z Y�•' �. ��.,.•a•��
. f�% .z .i lY`•
(,14
1 ;
Operating hours 7:00 AM to 5:00 PM 7 day"s" a",week:~-- - ,= :" 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 ',-° CO.L�UMBUS
Q, s. 3,- R\ "TENDERED
DAY �4R� l:a 4ur''`;4 Vl "`{`� r, "
CHANGE
:CHECK NO.
SIGNATURE
SITE TICKET-_`•` GRID WEIGHMAST_E_R .
SOUTHOLD TOWN DEPT SOLID WASTE ep
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935
DA E T ' TI t TIM ROLL OFF
9316 Town of Babylon
REFERENCE ORIGIN
UU-1130und I3.cKeT
SCALE 1 TARE WT 35100 LB
NET WEIGHT 28860 LB
11 ON UNIT„ DESCRIP,TION RATE' , ; EXTENSION FEE- TOTAL
14.43 ' .
t \, P
Operating hours 7:00 AM to 5:00 PM 7 days{a'.week: r ` -.v— 1' i' �`' :.-' •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 4, COLUMBUS.
DAY r%^ ,,_. -,p _ i TENDERED
-"•CHECK NO.
SIGNATURE
NO. 2583
e
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
SALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR-ANY-APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE : _.? TICKET :' . 'GRID` . - '", ''; MEIGHMASTER °
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 0 1 01922661 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN =.. DA,TEOUT -TIME:IN TIME:OUT VEHICLE ROLL
10/17/2 10/17/2 11: 3 11:29 19606TC,
9316 ..Town of Babylon
REFERENCE O
SC:ALE GROSS WT .67180 LB Outbound Ticket
SCALE 1 TARE WT 34240 LB
NET WEIGHT 32940 LB
QTY UNIT ,DESCRIPTION'--'- %;, - `. ;RATE EXTENSION FEE'- :TOTAL-
16.47 OUTGO.MSW 0.00e 0.00 0.00 0.0e
i
Operating hours 7:00 AM to 5:00 PM 7 days. 6 week. 5 " 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14`=,COLUMBUSENDERED',?^,-
9%,
DAY 's
CHECK NO:d'
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID WEIG HMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922661 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATEIN;'s JDATEOUT -TIMEIN TINIE`QUT VEHICLE " ;;ROLL OFF
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 67180 LB Outbound Ticket
SCALE 1 TARE WT 34240 LB
NET WEIGHT 32940 LB
NII < DESCRIPTION „„ - „,RATE EXTENSION". ':.FEE'. TOTAL".,, „-.,
16.47 OUTGO.MSW 0.000 0.00 0.00 0.0e
t'
Operating hours 7:00 AM to 5:00 PM 7 days a Week.. ,,.-
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14'ti COLUM6US' -- '--
DAY i 'r TENDERED
CHANGE.,.
ECK-NO,
'
SIGNATURE
NO. 2586
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
i HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY'CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED_
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE TICKET:,.,y GRID 1NEIGHMASTER''
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922602 Steph
PO Box 962/6155 Lox Lane
Cutchogue, ,Nk' 11935 ;DATE IN - DATE `'::TIME IN"TIME OUT VEHICLE -< ROLL OFF
10/17/2 10/17/2 07:2 07:3 19606TC
9316 Town of Babylon t t
REFERENCE ORIGIN
SCALE 2 GROSS WT 61300 LB Outbound Ticket
SCALE 1 TARE WT 35820 LB '
NET WEIGHT 25480 LB
UNIT_-, .. .. DESGRIRTION ,_ RATE EXTENSION " FEE-.`- TOTAL`':
12.74 OUTGO.MSW 0.000 0.00 0.00 0.0e
t"
Operating hours 7:00 AM to 5:00 PM 7 days,,a 'we eka- 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 '-r;COLUMBUS,.
DAY
,,CHANGE'
SIGNATURE
SITE TICKET,- GRID- WEiGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922602 Ste ph
PO Box 962/6155 Cox Lane_
Cutchogue, NY 11935 DATE IN'"C DATEOUT IME IN;;TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon REFERENCE ORIGIN
CAL: 2 GROSS WT -61300 LB Outbound Ticket
SCALE 1 TARE WT 35820 LB
NET WEIGHT 25480 LB
OTY "-"UNIT' - "^,'DESCRIPTION,.; RASE EXTENSION',, FEE TOTAL. -
12.74 OUTGO.MSW 0.000 0.00 0.00 0.0e
1
Operating hours 7:00 AM to 5:00 PM 7 days a wieek a
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14&, COLUMBUS,:
DAY e "r nfi;^,3t;3 _..: C` i`• JENDERED,
,,.,�::::,• :7.` CHANGE
f -CHECK' O.'.,^;,'T
SIGNATURE
NO. 2585
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY:
SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW.IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED.CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE) J
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE lNFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE, TICKET GRID. WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922788 Liz H
PO BOX 962/6155 COX Lane DATE IN DATE OUT TIME TIME OUT -VEHICLE ROLL OFF
Cutchogue, NY 11935
10/18/2 10/18/2 07:3 07:51 19606TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 67340 LB Outbound Ticket
SCALE 1 TARE WT 35920 LB
NET WEIGHT 31420 LB
QTY -UNIT DESCRIPTION. RATE;: EXTENSION FEE TOTAL
15.71 OUTGO.MSW 0.000 0.00 0.00 0.0e
E
Operating hours 7:00 AM to 5:00 PM 7 da}ys,a Week:-,..` ^:` J( f ~F • 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 Sr,,COLUMBUS;.. ;=a;?' ' TENDERED
DAY 'i"+'.i''i! a _
P CHANGE--
CHECK O.
