HomeMy WebLinkAbout06/2018 "DUPLICATE TICKET*" SITE `TigKET
SOUTHOLD TOWN DEPT SOLID WASTE 01 01368518 Dan
PO Box962/61`Cox Lane _ -
Cutchogue, NY 11935 DATE IN _DATE.t>U7 TIME IN TIME`OUT :_' ,' VEHICI E RQLL_OFF_
06/02/18 06/02/18 07:39 07:39 111 14T
009316 Town of Babylon
REFERENCE bRIGIN
L I
Scale 2 Gross Wt. 103860 LB Outbound-Charge ticket
Manual Tare Wt. 36260 LB
Net Weight 67600 LB
- ,-
QTY UNIT- `_-- DESCRIPTION= rr RATE:_ _ -' EXTENSION FEE ' ' -." -TOTAL
33.80 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Opera Ing Tours o ays a week. •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED'
C ANGE
SIGNATURE
"*DUPLICATE TICKET*" 8ITI~; TICKET, GR(b- WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01368518 Dan
PO Box 962/6155 Cox Lane
CUtChO9Ue, NY 11935 DATE IN- DATE OUT TIME IN T,ME OUT VEHICLE
ROLL OFF
06/02/18 06/02/18 07:39 107:39 111 14T
009316 Town of Babylon
REFERENCE ONGIN
FScale 2 Gross Wt. 103860 LB Outbound-Charge ticket
Manual Tare Wt. 36260 LB
Net Weight 67600 LB
—I- QV-= UNIT _ _ DESCRIPTION -RATE EXTENSION FEE TOTAL
33.80 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week. r •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED=u'
CHANGE,
`EHECK' O:'
SIGNATURE
NO. 8690
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: 4 1�� i.%� 1 i--Iy c__ )°i SHIP DATE:
r
COMMODITY SHIPPED: !'vi ,``, w
LOOSE: ° F ' (CU YDS)
BALES: (COUNT): I
TRUCK WEIGHT: /''.=} a .>G'f GROSS
TARE
l(, 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. 2 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. X"
DRIVER:
(PRINT NAME) lam'" (SIGNATURE)
/ DESTINATION
� °r1l"'VI ? r DISPOSAL LOCATIONS } 1J ° 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.
"".:PLICATE TICKET"` SIT TICKET ` GRID_-- _ `W'bGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01368390 Liz H
PO Box 962/6155 Cox Lane
DATE IN_ = DATE OUT -TIME IN TIME OUT- VEHICLE _, ROLL OFF
Cutchogue, NY 11935
06/01/18 06/01/18 10:30 10:30 11114T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 84040 LB Outbound-Charge ticket
Manual Tare Wt. 38700 LB
Net Weight 45340 LB
QTY-.+ UNIT DESCRIPTION "RATE "' "_ _ ' EXTENSION ^° FEE TOTAL'"
22.67 TON OUTGO.MSW 0.000 0.00 0.00 0.00
f°yJa }Yt
' �,� �,,,,.> `'^,._.-.✓"r-,,' 4 ..:2P (fie
Operating hours 7:00 AM to 5:00 PM 7 days a weeK;� is-� -,,,,, •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.,' 's Y` 0.00
'. '
NEXT HOLIDAY: Memorial Day, Monday, May 28 <,�;s',P` ' .�rjr((�'i';:��i ��,'µs TENDERED
CHE K NO:
SIGNATURE
---- --- - - ---- ---- --- -- -- --- - - -- --- - - - -- - - ---- -- -
- SIfE 71CKET, GRID -- 'WEIGHMASTER'
"*DUPLICATE TICKET"" _
SOUTHOLD TOWN DEPT SOLID WASTE 01 01368390 Liz H
PO BOX 962/6155 COX Lane ;DATE IN DArE OUT TIME IN TIME OUT,. VEHICLE' ;ROLLOFF=
Cutchogue, NY 11935
06/01/18 106/01/18 110:30 110:30 11114T
009316 Town of Babylon REFERENCE .
IGIN
Scale 2 Gross Wt. 84040 LB Outbound-Charge ticket
Manual Tare Wt. 38700 LB
Net Wei ht 45340 B
QTY., %'",,"r UNIT.' -DESCRIPTIONRATE'; ,EXTENSIONFEE, TOTAL,
22.67 TON UTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week 4,t ` ' •
o
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.�,�,/ t
NEXT HOLIDAY: Memorial Day, Monday, May 28 ,�',' "TENDERED
` CHAN E
=CHECK NO.
