HomeMy WebLinkAbout02/2025 SITE "TICKET GRID WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01947147 Dan
PO Box 96216155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN;TIME OUT VEHICLE' ROLL OFF
02/01/2 i '02/01/2 07:0 07:1 11103TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 69940 LB Outbound Ticket
SCALE 1 TARE WT 36400 LB
NET WEIGHT 33540 LB
QTY UNIT DESCRIPTION RATE EXTENSION FEE -TOTAL -
16.77 OUTGO.MSW 0.000 0.00 0..0.0 0.0e
P ��
A' • � pip
�s a
1
a ,
Operating hours 7:00 AM to 5:00 PM 7 days a week 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 oCOLUMBUS � ` TENDERED"
DAY
4 � 5
r Ja CHANGE
. ...::CHECK NO°'-..
SIGNATURE-
DUPLICATE TICKET SITE TICKET GRID, WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01947147 Dan
PO Box 962/6155 Cox Lane
CU tChOgUe, NY 11935 ,,DATE IN DATE'OUT TIME IN';TIME OUT .•.VEHICLE ,.ROLL OFF
9316 Town of Babylon
REFERENCE
•-
CALE 2 GROSS WT 69940 LB Outbound Ticket
SCALE 1 TARE WT 36400 LB
NET WEIGHT 33540 LB
QTY UNIT.3.• ^. DESCRIPTION ;. `RATE "EXTENSION" FEE' TOTAL
16.77 OUTGO.MSW 0.000 0.00 0.00 0.0e
y .
Q.
1
'V f
Q
tr
Operating hours 7:00 AM to 5:00 PM 7 days
CLOSED HOLIDAYS - NEXT: MONDAY, OCT. 14 " COLUMBUS--_.__.
DAY .E1';f :,. TENDERED
i
CHANGE
' 1 CHECK N09
SIGNATURE
NO. 2726
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/STAVE:
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 01947465 Liz H
PO Box 962/6155 Cox Lane
tutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
02/03/25 02/03/25 07:1 07:2 11103TC
931:6 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 70660 LB Outbound Ticket
SCALE 1 TARE WT 36720 LB
ET WEIGHT 33940 LB
OTY. UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
16.97 OUTGO.MSW.. 0.000 0.00. 0.00' 0.06
4 y-
rs
Operating hours 7:00 AM to 5:00 PM 7 daysa week. 0.02
Aj
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17, 2025, TENDERED
PRESIDENT'S DAY `si ..
CHANGE
CHECK NO.
-SIGNATURE--- - - - --
DUPLICATE TICKET SITE I TICKET GRID I WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01947465 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 70660 LB Outbound Ticket
SCALE 1 TARE WT 36720 LB
NET WEIGHT 33940 LB
CITY. UNIT DESCRIPTION RATE 'EXTENSION FEE` 'TOTAL
16.97 OUTGO.MSW 0.000 0.00 0.00 0.0e
�C
t
f'
F L:1 O t t x n
`alb �¢ �' � ^� s•. ' °r.,,'�;`.,
AV,
•
Operating hours 7:00 AM to 5:00 PM 7 days a week.
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17.,2.025 A 4
PRESIDENT'S DAY `' TENDERED
CHANGE
CHECK NO.
AI(:NATI IRF
NO. 2727
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 CERTIFYTHAT 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 01947493 Liz H
PO Box 962/6155 Cox Lane , DATE OUT TIME IN _fIME OUT VEHICLE ROLL OFF
Cutc�togue, NY 11935' DATE IN
02/03/25 ' 02/03/2 10:4 10:5 11103TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 67820 LB Outbound Ticket
SCALE 1 TARE WT 36700 LB
NET WEIGHT 31120 LB
OTY UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
15.56 OUTGO.MSW 0.000 0.00. 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days4� week: 0.0e
a d
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 1g, 2025 } TENDERED
PRESIDENT'S DAY �! � � �`� '
'�...,�... �d y �.."'
CHANGE
• 1 CHECK NO.
SIGNATURE -
DUPLICATE TICKET SITE I TICKET I GRID WEIGHMAST.Ui
SOUTHOLD TOWN DEPT SOLID WASTE 00 01947493 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
•-
CALE 2 GROSS WT 67820 LB _Outbound Ticket
SCALE 1 TARE WT -36700 LB
NET WEIGHT 31120 LB
CITY. UNIT DESCRIPTION ' RATE EXTENSION FEE "' TOTAL
15.56 OUTGO.MSW 0.000 0.00 0.00 0.0e
1 UU
_ 1 i
Operating hours 7:00 AM to 5:00 PM 7 days,.a
CLOSED HOLIDAYS - 'NEXT: MONDAY FEBRUARY'1]7,,I'2025 '4'
PRESIDENT'S DAY ,r TENDERED
? o
CHANGE
-CHECK NO:
cr_nnTi roc '
L
14
NO. 2728
GENERATOR
THIS MANIFEST IS FOR REFERENCEPURPOSES 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:
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 001 01947636 Will
PO Box 962/6155 Cox Lane _-
�2utchogue, NY 11935 DATEIN DATE OUT TIME IN TIME OUT VEHICLE ROLL-OFF
02/04/25 02/04/25 10:4 11:0 11103.TC
,9316 Town of Babylon
REFERENCE
.4
•�
SCALE 2 GROSS WT 65660 LB Outbound .Ticket
SCALE 1 TARE WT 36320 LB
NET WEIGHT 29340 LB
QTY. ,, UNIT DESCRIPTION RATE• EXTENSION_ FEE -TOTAL,
14.67 OUTGO.MSW 0.000 0.00 0:00 0.02
06 W gym '
P
v
Operating hours 7:00 AM to 5:00 PM 7 days_a week: - '
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY`17, 2025 �. ,
PRESIDENT'S DAYftq
p1}( `;' �� TENDERED
CHANGE
CHECK N
- - - SIGNATURE — --- — - - -
DUPLICATE TICKET SITE I TICKET ..,. - GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE b Wlil
r.