SIGNATURE
DUPLICATE TICKET SITE -TICKET_'= GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922788 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF -
9316 Town of Babylon
REFERENCE
SCA:2GROSS WT -67340 LB Outbound Ticket
SCAE WT 35920 LB
NET 31420 LB
UNIT DESCRIPTION 'RATE EXTENSION - FEE TOTAL -
15.71 OUTGO.MSW 0.000 0.00 0.00 0.0e
Cti
-_ Allw3ra ib7
',.. „=\•r- y"� -.;, '�-'gib •
Operating hours 7:00 AM to 5:00 PM 7 days a,week,:-
CLOSED HOLIDAYS — NEXT: MONDAY, OCT. 14YCOL6MB0S^Y
DAY - TENDERED
<:e•''C., Y:; `, CHANGE--
CHECK NO.
SIGNATURE
t
NO. 2587
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.'
DUP01,:ATE TICKET CAD TICKET'.: WEIGHMASTER
�SOUTHOLD TOWN DEPT SOLID WASTE 00 01922851 Liz H
PO Box 962/6155'Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT ` :VEHICLE ROLL OFF
10/18/2 10/18/2 11:2 111 19606TC
9316 Town of Babylon f - .
REFERENCE
F__
-
SCALE 2 GROSS WT . 74320 LB Outbound Ticket
SCALE 1 TARE WT 34680 LB
-NET WEIGHT 39640 LB
ITY UNIT DESCRIPTION _RATE''-_ EXTENSION- FEE TOTAL
19.82 OUTGO.MSW 0.000 0.00 0.00 0.0e
-tiyt�,' „f'in• irl
_ fed• \`.�
i i
<
r,
Operating hours 7-:00 AM to 5:00 PM 7 days,''_week. ,` - - Foe
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 1COLUMBUS. '^'ti' '' TENDERED
DAY
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET_:.- ' GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922811 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE.IN DATE.OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE OR1GIN
SCALE 2 GROSS WT 74320 LB Outbound Ticket
SCALE 1 TARE WT 34680 LB
NET WEIGHT 39640 LB
QTY. UNIT• DESCRIPTION RATE- EXTENSION FEE TOTAL
19.82 OUTGO.MSW 0.000 0.00 0.00 0.0e
t'
Operating hours 7:00 AM to 5:00 PM 7 days a="week:`::_ -v •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14°,=,CO,LUMBUS
DAY i' ( r TENDERED
CHANGE
CHECK NO.
SIGNATURE
NO. 2588
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
1 HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE-
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT'THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED_
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE TICKET SITE TICKET,'-''' GRID, 1, WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01922996 Steph
PO Box 962/6155 Cox Lane -
Cutcho�ue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE " ROLL OFF
10/19/2 10/19/2 07:2 07: 19606TC
9516 Town of Babylon
REFERENCE ORIGiN
SCALE 2 GROSS WT 69500 LB Outbound Ticket
SCALE 1 TARE WT 35140 LB
NET WEIGHT 34360 LB
QTY UNIT DESCRIPTIONRATE EXTENSION ., FEE TOTAL -
17.18 OUTGO.MSW 0.000 0.00 0.00 0.0e->l�e• \- L+t
b,
Operating hours 7:00 AM to 5:00 PM 7 days aweek. _ }` 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14 - COLUMBUS.. TENDERED ,
DAY
Z, ; r CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID, WEIGHMASTER
SOUTHOLD TOWN DEPT--SOLID WASTE 00 01922996 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT -VEHICLE ROLL OFF'
9316 Town of Babylon 113/19/7-Z 113/19/2 07;2� U/;,+f 196061C
to]I Icy]
-
SCALE 2 GROSS WT 69500 LB Outbound Ticket
SCALE 1 TARE WT 35140 LB
NET WEIGHT 34360 LB
QTY. 'UNIT " DESCRIPTION. RATE EXTENSION - FEE TOTAL '
17.18 OUTGO.MSW 0.000 0.00 0.00 0.0e
ii
Operating hours 7:00 AM to 5:00 PM 7 days P`a week:`' _. "R " •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14' COLUMBUS'-•-
DAY TENDERED
CHANGE
CHEtK NO
SIGNATURE
NO. 2589
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION_
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER_:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR. DISPOSAL LOCATION TICKET NO.