SIGNATURE
NO. 8689
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. r,
COMPANY: t ��J Iii! �r i �' (---I� SHIP DATE: f
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
—1 _7, -' TARE
4_ 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. S LICkNSE NO/STATE:
TRAILER NO. fP 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)
" (SIGNATURE) _
DESTINATION s�
DISPOSAL LOCATION: d —7 A DATE DELIVERED:
e 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 v -VEIGHMASTER`�
SOUTHOLD TOWN DEPT SOLID WASTE 01 1 01369252 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 n DATE IN "DATE_OUT- =TIME IN TIME VEHICLE _ ROLL-OFF
06/04/18 06/04/18 11:13 11:13 111 14T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 79100 LB Outbound-Charge ticket
Manual Tare Wt. 36620 LB
Net Weight 42480 LB
,QTY UNIT, _ DESCRIPTION RATE - EXTENSION,__, FEE TOTAL
21.24 TON UTGO.MSW 0.000 0.00 0.00 0.00
•.i i
Op -`' z _,;; r.� Via.. •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685:F s9 - �g 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 `° ,.y%,; t , 4 TENDERED; _-
� Y
CHANGE-
CHECKNo =
SIGNATURE
"DUPLICATE TICKET" rSIT'Ej TICKET„ WEIGHMASTER.
SOUTHOLD TOWN DEPT SOLID WASTE 01 01369252 Steph
PO BOX 962/6155 COX LaneN DATE OUT TIME IN TI MEOU7 VEH'ICLE"'
DATE ROLLOFF
Cutchogue, NY 11935 I `
06/04/18 06/04/18 11:13 11:13 11 114T
009316 Town of Babylon
REFERENCF
Scale 2 Gross Wt. 79100 LB Outbound-Charge ticket
Manual Tare Wt. 36620 LB
Net Weight 42480 LB
_QTY UNIT, DESCRIPTION,, ' - ,` RATE , . _' EXTENSION _ FEE.,__ TOTAL
21.24 TON OUTGO.MSW 0.000 0.00 0.00 0.00
t7 ;, ,
d y If
Operating hours :00 AM todays a wee .- -4 ~; -, �a? 1
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. :° ' 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 °fit.=1.: ;� ;� ; r
TENDERED'
CHANGE,
CHECK NO. _ -
SIGNATURE
NO. , 6692
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: ° ;` - ,� '- _,r SHIP DATE:' t '
COMMODITY SHIPPED:
LOOSE: f (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.
.. f
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. r ? 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.
{r r
DRIVER: a 4
(PRINT NAME) (SIGNATURE)
f� DESTINATION
DISPOSAL LOCATION: w__r�-1' ' '.F - i r ' 4 `' f 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.
F -
_SITEI 11�1„TICKET;, GRID,""' PGHMASTE
SOUTHOLD TOWN DEPT SOLID WASTE 01 1 01369206 Steph
PO Box 962/6155 Cox Lane
'DATE'1N
g:&ft MEIN TiME-0'U'T �EHIG' 0" L
Cutchogue, NY 11935
-06/04/18 06/04/18 107:15 1 07:15 111 14TC
009316 Town of Babylon
REFERENCE
Scale 2 Gross Wt. 84720 LB Outbound-Charge ticket
Manual Tare Wt. 36920 LB
Net Weight 47800 LB FEE
-,RATE.QTY UNIT,,,-- DESCRIPTION TE. B
23.90 TON DUTGO.MSW 0.000 0.00 0.00 0.00
%
J- `7
1pe
1C� rat1mg-hoars I-.Uu/-XIVI lu 0-.UU rivi I udyb d vvuu - Ilk
AwklQw-
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28
-TENDERED
CHANGE
1
CHECK 1\109
SIGNATURE
�SITEJ-7 316Kt7r, - GRID, WEIPHMASTER,,,,,_
SOUTHOLD TOWN DEPT SOLID WASTE 01 01369206 Steph
PO Box 962/6155 Cox Lane 71
DATE'IN"'. `6�TEOUT-'-, TIME IN TIME-OUT V646IL�-�-' o6l-LOFF'
Cutchogue, NY 11935 — T
1 06/04/18 06/04/18 07:15 107:15 1 11114TC
009316 Town of Babylon I
REFERENQE
Scale 2 Gross Wt. 84720 LB Outbound-Charge ticket
Manual Tare Wt. 36920 LB
Net Weight 47800 LB
aT�,F -UNIT - = DESCRIPTION RAE EXTENSION -- FEE
TOTAL
23.90 TON CUTGO.MSW 0.000 0.00 0.00 0.00
Z till
Op �sa ee
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685./', 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28
j � TENDERED-
CHANGE
-CHECK NO.