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 E-1N T O T E IN TI O V ROLL.OFF
9316 Town of Babylon
REFERENCE
•-
A0 u oun Ticket
SCALE 1 TARE WT 36320 LB
NET WEIGHT 29340 LB
QTY. UNIT DESCRIPTION RATE EXTENSION_ FEE TOTAL
14.67 OUTGO.MSW- 0.000 0.00 0.0
r
� t
i
61 �' tvs.F .��' 1rF, 7 "o
i 1
�yl
Operating hours 7:00 AM to 5:00 PM 7 days, a` week: •
CLOSED-HOLIDAYS - NEXT: MONDAY FEBRUARY'1�7, 2-025 �3 .: �
PRESIDENT'S DAY t ts; TENDERED
t i.•
L J
CHANGE
CHECK NO.
CI(�NATI IRF
NO. 2731
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:
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'' ;, WEIGHMASTER'
DUPLICATE TICKET
h SOUTHOLD TOWN DEPT SOLID WASTE 00 01947599 Will
PO Box 962/6155 Cox Lane
CUtChOgUe, NY 11935 DATE IN,' DATE OUT TIME IN TIME'QUT VEHICLE: ROLL OFF
02/04/25 02/04/25 07:1 07:2 11103TC
9316 Town of Babylon
REFERENCE
�.
SCALE 2 GROSS WT 74280 LB Outbound Ticket
SCALE 1 TARE WT 35900 LB
ET"WEIGHT 38380 LB
';QTY. " UNIT DESCRIPTION RATE EXTENSION .FEE' TOTAL;
19.19 OUTGO.MSW 0.000 0.00 0.00 0.0e
PIZ
�, p 1171.
N2,
r _� b
vp
dt4i.V-L� P9k �{ 3 x.. .amt j Yq
Operating hours 7:00 AM to 5:00 PM 7 days a week..- 0.0e
a _
CLOSED HOLIDAYS - NEXT: MONDAY FfBRUARY 17, 2025�s P, ��� F�j � �eTENDERED
PRESIDENT'S DAY
:CHANGE'
_ CHECK NO
SIGNATURE
DUPLICATE TICKET SITE TICKET . GRID` ' WEI'GHMASTER
_ r .'.
S06THOLD TOWN DEPT SOLID WASTE 00 01947599 1 Will
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 74280.. LB Outbound Ticket
SCALE 1 TARE WT 35900 LB
NET WEIGHT 38380 LB
QTY - UNIT •,DESCRIPTION RATE EXTENSION' ., '`• FEE TOTAL
19.19 OUTGO.MSW ' 0.000 0.00 0.00 0.0e
� bSaI �
ap - -
Y= '4S 3 Y
Operating hours 7:00 AM to 5:00 PM 7 days'r.ea week:
d
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY'147,,-2025
PRESIDENT'S DAY � � vl', TENDERED
P
r ' CHANGE
CHECK NO:
SI[.NATIIRF
M
NO. 2730
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:
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," .-WEIGH ER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01947740 Steph
PO Box 962/6155 Cox Lane
Cut�hoguL'; NY 11935 DATEIN' z ,DATE OUT TIME,IN,TIME OUT `VEHICLE ROLL OFF;
02/05/25 02/05/2 07:1 07:3 11103TC
9316. Town of Babylon
ORIGINREFERENCE
SCALE 2 GROSS WT 83120 LB Outbound Ticket
SCALE 1 TARE WT 36440 LB
ET WEIGHT 46680 LB
"UNIT .r'' ks ; •,'_. . :`iDESCRIPTION.. :.RATE EXTENSION, FEE TOTAL,°
23.34 OUTGO.MSW �0.000 0.00 0.00 0.0e
OW
s r ��
}
Y .
ANKOWLOperating hours 7:00 AM 'to 5:00 PM 7 days-,a week.`
�� - 0 0e
CLOSED HOLIDAYS - NEXT: MONDAY, FEBRUARY 17, 2025,,E F � ;TENDERED ,� `
PRESIDENT'S DAY � �� �
CHECK NO
SIGNATURE
SITE TICKET GRID'; WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01947740 Sep
PO Box 962/6155 Cox Lane
CutChogUe, NY 11935 :DATE IN ', .,°DATE OUT 71ME.I TtMEOUT UEH[CLE FtOLLOFF,
05,
9316 --Town of Babylon
REFERENCE
CALE 2 GROSS WT 83120 LB Outbound Ticket
SCALE 1 TARE WT 36440 LB
NET WEIGHT 46680 LB
,��VTTT7776 -=.UNIT QESCRIPTION RATE, IXTENSION ,--3 F_EE TOTALi'=
23.34 OUTGO.MSW 0.000 0.00 0.00 0.0e
wl
4, f
Z � £
Operating hours 7:00 AM to 5:00 PM 7 days 6,4eek<'
CLOSED HOLIDAYS - NEXT: - MONDAY FEBRUARYA7,-2025.
PRESIDENT'S DAY } , 7,s `� - TENDERED•`
"'�.�
CHANGE '
CHECK NO
.. cir_�n�•i goo' .-..,. .
NO. 2733
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 TRANSPORTATIONACCORDING 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 I WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01947858 Liz H
PO Box 962/6155 Cox Lane _
` Cutchogue, NY 11935 DATE IN DATEOUT' TIMEIN TIMEOUT VEHICLE ROLL OFF
02/06/2 02/06/2 07:0 07:1 11103TC
9316 "' Town of Babylon
REFERENCE OR1GIN
SCALE 2 GROSS WT - 76860 LB Outbound Ticket
SCALE 1 TARE WT 36720 LB
NET WEIGHT 40140 LB
QTY. UNIT :=w ., • DESCRIRT.ION c RATE :'' EXTENSION'; a'. . FEE '`.- a" TOTAL "4
20.07 OUTGO.MSW 0.000 0.00 0.00 0.0e
t� ' �
Operating hours 7:00 AM to 5:00 PM 7 days,a week` Me
CLOSED HOLIDAYS - NEXT: - MONDAY FEBRUARY'17, ,2025 `{
PRESIDENT'S DAY TENDERED
, CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE I TICKET GRID WEIGHMASTER .
SOUTHOLD TOWN DEPT SOLID WASTE 00 01947858 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 76860 LB Outbound Ticket
SCALE 1 TARE WT 36720 LB
NET WEIGHT 40140 LB
_.OTY UNIT , DESCRIPTION . RATE EXTENSION-, _ FEE TOTAL
20.07 OUTGO.MSW 0.000 0.00 0.00 me
Y"t
(� h
7
Operating hours 7:00 AM to 5:00 PM 7 days a week.
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 47,}2025
PRESIDENT'S DAY `` + °°r t�, ��l ''
JENDEREd'
CHANGE
CHECK NO. ..