SITE TICKET GRID WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01923521 Liz H
PO BOX 962/6155 COX Lane DATE IN DATE OUT TIME IN TIME OUT I,. VEHICLE ROLL OFF
Cutchogue, NY 11935
10/21/2 10/21/2 07:1 07:3 19606TC
9316 Town of Babylon
REFERENCE
SC:ALE GROSS WT 65960 LB Outbound Ticket
SCALE 1 TARE WT 35340 LB
NET WEIGHT 30620 LB
QTY. '_UNIT -DESCRIPTION --RATE EXTENSION FEE TOTAL
15.31 OUTGO.MSW 0.000 0.00 0.00 0.02
Operating hours 7:00 AM to 5:00 PM 7 daysa week® ,� r 3 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 `-:°'COLUMB�US;� C' r TENDERED
DAY U 7 1
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET- ' GRID' =` , WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01923521 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 65960 LB Outbound Ticket
SCALE 1 TARE WT 35340 LB
NET WEIGHT 30620 LB
QTY. UNIT. DESCRIPTION RATE EXTENSION FEE TOTAL
15.31 OUTGO.MSW 0.000 0.00 0.00 0.0Q
IF
tZ
,.
✓, .`�tl f �M i... � }ay
el
5 d
Operating hours 7:00 AM to 5:00 PM 7 days a�week�.,��_
CLOSED HOLIDAYS - NEXT: ' MONDAY, OCT. 14� COLUMBUS�-=-
DAY 4 AlTENDERED
r s 4
CHANGE
CHECK NO.
SIGNATURE
NO. 2590
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO. OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS:
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
1 HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
'TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/S-fATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW:
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED_
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR. DISPOSAL LOCATION TICKET NO.
.GRID`" ..; ;., , :'` VVEIGHMASTER '.. -
DUPLICATE TICKET .
SOUfHOLD TOWN DEPT SOLID WASTE 00 01923608 Liz H
PO Box 962/6155 Cox Lane -
CUtchogUe, NY 11935 DATE IN- D.ATE-OUT -TIME IN TIME OUT VEHICLE ROLL OFF' -
10/21/2 10/21/2 11:4 11:5 19606TC
9316 Town of Babylon
ORIGINREFERENCE
SCALE 2 GROSS WT 67340 LB Outbound Ticket
SCALE 1 TARE WT 35000 LB
ET WEIGHT 32340 LB
QTY _ ''UNIT -, , DESCRIPTION_ _ RATE ``EXTENSION-. FEE ,-_- TOTAL
16.17, OUTGO.MSW 0.000 0.00 0.00 0.0e
L p
� 3 r N, ✓ �.
Operating hours 7:00 AM to 5:00 PM 7 daysga Meek. ' .' ~`xi a • 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 s:COLUMBUS_ r r =s ,"' tl TENDERED'._'
DAY
ra CHANGE
CHECK NO: ..
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01923608 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN; DATEOUT TIMEIN' TIME`OUT 'VEHICLE "', ROLL OFF;,
9316 Town of Babylon
ORIGINREFERENCE
SCALE 2 GROSS WT 67340 LB Outbound Ticket
SCALE 1 TARE WT 35000 LB
NET WEIGHT 32340 LB
QTY UNIT.; `; °,DESCRIPTION•., ,RATE EXTENSION': FEE- „TOTAL`
16.17 OUTGO.MSW 0.000 0.00 0.00 0.0e
• wjtJ�"� ^a rosy
• TN �' vim-..:°.a"^.s�<K'3
Operating hours 7:00 AM to 5:00 PM 7 days awweek -. ?� _. -- a, A,
TENDERED;,,
CLOSED HOLIDAYS - NEXT: MONDAY 4 CO�L`UMBUS =� �'N .
DAY a OCT..
CHANGE,"
CHECK NO?
SIGNATURE
NO. 2591
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE,_ AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICA;E TICKET SITE TICKET.' 1 1 GRID I WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01923798 Steph
PO"Box 962/6155 Cox Lang DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
Cutchogue, NY 11935
10/22/2 10/22/2 10:5 11:1L 19606TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 :GROSS WT .76640 LB Outbound Ticket
SCALE 1 E WT 34540 LBNET WEIG 42100 LB
QTY. UNIT DESCRIPTION RATE EXTENSION '--__TEE TOTAL
21.05 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 daysa.week: _ r 0.0e
;.
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14-COLUMBUS,, TENDERED
DAY
CHANGE
CHECK NO:
SIGNATURE
DUPLICATE TICKET ; SITE . TICKET, GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01923798 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon Lv/�41] �V.j �.L.] L.7uvu I
REFERENCE ORIGIN
SCALE 2 GROSS WT 76640 LB Outbound Ticket
SCALE 1 TARE WT 34540 LB
NET WEIGHT 42100 LB
QTY. UNIT' DESCRIPTION RATE EXTENSION '_ FEE TOTAL.-
21.05 OUTGO.MSW •0.000 0.00 0.00 0.0e
<y
�.` `
Operating hours 7:00 AM to 5:00 PM 7 day a'week:� %`._. `� "' •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 '_COLUMBUS-------- 1 -was
DAY > f;r, �t'f?;, y e;V,ti f�'1 TENDERED
CHANGE
CHECK NO.