SIGNATURE
C i
NO. 8691
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. j
COMPANY:
SHIP DATE: ;
COMMODITY SHIPPED:
vy J f
LOOSE: ! 4F (CU YDS)
a
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. t 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)
r.
DESTINATION
DISPOSAL LOCATION ., J Pf ji , ti , ;�; .f t s DATE DELIVERED:
ADDRESS: , 1
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
SOUTHOLD TOWN DEPT SOLID WASTE 31 01369425 Steph
PO BOX 962/6155 COX Lane 7
_,DATE 1N DATE OUT TIME"IN-TIME OUT-°° VEHICG%
Cutchogue, NY 11935
6/05/18 06/05/18 1:26 111:26 11114T
009316 Town of Babylon
Scale 2 Gross Wt. 96160 LB Outbound-Charge ticket
Manual Tare Wt. 36920 LB
Net Weiaht 59240 LB
QTY UNIT. DESCRIPTION - RATE, EXTENSION, FEES-; TOTAL
29.62 TON CUTGO.MSW 0.000 0.00 0.00 0.00
f Y+at�
fi
_a A
o
Operating hours 7:00 AM to 5:00 PM 7 days a week. ;YY_ :r :-y s y •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.° a :s ' ;,�h< < 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 ''a':v �r '° - TENDERED
CHANGE
CHECK NO.
SIGNATURE
SITE -_ ".TICKED:=' •; ,., ,, ",GRIR , ',, '=;„, 5;�� WEIGHMASTER -,ksi,
SOUTHOLD TOWN DEPT SOLID WASTE 01 01369425 Steph
PO BOX 962/6155 COX Lane DATE IN DATE OUT- TIME IN TIMEOUT VEHICLE' ROLLOFF'
Cutchogue, NY 11935
06/05/18 106/05/18 11:26 111:26 11114TC
009316 Town of Babylon REFERENCE O.
IGIN
Scale 2 Gross Wt. 96160 LB Outbound-Charge ticket
Manual Tare Wt. 36920 LB
QTY; UN ,; ;' ,DESCRIPTION RATE..” EXTENSION FEE ;NOTAL%;
29.62 TON UTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.'�;';- - r ,, ;' 0.00
.. `' v gt
TENDERED-
NEXT HOLIDAY: Memorial Day, Monday, May 28 4 -t a`
CHANGE-
CHECK NO...
SIGNATURE
NO. 8693
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: 4'(
LOOSE: ' (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: i GROSS
TARE
- ° NET
• i
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-AFPLICABLt§-TATE L-AW'HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANS PORTATION_AGCORDING TQ APPLICABLE REGULATION
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER €
TRANSPORTATION/FREIGHT CO. J ' t`•a
TRUCK NO. d ; LICENSE NO/STATE:
TRAILER NO. 1 f ° ; LICENSE NO/STATE:
n
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: ` " r�
(PRINT NAME) (SIGNATURE)
DESTINATION,
DISPOSAL LOCATION: t.-
tI - 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.
77,
""DUPLICATE TICKET" SITE 1,- TICKET GRID -WEIGHMASTER -
SOUTHOLD TOWN DEPT SOLID WASTE 01 01369688 Dan
PO Box 962/6155 Cox Lane
DATE IN<, :DATE OUT `TIME IN TIME OUT VEHICLE= "'ROLL OFF. _
Cut;%gue,NY 11935 _
6/06/18 06/06/18 13:28 13:28 11114TC
009316 Town of Babylon
REFERENCE
Scale 2 Gross Wt. 101940 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
—7- : Net Weight 61540 LB
QTY UNIT'„`_ _DESCRIPTION = _'RATE_°' -EXTENSION. " - FEE TOTAL`
30.77 TON OUTGO.MSW 0.000 0.00 0.00 0.00
r
Z
Operating hours o •Ilk
�-, tee. o� .t
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685., .:,° `~�;_`�° .�°� 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED `
r � C GE
CHECK NO.