CI(�NATIIRF
NO. 2734
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 001 01947906 Liz H
PO Box 962/6155 Cox Lane
;4UtChOgUe, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
02/07/25 02/07/25 07:2 07:51 11103TC
9316 Town of Babylon r
REFERENCE
•-
SCALE 2 GROSS WT 75720 LB Outbound Ticket
SCALE 1 TARE WT 36040 LB
ET WEIGHT 39680 LB
CITY UNIT DESCRIPTION RATE EXTENSION FEE TOTAL.
19.84 OUTGO.MSW •0.000 0.00 0.00 0.02
r` ,r
vdz :z,
on ml
Operating hours 7:00 AM to 5*00 PM 7 day�a week: r= �4 0.02
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17, 2025 ` AV
PRESIDENT'S DAY '` ii i y �' r` TENDERED
` CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET .SITE TICKET -GRID 1WEIGH
MASTER
SOUTHOLD TOWN DEPT SOLID WASTE 001 01947906 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
ORIGINREFERENCE
CALE 2 GROSS 14T 75720 LB Outbound Ticket
SCALE 1 TARE WT 36040 LB
NET WEIGHT 39680 LB
CITY. UNIT DESCRIPTION RATE EXTENSION` FEE TOTAL
19.84 OUTGO.MSW 0.000 0.00 0.00 0.02
7y, z"'
r!
Operating hours 7:00 AM to 5:00 PM 7 days, a,week � r ,
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY,_ii 2025 y „ '
PRESIDENT'S DAY
TENDERED
'CHANGE
CHECK NO.
01!_Kf A"IBC 7
,
i
NO. 2735
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.
SITE TICKET GRID WEIGHM'ASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 001 / 01948033 Ste.ph
PO Box 962/6155-.C6x Lane
Cutchogue, NY 11935 DATE IN DATE OUT 1 TIME IN TIME OUT ,'VEHICLE ROLL OFF
02/08/2.5 02/08/25 07:1 07:37 111037C
9316 Town of Babylon
ORIGINREFERENCE
SCALE 2 GROSS WT 86260 LB Outbound Ticket
SCALE 1 TARE WT 37080 LB -
ET WEIGHT 49180 LB
QTY UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
24.59 OUTGO.MSW .0.000 0.00 0.00 0.0e
s T � � .
S,1V sf�
Operating hours 7:00 AM to 5:00 PM 7 days-s-�-,,a week.` ' 0.0e
CLOSED. HOLIDAYS - NEXT: MONDAY FEBRUARY 171 202'5t ' '4`
TENDERED.
PRESIDENT'S DAY :;/ter HIEa k;" t
=w.,,°"a`zra .-CHANGE-
CHECK NO.:',
SIGNATURE
DUPLICATE TICKET SITE I TICKET" GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 001 01948033 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 86260 LB Outbound Ticket
SCALE 1 TARE WT 37080 LB
NET WEIGHT. 49180 LB
QTY. UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
24.59 OUTGO.MSW 0.000 0.00 0-00 0.0e
1 r+
_ yit
Operating hours 7:00 AM to 5:00 PM 7 days a�week:-
rr
CLOSED HOLIDAYS - NEXT: - MONDAY' FEBRUARY'1.7, {2025
PRESIDENT'S DAY ��j" "�.a TENDERED
' t'�..5 c ._•4.r; CHANGE
CHECK NO.
SIGNATURE-
,
NO. 2736
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 THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
1S TRUE AND ACCURATE:
RECEIVED BY:
AUTHORIZED AGENT(PRINT NAME) - SIGNATURE/DATE
KEY: WHITE TO DISPOSAL LOCATI.ON_
GREEN TO TRANSPORTER
YELLOW TO TRANSPORTER.
PINK TO GENERATOR
GOLD TO GENERATOR. DISPOSAL LOCATION PICKET NO.
SITE TICKET GRID ;"WEIGHMASTER
DUPLICATE TICKET
SOUTHOI,D TOWN DEPT SOLID WASTE 00 01948250 Liz H
PO,Box' 962/6155 Cox Lane
Cutch6gue, NY 11935
DATE fN' . .DATE OUT , TIME tN' TIME OUT VEHICLE`' _' ROLL OFF. `
02/10/25 02/10/25 07:3 08:1 11103TC
9316 Town •of Babylon
REFERENCE
SC:ALE GROSS WT 74000 LB Outbound Ticket
SCALE 1 TARE WT 35900 LB
NET WEIGHT .38100 LB
QTY. UNIT'_ DESCRIPTION''. :. RATE :; EXTENSION FEE TOTAL; '
19.05 OUTGO.MSW 0.000 0.00 0.00 0.0e
1r
*' �
k
Operating hours 7:00 AM to 5:00 PM 7 daya�week: 0.0e
8
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17 2025
? ;TENDERED
PRESIDENT'S DAY K.
4 CHANGE
CHECK NO:. ."
SIGNATURE
DUPLICATE TICKET SITE 'TIGKEf GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01948250 Liz H
PO Box 962/6155 Cox Lane -
Cutchogue, NY 11935 DATE IN DATE'OUT• ''TIME IN TIME UT VEHICLE ROLL OFF
9316 Town of Babylon
ORIGINREFERENCE
C_AL E. 2 GROSS WT 74000 LB Outbound Ticket
SCALE 1 TARE WT _ 35900 LB
NET WEIGHT 38100 LB
CITY DESCRIPTION .., , RATE °:'° EXTENSION,- :" FEE TOTAL
19.05 OUTGO.MSW 0.000 0.00 0.00 0.0e
%'a '� w�� ,r`' ✓,' '� ,.;� Kam. �9 -- '
Operating hours 7:00 AM to 5:00 PM 7 days a,week,., ; '° ,� •
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY V7j(20Z5 0�
PRESIDENT'S DAY - t
Ar TENDERED'
CHANGE-
I
CHECK NO.