RMNATHRF
_ 11
NO. 2593
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
SALES: (COUNT):
TRUCK WEIGHT: ^ ` GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART'260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE,_ AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE . TICKET GRID WEIGHMASTER
SOUTHOL6 TOWN DEPT SOLID WASTE 00 01923745 Steph
POAbx 962/6155'Cox Lane
Cutchogue, NY 11935 DATE IN DATE,OUT" TIME IN TIME OUT VEHICLE ROLL OFF
10/22/2 10/22/2 07:1 07:3 19606TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 68760 LB Outbound Ticket
SCALE 1 TARE WT 35420 LB
NET WEIGHT 33340 LB
QTY. "UNIT DESCRIPTION RATE- EXTENSION -FEE TOTAL
16.67 OUTGO.MSW 0.000 0.00 0.00 0.0e
,�� L.4" ,S / ^�"• t ''. " rat
Operating hours 7:00 AM to 5:00 PM 7 days a Week*,-----' f` 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14`-`C'OLUMBUS' TENDERED
DAY �, ;,:;, ,. ;; { ,t�..t_. >,,
�y ZZZ2_;:_ CHANGE
CHECK NO.
SIGNATURE
SITE I TICKET_-`__ - GRID_- - , WEIGHMASTER_
SOUTHOLD TOWN DEPT SOLID WASTE ep
PO Box 992/6155 Cox Lane
Cutchogue, NY 11935
OA E I DAT OUT 'TIME IN-TIME OUT E 1 ,.,ROLL OFF
9316 Town of Babylon
REFERENCE
•-
CALF 2 GROSS WT 68760 LB Out oun Tic et
SCALE 1 TARE WT. 35420 LB
�NE�TWIEIGHT 33340 LB 7
QTY
•„,DESCRIPTION' ;', r RATE, EXTENSION FEE,. . TOTAL,
16.67 OUTGO.MSW 0.000 0.00 0.00
-z.;.,..
Lv'
s
Operating hours 7:00 AM to 5:00 PM 7 days "a`,We,e61
` s�---- :' ?` •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 CO"LUMBUS.__ z�
DAY e= s. €�°`°.. a L)
<s
r ��( TENDERED
rV
CHANGE
CHECK NO.
SIGNATURE
Y
NO. 2592
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING.TO,APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE I TICKET GRID WEIGH MASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01923947 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATEJN DATE OUT TIME IN TIME'OUT VEHICLE ROLLOFF
10/23/2 10/23/2 07:1 07:2 19606TC
9316 ,'(own of Babylon
REFERENCE
•-
FWEIGHT
SS WT 62600 LB Outbound Ticket
E WT 35760 LB
26840 LB
UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
13.42 OUTGO.MSW 0.000 0.00 0.00 0.0e
f�✓ +l t,a,, al_I141'_ `,i 1[^'J 3..,(1J f';s.' L.�r.�
t{
Operating hours 7:00 AM to 5:00 PM 7 days,a' week: 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14` COLUABUS, `-"-' ^?.
TENDERER
DAY
CHANGE
CHECK NO.
SIGNATURE
SITE s,TICK GRID GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 001 019239471 Step
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DA E IN . DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
SS T 62600 LB Out oun Tic et
SCALE 1 TARE WT 35760 LB
NET WEIGHT 26840 LB
QTY.
` UNIT DESCRIPTION RATE " EXTENSION FEE TOTAL
13.42 OUTGO.MSW 0.000 0.00 0.00 0.0e
If
Operating hours 7:00 AM to 5:00 PM 7 days 'ate week{°_ `•- °`' •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14�='7 COLUMBUS-
DAY C 'Z 2;% >`. ,a i `' TENDERED
CHANGE
„%�b.:� '.fir°•-"..
• CHECK NOj
SIGNATURE
NO. _ 2594
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANS PORTATION.ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE-
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION'PROVIDED
IS TRUE AND ACCURATE:
RECEIVE_D BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE TICKET GRID, WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01923999 Steph
PO Box '962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN_TIME OUT VEHICLE ROLL OFF
10/23/2 10/23/2 11:0 11:1 19606TC
9316 Town of Babylon
i REFERENCE
•-
SCALE 2 GROSS WT 72600 LB Outbound Ticket
SCALE 1 TARE WT 34420 LB
NET WEIGHT 38180 LB
QTY UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
19.09 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days,,a ,week. ' ,*,.w
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 ,COLUMBUS•.,. TENDERED''
DAY -
,,� CHANGE
• 1 CHECK NO.
SIGNATURE
SITE I TICKED-_;_ GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01923999 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE.OUT TIME I ° TIME OUT VEHICLE :ROLL OFF
9316 Town of Babylon
REFERENCE ORIGIN
CALE 2 GROSS WT 72600 LB Outbound Ticket
SCALE 1 TARE WT 34420 LB
NET WEIGHT 38180 LB
,OTY' UNIT, .' DESCRIPTION, RATE. {EXTENSION
19.09 OUTGO.MSW 0.000 0.00 0.00 0.0e
x �:o n*
Operating hours 7:00 AM to 5:00 PM 7 days a,.week`.,, y .
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 t=�COLUM_BUS--___.�
DAY ° �`d.,` ti jfit,. •-axf� '��y' TENDERED
CH NGE
CHECK NO.
SIGNATURE '
N0. 2595
J
• i
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:,
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT- GROSS
TARE
{ NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260..10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO.APPLICABLE REGULATION.
A �Lfi
GENERATOR AUTHORIZED AGENT(PRINT NAME) _ (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE-
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE_, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY_: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE TICKET SITE TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01924192 Steph
PO Box 962/6155 Cox Lane - DATE IN-- DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
Cutchogue, NY.i11935
.. 10/24/2 10/24/2 11:3 11:4 19606TC
9316 Town of Babylon
REFERENCE
•.
SCALE 2 GROSS WT 73200 LB Outbound Ticket
SCALE 1 TARE WT 34640 LB
NET WEIGHT 38560 LB
QTY UNIT DESCRIPTION °` RATE EXTENSION;=° FEE TOTAL
19.28 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days,a week.,"-'--'-' 0.0.e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 `-:;gOLUMBUS;F, .' °.`' r .` TENDERED
DAY
CHANGE,
CHECK NO::::l
SIGNATURE
DUPLICATE TICKET SITE TICKET `. GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01924192 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN • DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE if ORIGIN
GALE 2 GROSS WT 73200 LB Outbound Ticket
SCALE 1 TARE WT 34640 LB
�NETIWEIGHT 38560 LB
QTY '" ''_' UNIT DESCRIPTION,'_',.- RATE EXTENSION',' FEE TOTAL:
19.28 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days, a;5week ^�__ F ' ^`x ` + , •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 -, COLU,MBUS- -— ' � A,,• ,(`,
DAY `5 ti i ?t TENDERED
e` r.t91f;•I_ 'la'` f, •,
'I 1
-CHANGE
CHECKNO:::j
SIGNATURE
a,
NO. 2597
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
{ NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED'BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE SITE TICKET GRID WEIGHMASTER
" ,.CET
SOUTHOLD �N{DEPT SOLID WASTE 00 01924112 Steph
PO -Box ' 0155 Cox Lane
Cut Cho•' NY'I 11935 DATE IN DATE OUT TIME IN- TIME OUT VEHICLE ROLL OFF
10/24/2 10/24/2 07:2 07:4 19606TC
9316 Town of Babylon
REFERENCE
•-
I
SCALE 2 GROSS WT 71600 LB Outbound Ticket
SCALE 1 TARE WT 35240 LB
NET WEIGHT 36360 LB
QTY. UNIT DESCRIPTION' RATE EXTENSION'-- FEE '- TOTAL ,
18.18 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days,a,,Aweek:�,;=--
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14 -a_CO�LUMBUS
TENDERED
DAY
CHANGE.,;.,,.: ,
CHECK NO,
SIGNATURE
DUPLICATE TICKET. SITE TICKET I GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE ep
PO Box 9.62/6155 Cox Lane
Cutchogue, NY 11935 -
D TI I TI UT I ROLL OFF
9316 Town of Babylon
REFERENCE ORIGIN
U01bound IICKef
7WEIGHT
E WT 35240 LB
36360 LB
UNIT" "'". DESCRIPTION RATE` „'EXTENSION''<, FEE'• ,TOTAL;
,
F✓,, `*<`S,'- ``. 'rig%:'•'} i
-
Operating hours 7:00 AM to 5:00 PM 7 days a` w'eekA > '4 __._-: •
�Y ;• -
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14,(' COLUMBUS-
DAYS TENDERED
CHANGE,-
' CHECK NO.
SIGNATURE
NO. 2596
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
I
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I'HEREBYCERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVE_D BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
SITE' „TICKET, GRID", ,
WEIGHMASTER'
DUPL7KATE TICKET
-,SOUfHOLD TOWN DEPT SOLID WASTE 00 01924364 Liz H
PO Box 962/6155 Cox Lane
CUtchogUe, NY 11935 DATE iN DATE OUT TIME It3 TIME OUT ;VEHICLE ^-ROLI OFF;
10/25/2 10/25/2 10:1 10:5 11103TC
9316 Town of Babylon
REFERENCE
SC:ALE GROSS WT 74500 LB Outbound Ticket
SCALE 1 TARE WT 36100 LB
NET WEIGHT 38400 LB
QTY _ `'UNIT-- DESCRIPTION _ RAM - EXTENSIONFEE.