SIGNATURE
4
NO. 2737
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 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:
1 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 .-- 1. GRID WEIGHMASTER'
SOUTHOLD TOWN DEPT SOLID WASTE 001 01948323 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935
'DATE IN.,° DATE OUT TIME IN TIME OUT VEHICLE-`. ROLL-OFF
02/11/25 02/11/25 07:0 07:1 111031
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 77040 LB Outbound Ticket
SCALE 1 TARE WT -35980 LB
ET WEIGHT 41060 LB
LQTY° UNIT. DESCRIPTION, = RATE . "EXTENSION :: -FEE,' TOTAL
20.53 OUTGO.MSW 0.000 0.00 0.00 . 0.0e
;ate `
_
Operating hours 7:00 AM to 5:00 PM 7 days a week. 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17, 2025 TENDERED
PRESIDENT'S DAY ,
�' w 9 CHANGE
CHECK NO.
SIGNATURE
SITE TICKET GRID, WEIGHMAST.ER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01948323 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 77040 LB Outbound Ticket
SCALE 1 .TARE WT 35980 LB
NET WEIGHT 41060 LB
CITY. UNIT DESCRIPTION. ' RATE F EXTENSION FEE :'`.. TOTAL
20.53 OUTGO.MSW 0.000 0.00 0.00 0.0e
,r ?
-2o 'k1 x r
t
f
E f `
Operating hours 7:00 AM to 5:00 PM 7 day's "-,week •a
CLOSED HOLIDAYS - NEXT: » MONDAY FEBRUARY 172025
PRESIDENT'S DAY 4,,=a r{ .t . ` TENDERED
CHANGE
CHECK'NO:
SIGNATURE
NO. 2738
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 CERTIFYTHATTHE 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
DUPLICATE TICKET TICKET `_.
, GRID �� �, „WEIGHMASTER °
SOUTIPOLD TOWN DEPT SOLID WASTE 001 01948401 Steph
PO Box 962/6155 Cox Lane
CUtChOgUe, NY 11935 DATE 1N.; DATE OUT'.' TIME IN.TIME OUT VEHICLE- ,ROLL OFF
02/12/25 02/12/25 08:37 09:28 11103TC-
9316 Town of Babylon
REFERENCE
SCA
LE 2 GROSS WT 74880 LB Outbound Ticket
E 1 TARE WT 36820 LB
WEIGHT 38660 LB .
QTY :° ;UNIT DESCRIPTION° RATE.,: EXTENSION,'. FEETOTAL
19.03 OUTGO.MSW 0.000 0.00 0.00 0.0e
' d 6a 'aj
¢ ,
IN
1
a
t �
F '
Operating hours 7:00 AM to 5:00 PM days-'.a week. _ 0.0e
CLOSED.HOLIDAYS - NEXT: MONDAY FEBRUARY 11- 2025 TENDERED
PRESIDENT'S DAY ', `,r r ' 'a `
'CHANGE:
CHECKtO-
SIGNATURE-
DUPLICATE TICKET SITE `'• TICKET GRID '" WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 001 01948401 -Steph
PO Box-962/6155 Cox Lane
Cutchogue,- NY 11935 DATE'IN DATE our TIME IN TIME OUT ' ' VEHICLE ROLL=OFF,
9316 Town of Babylon
ORIGINREFERENCE
CALE 2 GROSS WT 74880 LB Outbound Ticket
SCALE 1 TARE WT 36820 LB
NET WEIGHT 38060 LB
OTY. §, .. °UNIT .. DESCRIPTION "t` :'. w:` ' ..RATE,.. ::, •EXTENSION FEE, "', ' " ;.TOTAL'
19.03 OUTGO.MSW 0.000 0.00 0.00 0:0e
-
S
171F _.
4
Operating hours 7:00 AM to 5:00 PM 7 daysa week ,
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY�17, 2025
,TENDERED
PRESIDENT'S DAY
CHANGE
CHECK NO.
SIGNATURE
NO. 2739
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 THATIT'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 :'TICKED GRID WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 001 01948451 Steph
PO' Box 962/6155 Cox Lane
Cutchogue,�
�" NY 11935 DATEIN ,•DATE OUT TIME IN TIME OUT VEHICLE . ROLL OFF
-
02/13/25 02/13/25 07:31 08:29 11103TC
9316 Town of Babylon
REFERENCE
SCALE 2 GROSS WT 81920 LB Outbound Ticket
SCALE 1 TARE WT 36880 LB
ET WEIGHT 45040 LB
QTY UNIT = DESCRIPTION r - RATE' EXTENSION'S .'FEE-: TOTAL-
22.52 OUTGO.MSW 0.000 0:00 0.00 - 0.0¢
C
Th �.ryw
Operating hours 7:00 AM to 5:00 PM 7 daysa week ' � � � , 0.0¢
CLOSED HOLIDAYS NEXT: MONDAY FEBRUARY 17,, 2025 :TENDERED
PRESIDENT'S DAY � u
-.CHANGE _.
HECK ::9-
SIGNATURERE
DUPLICATE TICKET SITE ' TICKET GRID WEIGHMASTER.,
SOUTHOLD TOWN DEPT SOLID WASTE 001 01948451 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
REFEREI •-
CALE 2 GROSS WT 81920 LB Outbound Ticket
CALE 1 TARE WT 36880 LB .
ET WEIGHT 45040 LB
CITY. UNIT „-;.DESCRIPTION RATE' .EXTENSION," FEE, : TOTAL ,
22.52 OUTGO.MSW- 0.000 0.00 0.00 0.0¢
Y
Operating hours 7:00 AM to 5:00 PM 7 days°,,a weekb, `
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17., 2025 `
PRESIDENT'S DAY -
:� �� ` >tr� ^�>' TENDERED'
tj-
r CHANGE
CHECK NO.
SIGNATURE
A
NO. 2740
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' WEIGHMASTER,
SOUTHOLD TOWN DEPT SOLID WASTE 00 01948524. Will
PO Box 962/6155 Cox Lane
Cutc`hogue, NY 11935 DATE.` D`ATE'OUT TIME IN'TIME OUT VEHICLE _r ROLL OFF -
02/14 .'; 02/14/2 07:0 07:2 11103TC
9316 Town of Babylon
SCALE 2 GROSS WT 74820 LB Outbound T `
SCALE 1 TARE' WT 37140 LB
NET WEIGHT 37680 LB
0TY UNIT` DESCRIPTION RATE EXTENSION"' FEE; TOTAL_.