19.20 OUTGO.MSW 0.000 0.00 0.00 0.0e
1„' •-ate__,. ..:�'i' �,;F
' a -
Operating hours 7:00 AM to 5:00 PM 7 daysl.a `week.` _'. 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 - CdLUMBUS:, -:-=-TENDERED`
DAY
CHANGE,
',CHECKNO.^
SIGNATURE
ITE TICKET
DUPLICATE TICKET S ' GRID, W_ EIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01924164 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 r DATE 1N=, DATE OUT TIME IN;TIME,OUT ';VEHICLE ROLL OFF
9316 Town of Babylon
ORIGINREFERENCE
SCALE 2 GROSS WT 74500 LB Outbound Ticket
SCALE 1 TARE WT 36100 LB
NET WEIGHT 38400 LB
Q_TY ".',;, lJN►T----' DE$CRIPT(ON FAT Ep EXTENSION_ FEE .' TOTAL.;- _
19.20 OUTGO.MSW 0.000 0.00 0.00 me
Operating hours 7:00 AM to 5:00 PM 7 days asweek: m'
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14`>-° COLUMBUS•h`. A'
_> ``" TENDERED'
DAY
CHANGE
,C ECK NOr,•4
cir_nieTi icG
NO. 2598
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW.IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
1 HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
1 HEREBYCERTIFYTHATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE TICKET SITE I TICKET'_, I GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01924557 Dan
,Ln_,dox-962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN,,TIME OUT VEHICLE ROLL OFF
10/26/2 10/26/2 07:1 07:2 11103TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE :GROSS WT 73180 LB Outbound Ticket
SCALE E WT 36480 LB
NET WE 36700 LB
QTY., UNIT - DESCRIPTION RATE EXTENSION FEE TOTAL
18.35 OUTGO.MSW 0.000 0.00 0.00 me
" I,
\ Z
T
w..r.
Operating hours 7:00 AM to 5:00 PM 7 days.,a":week:`�:_, � 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 "-,"'66 UMBUS� " " . TENDERED'
DAY
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE I TICKET GRID_ WEIGHMAS_TER-
SOUTHOLD TOWN DEPT SOLID WASTE F
0 01924557 an
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DA E IN DATE OUT TIME IN_ TIME OUT VEHICLE -ROLL OFF
9316 Town of Babylon
REFERENCE
CALE 2 GROSS WT 73180 LB Out oun Tic et
SCALE 1 TARE WT 36480 LB
NET WEIGHT 36700 LB
CITY UNIT, '' „DESCRIPTION; fiATE -EXTENSION ",'.FEE„ TOTAL
18.35 OUTGO.MSW 0.000 0.00 .0.00 0.0e
= \ ; CV
Operating hours 7:00 AM to 5:00 PM 7 days aweek 4 __,--, % ' { •
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14+L- COLUMBUS-- '
�,s � r'
DAY _ ^rXi� 'ar 'i-�"i� {\as'� �*',> TENDERED
CHANGE
CHECK NO.
:)
RIr,NATIIRF
_r
NO. _ 2599
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS_
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THL SHIPMENT OF SUCH MATERIALS:
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
i TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED;CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION_
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE TICKET "SITEJ, . TICKET GRID j WEIGHMASTER
-
SOUTNOLD TOWN DEPT SOLID WASTE 00 01925102 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
10/28/2 10/28/2 07:1 07:2 11103TC
9316 Town of Babylon
REFERENCE
LCE
•.
SCALE 2 GROSS WT 66580 LB Outbound Ticket
SCALE 1 TARE WT 37140 LB
NET WEIGHT 29440 LB
QTY UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
14.72 OUTGO.MSW 0.000 0.00 0.00 0.0e
t`
Operating hours 7:00 AM to 5:00 PM 7 days. a week:`--. ~. 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 = COLUMBUS J ;f ":` ,"TENDERED
q31a
DAY
CHANGE
CHECK NO.-
SIGNATURE
DUPLICATE TICKET SITE I TICKEE__ GRID` WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01925202 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN. 'DATE OUT TIME IN'- TIME OUT VEHICLE .:;;ROLL OFF,
9316 Town of Babylon
REFERENCE
•.
CALE 2 GROSS WT 66580 LB Outbound Ticket
SCALE 1 TARE WT 37140 LB
�NE�TWEIGHT �29440 LB
QTY.