18.84 OUTGO.MSW 0.000 0.00 0.00 0.0e
A t� § ¢
g.l
a
z 7
Operating hours 7:00 AM to 5:00 PM 7 daysl a week: 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY17,�2025 4 c � #y TENDERED
PRESIDENT'S DAY
man
CHANGE
CHECK"NO—
SIGNATURE
DUPLICATE TICKET SITF TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01948524 Wi 11
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE*IN 1 DATE OUT ' 'TIME IN TIME OUT VEHICLE. : ROLCOFFr
9316 Town of Babylon
ORIGINREFERENCE
CALE 2 GROSS WT 74820 LB Outbound Ticket
SCALE .1 TARE WT 37140 LB
NET WEIGHT 37680 LB
QTY.
' UNIT . `. ,' ., , . DESCRIPTION. RATE EXTENSION ' ;FEE "` TOTAL,
18.84 OUTGO.MSW 0.000 0.00 0.00 0.0e
A
Ile
g 3 k '
Operating hours 7:00 AM to '5:00 PM 7 days a"week ` ' •
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY1}7,,F¢2025 s ,
PRESIDENT'S DAY %. y .r,,q TENDERED
L CHANGE .,
CHECK NO.
SIGNATURE
NO.
2741
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
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 1S 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 WEIGHMASTER' "
SOUTHOLD TOWN DEPT SOLID WASTE 001 01948605 Steph
PO Box 962/6 55 Cox Lane VEHICLE "_ ROLL OFF
Cutchogue, NY 11935 DATE IN , ' DATE OUT TIMEIN TIMEOUT °,m X
02/15/25 02/15/25 07:05 07:30 11103TC
9316 Town of .Babylon
REFERENCE
•-
(ET
ALE -2 GROSS WT 77200 LB Outbound Ticket .
ALE 1 TARE WT 35840 LB
WEIGHT 41360 LB
QTY 'UNIT DESCRIPTION ;, RATE = EXTENSION FEE, TOTAL
20.68 OUTGO.MSW 0.000 0.00 0.00 0.0e
qr
, �p
{ t
Operating hours 7:00 AM to 5:00 PM 7 daysa`week' � �� 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 1T 2025 � >
t e<r. bz r TENDERED
PRESIDENT'S DAY `fix -M,
CHECK NO
SIGNATURE
DUPLICATE TICKET E ;� TICKET, GRID WEIGHMA8TER
.SIT
SOUTHOLD TOWN DEPT SOLID WASTE 001 01948605 teph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 <DATE IN. DATE OUT TIME IN`TIME OUT VEHICLE -' , " ILL
9316 Town of Babylon
REFERENCE
•-
CALE .2 GROSS WT 77200 LB Outbound Ticket
SCALE 1 TARE WT 35840 LB
NET WEIGHT 41360 LB
-QTY. UNIT DESCRIPTION,^. -RATE-
.,EXTENSION FEE. TOTAL-
20.68 OUTGO.MSW 0.000 0.00 0.00 0.0e
�
d
�a �s rt "
@ L
Operating hours 7:00 AM to 5:00 PM 7 days week - `' r �`, ? •
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17, ,2025
PRESIDENT'S DAY 4 �' ltl t � ^TENDERED';"
-CHANGE
iI CHECK NO.
SIGNATURE
NO. 2742
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)
s
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.
DUPL TE TICKET SITE TICKET GRID WEIGHMASTER_'
SOUT D TOWN DEPT SOLID WASTE 001 01948818 Will
PO Box 962/6155 Cox-Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE,,, I ROLL OFF
.02/18/25 02/18/25 07:09 07:27 11103TC _ .
9316 Town of Babylon
REFERENCE
•-
CALE 2 GROSS WT 75540 LB Outbound Ticket
CALE 1 TARE WT 36240 LB
ET WEIGHT 39300 LB
QTY. UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
19.65 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 FEBRUARY 17, 2025 a� .r =' TENDERED
PRESIDENT'S DAY `
'CHANGE'
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 001 01948818 Will
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN` ' DATE OUT 'TIME IN fin TIME OUT VEH C E ROLL OFF
9316 Town of Babylon
ORIGINREFERENCE
CALE 2 GROSS WT 75540 LB Outbound Ticket
SCALE 1 TARE WT 36240 LB
NET.WEIGHT 39300 LB
QTY. UNIT DESCRIPTION RATE EXTENSION -FEE TOTAL"'`
19.65 OUTGO.MSW 0.000 0.00 0.00 0.0e
tti k
Operating hours 7:00 AM to 5:00 PM 7 days, a- week::- •
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17, 2625
PRESIDENT'S DAY ;. , TENDERED
CHANGE
CHECK NO.
SIGNATURE
NO. 2743
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,, : W.EIGHMASTER,
DUPLICATE TICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01949007 Steph
PO BOX 962/6155 Cox Lane ,DATE IN DATE OUT TIME IN, TIME OUT VEHICLE ROLL OFF
Cutchogue, NY 11935
02/19/2 02/19/2 11:2 11:3 11103TC
9316 Town of Babylon
REFERENCE
•-
SCALE 2 GROSS WT 78400 LB Outbound Ticket
SCALE 1 TARE WT 35560 LB
ET WEIGHT 42840 LB
_'QW." UNIT- DESCRIPTION RATE EXTENSION __,FEE ,_-TOTAL
J
21.42 OUTGO.MSW 0.000 0.00 0.00 0.0e
AZ
A �
Operating hours 7:00 AM to 5:00 PM 7 days�a =week ' r 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17�2025 ° T,ENDERED, 'w
� ' j `
PRESIDENT'S DAY
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET - GRID WEIGHMASTER `
SOUTHOLD TOWN DEPT SOLIR WASTE 00 01949007 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE.OUT TIME,►N TIME.OUT , VEHICLE{' ROLL OFF
9316 Town of Babylon
ORIGINREFERENCE
CALE 2 GROSS WT 78400- LB Outbound .Ticket
SCALE 1 TARE WT 35560 LB
NET WEIGHT 42840 LB
„ QTY DESCRIPTION,,,: E-.w� ";RATE'. EXTENSION, FEE,,,,,., TOTAL
21.42 OUTGO.MSW 0.000 0.00 0.00 0.0e
1 fri
� —7
t ,
Operating hours 7:00 AM to 5:00 PM 7 days ,week:"—� %� q •
CLOSED*HOLIDAYS - NEXT: MONDAY FEBRUARY�1*7 2625
PRESIDENT'S DAY a f) �a �� '"' TENDERED
a -CHANGE
CHECK NO.
RMNAT1IRF _
NO. 2745
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 "
'SOUTHOLD TOWN DEPT SOLID WASTE 00i -01948967 Steph
PO Box 962/6155 Cox Lane - -
Cutchogue, NY 11935 -DATE IN : DATE IOUT TIME IN]TIME OUT VEHICLE ROLL OFF
02/19/2 02/19/2 07:0 07:2 11103TC
9316 Town of Babylon
ORIGINREFERENCE
SCALE 2 GROSS WT 83800 LB Outbound Ticket
SCALE 1 TARE WT 36500 LB
NET WEIGHT 47300 LB
QTY UNIT; ' DESCRIPTION" ' :_ RATE ' EXTENSION ; -FEE TOTAL°; ""
23.65 OUTGO.MSW .0.000 0.00 0.00 0.02
m
i
Operating hours 7:00 AM -to 5:00 PM 7 day!�,a week: ` . 0.02
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 1 2025p _ �
a I '�§, TENDERED
PRESIDENT'S DAY
r .;CHA GE
CHECK NO.
SIGNATURE
SITE TICKET° GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 019,48967 1 Step
PO Box 962/6155 Cox Lane -
Cutchogue, NY 11935 DATE IN`' DATE OU `TIME IN TIME OUT VEHICLE_` ROLL OFF
9316 Town of Babylon
REFERENCE
•.
CALE 2 GROSS WT 83800 LB Outbound Ticket
SCALE-1 TARE WT 36500 LB
NET WEIGHT 47300 LB
"QTY UNIT DESCRIPTION RATE EXTENSION=_ ' :``;FEE TOTAL :x
23.65 OUTGO.MSW 0.000 0.00 0.00
i,
Operating hours 7:00 AM to 5:00 PM 7 days a'wee'k '-_ ��r •
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17, 025
�
PRESIDENT'S DAY 8�� r % ' TENDERED..�
" t CHANGE
CHECK NO.
. cir_nieri iaG `- .
7
i
NO. 2744
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 LAIN,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:
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 01949085 Steph
PO Box 962/6155 Cox Lane
Cutchogur,'NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
02/20/2 02/20/2 07:3 08:0 11103TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 72880 LB Outbound Ticket
SCALE 1 TARE WT 36320 LB
NET WEIGHT 36560 LB
QTY UNIT _ DESCRIPTION s; •.RATE" EXTENSION FEE -TOTAL
18.28 OUTGO.MSW 0.000 0.00 0.0.0 0.0e
j)'
Operating hours 7:00 AM to 5:00 PM 7 daysNa ZZ-V ek ✓ ` t 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 1T 2025r ,,-'TENDERED
PRESIDENT'S DAY
CHANGE
CHECK NO. .
SIGNATURE
DUPLICATE TICKET SITE I TICKET ___' GRID_ WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE .00 01949085 Steph
PO Box 902/6155 Cox Lane
Cutchogue, NY 11935 =;DATE IN. DATE 0UT' j TIME'INJTIME OUT VEHICLE _:`ROLL OFF.
9316 Town of Babylon
CALE 2.,GROSS WT 72880 LB Outbound Ticket
SCALE 1 TARE WT .36320 LB
NET WEIGHT 36560 LB
77
.0TY.. �EXTENSION FEE JOTAL
18.28 OUTGO.MSW.. 0.000 0.00 0.00 0.0e
C � 'll
( _j l
sty^"°•.\k �m: / ♦tS''«.yiG..^'b .�
Ya
Operating hours 7:00 AM to 5:00 PM 7 days a,week:vk y
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY�1,7,62025 -1fiJ
rV
PRESIDENT'S DAYS a r TENDERED
k A " CHANGE
CHECK NO.
CM(IKIATI IPF
NO. 2746
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 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 01949194 Liz H
PO Box 962/6155 Cox Lane
DATE IN`. DATEOUT TOE IN TIME OUT VEHICLE ;" ROLLAFF
Cutchogue, NY 11935
02/21/2 02/21/2 07:0 07:1 11103TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 76800 LB Outbound Ticket
SCALE 1 TARE WT 36106 LB
NET WEIGHT -40700 LB
OTY UNIT, DESCRIPTION RATE EXTENSION `;';FEE TOTAL
20.35 OUTGO.MSW 0.000 0.00 0.00 0.0e
I . Sa:
I'd
Operating hours 7:00 AM to 5:00 PM 7 da a week 0.02
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17s, 2025 � TENDERED
PRESIDENT'S DAY � ; x
CHANGE,
.CHECK NO-
5
SIGNATURE
DUPLICATE TICKET SITE TICKET,' GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01949194 I Liz H
PO Box 962/6155 Cox Lane
Cutcho ue, NY 11935
g DATEIN DATE OUT TIME IN TIME.OUT VEHICLE ROLL-OFF
9316 Town of Babylon
REFERENCE
CALE 2 GROSS WT 76800 LB Outbound Ticket
SCALE 1 TARE WT 36100 LB
NET WEIGHT 40700 LB
OTY UNIT =_ DESCRIPTION RATE EXTENSION. FEE TOTAL
20.35 OUTGO.MSW 0.000 0.00 0.00 me
vNv
A �
X
Operating hours 7:00 AM to 5:00 PM 7 days aweek.
CLOSED-HOLIDAYS - NEXT: MONOAY FEBRUARY 17,4,2025 �_w✓`
PRESIDENT'S DAYS �, TENDERED
CHANGE
CHECK NO.
cir-tiara iaG `
NO.- 2747
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:
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 TPICKET
SOUTHOLD TOWN DEPT SOLID WASTE 00 01949296 Steph
Po Box 962/6155 Cox Lane
Cutchogue,_ NY 11935 DATE IN DATE OUT TIME IN''TIME OUT VEHICLE , ROLL OFF
02/22/2 02/22/2 07:0 07:1 11103TC
9316 - Town of Babylon
REFERENCE
SCALE 2 GROSS WT 70980 LB Outbound Ticket
SCALE 1 TARE WT 36880 LB
NET WEIGHT 34100 LB
QTY UNIT DESCRIP_ffON RATE EXTENSION FEE
17.05 OUTGO.MSW 0.000 0.00 0.00 0.0e
..1za
/J le
,150
sP}d*� 4�srs'."aq t -.-r^.••-"^\ yt - /'j_ !f �'F�a -
Operating hours 7:00 AM to 5:00 PM 7 days--a week. � /, � 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY „ 2,7025y, a �� � 'TENDEREDa ,
PRESIDENT'S DAY
CHANGE -
CHECK NO.