UNIT, ' DESCRIPTION„ RATE EXTENSION FEE _-:..TOTAL,
14.72 OUTGO.MSW 0.000 0.00 0.00 0.0e
a rF`t'•'Ir t,6� �:." �r' `+yam`',"; `
'tq
•y,, ,..r „ .. `., �t r=ram v •
Operating hours 7:00 AM to 5:00 PM 7 days "a„weeki
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14�_ COLUMBUS-__'____ '
DAY1'`r TENDERED
..�,4iR r-•„ tlµµ.,.•Y,x,'.a'c`✓-{ .t .CHANGE
CHECK NO.:::j
SIGNATURE
NO. 2600
GENERATOR
f THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU.YbS)
BALES:(COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
l HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
e ,
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
t
SITE ' TICKET I GRID, I WEIGHMASTER
DUPLICATE TICKET
SC; THOLD TOWN DEPT SOLID WASTE 00 01925182 Liz H
.fP6 �ox 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
10/28/2 10/28/2 11:2 11:3 11103TC
9316 Town of Babylon REFERENCE ORIGIN
SCALE 2 GROSS WT 72000 LB Outbound Ticket
SCALE 1 TARE WT 35620 LB
NET WEIGHT -36380 LB
QTY. UNIT DESCRIPTION RATE EXTENSION :FEE TOTAL
18.19 OUTGO.MSW 0.000 0.00 0.00 me
r'
Operating hours 7:00 AM to 5:00 PM 7 days,a`'week '` '
Foe
HOLIDAYS - NEXT: MONDAY, OCT. 14 - .,COLUMBUS.,,
TENDERED
DAY
: CHANGE
.CHECK NO.-
SIGNATURE
DUPLICATE TICKET _SITE I TICKET__. ' GRID_ WEIGHMASTER,
SOUTHOLD TOWN DEPT SOLID WASTE 00 01925182 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 72000 LB Outbound Ticket
SCALE 1 TARE WT 35620 LB
NET WEIGHT 36380 LB 7
QTY UNIT ;, DESCRIPTION RATE EXTENSION >,FEE TOTAL, 7
18.19 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14�r, COL' BUS`--- --" ;, � :
TENDERED
DAY
ztz�, r; CHANGE
CHECK NO.
__j
G.1l�..1 ATI I�G
NO. 2604
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
.SITE' ' TICKET'' GRID..: WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01925344 Steph
P#0 Box 962/6155 Cox Lane
Cutchogue, NY 11935 ,:°:DATEIN` DATEOUT ;' TIMEIN`TIME OUT VEHICLE ROLL'OF.F;
10/29/2 10/29/2 07:2 07:4 11103TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 69840 LB Outbound Ticket
SC:ALE TARE WT .37140 LB
NET WEIGHT 32700 LB-
_---,'QTY UNIT ', «DESCRIP-TION RATE - EXTENSION' = FEE i07AL' '_`
16.35 OUTGO.MSW .0.000 0.00 0.00 0.0e
rj
Aj •
Operating hours 7:00 AM to 5:00 PM 7 days-,a`w"eek.` �'..,-' 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 :,„COL:UMBUS r . ;.::TENDERED
DAY `•
'CHANGE-"
'CHECK NO
SIGNATURE
DUPLICATE TICKET SITE _ _ -TICKET GRID' VV_EIGHMAST_ER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01925344 1 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN : DATEOUT ` ,.TIMEIN`TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
REFERENCE ORIGIN
CALE 2 GROSS WT 69840 LB Outbound Ticket
SCALE 1 TARE WT 37140 LB
NET WEIGHT 32700 LB
` DESCRIPTION -RATE-'.,,, EXTENSION?.: ":FEE " w,TpTAL-
QTY UNIT _'
16:35 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days a=week:
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14`,' .COLUMBUS
TENDERED
DAY
;CHECK NO:
SIGNATURE
�J
I .M
NO.
2605
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE 'LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR-TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE "TICKET SITE TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01925439 Steph
PO BOX 962/6155 Cox Lane Cbtehogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
10/29/2 10/29/2 12:0 12:1 11103TC
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 69380 LB Outbound Ticket
SCALE 1 TARE WT 35580 LB
NET WEIGHT -33800 LB
-OTY UNIT DESCRIPTION RATE. EXTENSION FEE TOTAL
16.90 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days ek,a we `' �F,,."" 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 -,§,COLUMB,USjA - rz ;;~' TENDERED
DAY t aµFxF
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID ' WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01925439 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 `"'DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
CALE 2 GROSS WT 69380 LB Outbound Ticket
SCALE 1 TARE WT 35580 LB
NET WEIGHT 33800 LB
ETENSIODESCRIPTION, RATE 1
FEE TOTAL,
' 16.90 OUTGO.MSW / y 0.000 0.00 0.00 me
�� .•.
Operating hours 7:00 AM to 5:00 PM 7 days a.-week:
CLOSED HOLIDAYS - NEXT: MONDAY OCT. 14L7' COLUMBUS--•-•_ { ^ `(-� 0.'
i ;c• TENDERED
DAY
CHANGE
CHECK NO.
CI!_61 ATl Ina
No 2606
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION.TICKET NO.
SITE TICKET GRID WEIGHMASTER
SONTHOLD TOWN DEPT SOLID WASTE 001 01925650 Steph
PQj Box 962/6155 Cox Lane• -
C'eitchogue, NY 11935 DATE IN DATE OUT. TIME IN TIME OUT VEHICLE, ROLL OFF'
r 10/30/24 10/30/24 12:22 12:35 11103TC
9316 Town of Babylon
REFERENCE
�.
SCALE 2 GROSS WT 73380 LB' Outbound Ticket
SCALE 1 TARE WT 36240 LB
ET WEIGHT 37140 LB
OTY. UNIT DESCRIPTION - RATE EXTENSION FEE - i TOTAL --
18.57 OUTGO.MSW 0.000 0.00 0.00 0.0e
Opt 3 6 �, _; �a� •
` ., , ..,.