SIGNATURE
DUPLICATE TICKET SITE TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01949296 Steph
PO Box' 962/6155 Cox Lane
Cutchogue, NY 11935 > DATE IN DATE OUT TIME IN'TIME OUT VEHICLE ROLL OF
9316 Town of Babylon
REFERENCE ORIGIN
CALE 2 GROSS WT 70980 LB Outbound Ticket
SCALE 1.,TARE WT 36880 LB
NET WEIGHT - 34100 LB
QTY UNIT, ::DESCRIPTION RATE EXTENSION;.. FEE TOTAL >.
v:.
17.05 OUTGO.MSW 0.000 0.00 0.00 0.0e
V - y
Operating hours 7:00 AM •to 5:00 PM 7 d ys a�fweek� _' %, ' I •
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARYV,_16/
2025
PRESIDENT'S DAY wtfp
rr TENDERED
1uIiiEl�il 4 `�
< } CHANGE
CHECK NO.
cir_1mATi Iar
4�
NO, 2748
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 CERTIFYTHATTHE 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 ,
SOI THOLD TOWN DEPT SOLID WASTE 00 01949601 Liz H .
PO Box 962/6155 Cox Lane
Eutchogue, NY 11935 DATE IN, DATE OUT TIME IN TIME OUT VEHICLE' ROLL OFF
r .02/24/25 02/24/25 07:2 07:38 11103TC
9316 Town of Babylon
ORIGINREFERENCE
SCALE 2 GROSS WT 69880 LB Outbound Ticket
SCALE 1 TARE WT 36400 LB
ET WEIGHT 33480 LB
QTY UNIT " DESCRIPTION x, RATE' . ' ,EXTENSION'., FEE TOTAL
16.74 OUTGO.MSW _0..000 0.00 0.00 0.0e
�r l P ,
4 l ?E a !e F
a a
v �
r
N
Operating hours 7:00 AM to 5:00 PM 7 days a'week 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17, 2025 g � m
PRESIDENT'S DAY = , I, $ TENDERED
CHANGE
CHECK NO;;j
SIGNATURE
DUPLICATE TICKET "TICKET; . GRID„ WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01949601 1 Liz
PO Box" 962/6155 Cox Lane
Cutchogue, NY 11935 ",DATE IN DATE OUT >TIME IN TIME OUT VEHICLE` ' ROL'L`OFF
9316 Town of Babylon
REFERENCE
CA LE 2 GROSS WT 69880 LB Outbound Ticket
SCALE 1 TARE WT 36400 LB
NET WEIGHT 33480 LB
•`_ ' QTY UNIT' `•DESCRIPTION RATE EXTENSION` ;, FEE'-`
t TOTAL"'_. -
16.74 OUTGO.MSW 0.000 0.00 0..00 0.0e
:-
�Jet �
may^'
t r�
Operating hours 7:00 AM to 5:00 PM 7 days "a{ week:
CLOSED HOLIDAYS = NEXT: _ MONDAY FEBRUARY'�17, 2025'
Y
PRESIDENT'S DAY y TENDERED,,,"
" a ` CHANGE
. .... _ CHECK NO:
SIGNATURE
n
NO.
2749
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 01949797 Will
PO'Box'962/6155 Cox Lane
CUtc'hogue, NY 11935 DATE IN ` DATE OUT' TIME IN.TIME OUT VEHICLE I ROLL OFF'
02/25/2 02/25/2 10:3 10:5 11103TC
9316 Town of Babylon
REFERENCE ORIGIN
SCALE 2 GROSS WT 78360 LB Outbound Ticket
SCALE 1 TARE WT 36780 LB
NET WEIGHT 41580 LB
CITY UNIT DESCRIPTION RATE EXTENSION"" "FEE -':TOTAL'
20.79 OUTGO.MSW 0.000 0.00 0.00 0.0e
Jl U '
Al
Operating hours 7:00 AM to 5:00 PM 7 days a week.- ;` � � Foe
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY`17, 2025', P TENDERED;
PRESIDENT'S DAY � r CHANGE
CHECK No.
SIGNATURE
DUPLICATE TICKET SITE I TICKET ' GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01949797 Will
PO Box 962/6155 Cox Lane
CUtChOgUe, NY 11935 DATE IN DATE OUT TIME IN.'TIME OUT VEHICLE ROLL OFF
9316 Town of Babylon
ORIGINREFERENCE
CAL: 2 GROSS WT 78360 LB Outbound Ticket
SCALE 1 TARE WT 36780 LB
�NET.WEIGHT 41580 LB
CITY.,
UNIT' `--EDESCRIPTION RATE EXTENSION = , FEE _ TOTAL',.
20.79 OUTGO.MSW 0.000 0.00 0.00 me
t a 7
a
ty�µry 1
Operating hours 7:00 AM to 5:00 PM 7 days
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17,E- 22025` . -:-
PRESIDENT'S DAY '��. „tf ' %; ?'.TENDERED`'
CHANGE
' i CHECK NO.
CI fANAT[IRF
NO.
2751
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 01949758 Will
PO�Box 962/6155 Cox Lane
•Cutchogue, NY 11935 DATE IN ; . DATE OUT= JIME,IN TIME OUT VEHICLE „ .ROLL OFF
02/25/2 02/25/2 07:0 07:2 11103TC
9�326 Town of Babylon
,GREFERENCE •-
FWEIGHT
SS WT 73060 LB Outbound Ticket
E WT 35920 LB
37140 LB
71, UNIT DESCRIPTION '. RATE, n- EXTENSION. FEE . TOTAL
18.57 OUTGO.MSW 0.000 0.00 0.00 - 0.0e
E
ati
S�lu rlr ammOrav•
Operating hours 7:00 AM to 5:00 PM 7 daysa {week �R 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY '17, 2025 ,xt TENDERED
/ }
PRESIDENT'S DAY s„�,.. � x '� � � -�" '}
CHANGE'"
CHECK O.