Operating hours 7:00 AM to 5:00 PM 7 days a week..4'���,�' t 0..0e
CLOSED HOLIDAYS - NEXT: . MONDAY, OCT. 14 - COL UMBUS-, �Z TENDERED.
DAY U 9
CHANGE
CHECK NO.'
SIGNATURE
SITE TICKET GRID WE_IGHMASTER
SOUTHOLD TOWN DEPT50 LID WASTE 00 01925650 1 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN , DATE OUT TIME IN TIME OUT VEHICLE I ROLL OFF'
9316 Town of Babylon
REFERENCE
�.
SCALE :2GRO'SS WT 73380 LB Outbound Ticket
SCALE E WT 36240 LB
NET WE 37140 LB
CITY. UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
18.57 OUTGO.MSW 0.000 0.00 0.00 0,.0e
oil;
In
Operating hours 7:00 AM to 5:00 PM 7 days a eekk'1-yp c`rO
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14OLUMBUS
DAY .z`- TENDERED
IV� �
C NGE
CHECK NO.
SIGNATURE
f
f
♦I
NO.
2607
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
SALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION-FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE]-`
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
DUPLICATE TICKET SITE TICKET 'GRID WEIGHMASTER
SOUTk 5 TOWN DEPT SOLID WASTE 00 01925829 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT, TIME IN TIME OUT VEHICLE ROLL OFF ,
10/31/2 10/31/2 11:0 11:1 11103TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 75080 LB Outbound Ticket
SCALE 1 TARE WT 35820 LB
NET WEIGHT 39260 LB
QTY UNIT DESCRIPTION RATE- EXTENSION , -FEE TOTAL
19.63 OUTGO.MSW 0.000 0.00 0.00 me
tY
,.w
Operating hours 7:00 AM to 5:00 PM 7 days,.a,week.`"-, ,:;
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 `=KCOLUMB,US,, TENDERED
DAY
CHANGE-
I
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE <.TICKET, b GRID_ ,.WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01925829 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT j TIME IN ITIME OUT VEHICLE ROLL OFF° ,
9316 Town of Babylon
REFERENCE ORlGiN
CALE 2 GROSS WT 75080 LB Outbound Ticket
SCALE 1 TARE WT 35820 LB
NET WEIGHT 39260 LB
CITY. UNIT"' 'DESC_RIPTION'' RATE' EXTENSION' FEE " TOTAL
19.63 OUTGO.MSW 0.000 0.00 0.00 0.0¢
v) r
'.3�' +•L'. i; .tit`` �1
Operating hours 7:00 AM -to 5:00 PM 7 days a week,:
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14',?, COLUMBUS'_',
DAY ` jr "`f Y TENDERED
c :• `
,. p C:'a: :is r.'•» CHANGE
HECK NO. '
CM(.`,NATI IRF
NO. 2609
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART'260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED;CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
e`
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.
AU`LICATE TICKET SITE I TICKET 1 , GRID-, WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01925764 Liz H
-PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATEOUT TIME IN TIME OUT VEHICLE ROLL OFF
10/31/2 10/31/2 07:"07:4 03TC
C=E9316 Town of BabylonREFERENCE -
SCALE 2 GROSS WT 71220 LB Outbound Ticket
SCALE 1 TARE WT 36740 LB
NET WEIGHT 34480 LB
ITY. UNIT - DESCRIPTION RATE EXTENSION FEE TOTAL
17.24 OUTGO.MSW 0.000 0.00 0.00 0.02
Operating hours 7:00 AM to 5:00 PM 7 days•a"week:` " 0.02
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 COLUMBUS.,..,_ �� ,, � -
TENDERED,DAY
,f ,• - CHANGE
j
CHECK NO.-
SIGNATURE
DUPLICATE TICKETKSITEJ TICKET - GRID -WEIG_ HMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01925764 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
CALE 2 GROSS WT 71220 LB Outbound Ticket
SCALE 1 TARE WT 36740 LB
NET WEIGHT 34480 LB
CITY. UNIT DESCRIPTION, RATE- EXTENSION FEE TOTAL
17.24 OUTGO.MSW _ 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days, a,week`:', -- _, -_-
CLOSED HOLIDAYS - NEXT: •MONDAY, OCT. 14='= COLUMBUS_-.__
DAY °•r, ?r !f. ~ -'r TENDERED
CHANGE
CHECK NO.
.R1r,NATI IRF
No. 2608
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
TARE
NET
1 HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 CFR PART 260.10 OR ANY
APPLICABLE STATE LAW,IS NOT HAZARDOUS WASTE AS DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TQ APPLICABLE REGULATION.
a
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE-
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: DATE DELIVERED:
ADDRESS:
1 HEREBY CERTIFY THATTHE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
IS TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATION
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR DISPOSAL LOCATION TICKET NO.