SIGNATURE
DUPLICATE TICKET SITE ,;_. TICKET _ GRID, .3 WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01949 58 Will
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN'< DAf OUT TIME IN TIME OUT VEHICL ROLL'OFF
9316 Town of Babylon
ORIGINREFERENCE
CAL: 2 GROSS WT 73060 LB Outbound Ticket
SCALE 1 TARE WT 35920 LB -
NET WEIGHT 37140 LB
QTY UNIT _ DESCRIPTION'" 'RATE EXTENSION ''" •``FEE'" TOTAL ;
18.57 OUTGO.MSW 0.000 0.00 0.00 0.0e
�4 ol
t"f"i r �
Operating hours 7:00 AM to 5:00 PM 7 days a week:`
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17;1L;�20,25 - c
PRESIDENT'S DAY
f - S K1,`'' 1 ' TENDERED
'Ira
CHANGE
CHECK NO:::l
SIGNATURE
NO. 2750
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:
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.
SITE TICKET GRID WEIGHMASTER
DUPLICATE TICKET
SOUTHOLD'TOWN DEPT SOLID WASTE 00 01949937 Steph
PO Box 962/6155 Cox Lane
CUtChOgUe, NY 11935 DATE IN DATE,OUT TIME 1N TIME OUT VEHICLE ROLL OFF
02/26/2 02/26/2 07:2 08:1 11103TC
9316 Town of Babylon ...
REFERENCE
SCALE 2 GROSS WT 82200 LB Outbound. Ticket
SCALE 1 TARE WT 35840 LB
NET WEIGHT 46360 LB
OTY: UNIT bESCRIPTION RATE EXTENSION .._ FEE ;:' TOTAL.,
23.18 OUTGO.MSW 0.000 0.00 0.00 0.0e
Operating hours 7:00 AM to 5:00 PM 7 days:�a week. `���NN 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17f, 20�25 �, , *: y TENDERED
PRESIDENT'S DAY
CHANGE
CHECK NO.
SIGNATURE
DUPLICATE TICKET (SITE , TICKET i GRID ' WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01949937 Steph
PO Box 962/6155 Cox Lane
CUtchogue, NY 11935 DATE IN DATE OUT TIMEIN -TIME OUT VEHICLE .,ROLL OFF ,.
0.
9316 Town of Babylon
REFERENCE
•.
SCALE 2 GROSS WT 82200- LB Outbound Ticket
SCALE 1 TARE WT 35840 LB
NET WEIGHT 46360 LB
OTY° UNIT ,<* DESCRIPTION :t RATE EXTENSION, FEE TOTAL
23.18 OUTGO.MSW 0.000 0.00 0.00 0.0e
1 r f
Q�r
Ip
Operating hours 7:00 AM to 5:00 PM 7 days a}week�:� � 4 �: •
CLOSED HOLIDAYS - NEXT: •MONDAY FEBRUARY�17,1�-2�025
TENDERED .
PRESIDENT'S DAY f, f, ;
CHANGE..
CHECK NO.
SIGNATURE
t '
NO. 2752
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 '
SOUTHOLD T014N DEPT SOLID WASTE; 001 01950091 Steph
PO Box.962/6155 Cox Lane
Cutchogue, NY 11935 ,DATE IN - DATE OUT TIME IN-TIME OUT VEHICLE ROLL OFF
02/27/25 02/27/25 07:10 07:21 11103TC
9316 Town of Babylon
REFERENCE
�.
SCALE 2 GROSS WT 83020 LB Outbound Ticket
SCALE 1 TARE WT 36560 LB
ET WEIGHT 46460 LB
OTY UNIT. DESCRIPTION - RATE EXTENSION-' FEE TOTAL_''
23.23 OUTGO.MSW 0.000 0.00 0.00 0.0e
2
' t rli�
r `j �# �
J qc ya
\` Z
y� t
Operating ,hours 7:00 AM to 5:00 PM 7 daysaa week','--`�
CLOSED HOLIDAYS - NEXT:- MONDAY FEBRUARY 1'7", 2025 �� Lz
PRESIDENT°S DAY `C � +� f � of } TENDERED
ltj, L;1 Leif itl l t
�u,N
t ,CHANGE`
CHECK NO.
SIGNATURE
SITE TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 01 09 ep
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN' DAT DU TIME IN TIME D T H ROLL OFF'-
9316 Town of Babylon
REFERENCE
•-
CALE 2 GROSS WT 83020 LB Outbound Ticket
SCALE 1 TARE WT 36560 LB
NET WEIGHT 46460 LB
QTY. UNIT ;DESCRIPTION RATE EXTENSION FEE :; TOTAL r
23.23 OUTGO.MSW 0.000 0.00 0.00- o.oe
ij f F
Operating hours 7:00 AM to 5:00 PM 7 days a meek
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY`17,{2025IJ
PRESIDENT'S DAYS TENDERED
1
_ �j�• , _�.`."°- -CHANGE
CHECK NO.-•
SIGNATURE
�v
NO.- 2753
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSESONLY.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)
'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 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
0
SOUTHOLD TOWN DEPT SOLID WASTE 001 01950140 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN TIME OUT VEHICLE ROLL OFF
02/27/25 02/27/25 10:51 11:02 11103TC:
9316 Town of Babylon
REFERENCE
CE
•-
SCALE 2 GROSS WT 72040 LB Outbound Ticket
SCALE 1 TARE WT 36440 LB
ET WEIGHT 35600 LB
CITY. UNIT DESCRIPTION "RATE EXTENSION FEE TOTAL _.
17.80 OUTGO.MSW 0.000 0.00. 0.00 . 0.0e
[t 1
F
N
� i
Operating hours 7:00 AM to 5:00 PM 7 daysa`we-ek. ' _ 0.0e
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17>, 2025 ' Yy TENDERED
PRESIDENT'S DAY
a, t F .
_Z_Z_ F u y � vpW CHANGE
HECK NO.
SIGNATURE
DUPLICATE TICKET SITE . TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 00 1 01950140 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
•-
GALE 2 GROSS WT 72040 LB Outbound Ticket
SCALE .1 TARE WT 36440 LB
NET WEIGHT 35600 LB
CITY UNIT DESCRIPTION RATE EXTENSION FEE TOTAL.
17.80 OUTGO.MSW 0.000 0.00 0.00 0.0e
f 6 _
Operating hours 7:00 AM to 5:00 PM 7 days a, week-:
CLOSED HOLIDAYS - NEXT: MONDAY FEBRUARY 17,`'�2025 ' {t
PRESIDENT'S DAY `` 3�it {; E> TENDERED
CHANGE'.
CHECK NO.
SIGNATURE
NO. 2754
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:
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 CERTIFYTHAT 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.