SIGNATURE
"`DUPLICATE TICKET"* SITE _ TICKET - GRID" = WEIGHMASTER -
SOUTHOLD TOWN DEPT SOLID WASTE 01 01369688 Dan
PO Box 962/6155 Cox Lane - - - -
CUtChogUe, NY 11935 DATE INr*r DATErOUT ;TIME IN`TIME OUT `VEHICLE } ;TROLL OFF
06/06/18 06/06/18 13:28 13:28 111 14T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 101940 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Wei ht 61540 LB
QlY
UNiT. a',,, ;DESCRIPTION"' RATE'"`'"' EXrENSiON FEE v'TOTAL
30.77 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week.`; x5 V --� k. •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-1685 �� '_- °, s1 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28a :rt;;; T, ,>pj=, ;='', `fir TENDERED
RANGE
:CHECK NO. -
SIGNATURE
NO. 8694
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. r �'
COMPANY: IL ff_" =r
SHIP DATE: `- f
COMMODITY SHIPPED: ;` 1 <J f
LOOSE: I `–' ' (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT:
GROSS
TARE
i
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) (SIGNATUREj""`-- -L .
TRANSPORTER I
TRANSPORTATION/FREIGHT CO. JLJ
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. tfjt i LICENSE NO/STATE: ,
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LIST P'/ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW. r
DRIVER: ---- �` ' � •• � `�
(PRINT NAME) (SIGNATURE)
r
DESTINATION off;
DATE DELIVERED: i 1
DISPOSAL LOCATION:�-_��.% '�' ; :� yj � : '� ,, � �. � — •
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.
"DU�'LTCATE TICKET " SITE TICKET m„- ,, GRID' _WEIGHMASTER -;
SOUTHOLD TOWN DEPT SOLID WASTE 01 01369870 Pat H
PO BOX 962/6155 COX Lane . :DATE IN ;,[.DATE OUT'vTIME,IN: TIME OUT ", VEHICLE,,, OFF,
OFF,
Cutchogue, NY 11935 `
06/07/18 106/07/18 12:52 12:52 111 14T
009316 Town of Babylon ORIGINREFERENCE
Scale 2 Gross Wt. 102940 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
QTY'° UNIT DESCRIPTION'-' -' RATE`` _EXTENSION FEE'' TOTAL
31.27 TON DUTGO.MSW 0.000 0.00 0.00 0.00
LIU
�J ` l - � � •- 1.fit+
Operating hours 7:00 AM to 5:00 PM 7 days a week:.
CLOSED HOLIDAYS-QUESTIONS CALL 631-734n no
NEXT HOLIDAY: Memorial Day, Monday, May 28 'vii � g4' - .' TENDERED
,, i
CHECK NO.
SIGNATURE
SITE TICKET _ " '_GRID WEIG_ HMASTER -
*"DUPLICATE TICKET" `
SOUTHOLD TOWN DEPT SOLID WASTE 01 01369870 Pat H
PO Box 962/6155 Cox Lane DATE IN ,,;yDATE ,TIME IN TIME OUT VEHICLE ;ROLLOFF -
Cutchogue, NY 11935
06/07/18 06/07/18 12:52 112:52 11114TC
009316 Town of Babylon ORIGIN
Scale 2 Gross Wt. 102940 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
2540 LB
'-e QTY. UN, DESCRIPTION ,RATE. ;EXTENSION_: FEE- ,TOTAL
31.27 TON CUTGO.MSW 0.000 0.00 0.00 0.00
bi
Operating hours 7:00 AM to 5:00 PM 7 days a week.
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. '�` `~ -- f< ",
NEXT HOLIDAY: Memorial Day, Monday, May 28 � TENDERED
CHANGE
CHECK NO
SIGNATURE
s
NO. 8699
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NIT-ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS. 1
COMPANY: Vj�{ �—E !�l v (.....) ) —'--'-SHIP k`
DATE:
COMMODITY SHIPPED: lfi
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: ` GROSS
TARE
° f
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) G(SIGNATURE)
T{�
TRANSPORTERell
TRANSPORTATION/FREIGHT CO.
/ y« -
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�4BOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW
DRIVER:
(PRINT NAME) ,;f' (SIGNATURE)
!- r
DESTINATION
DISPOSAL LOCATIO A,, 1\J DATE DELIVERED:
.ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THE INFORMATION PROVIDED
1 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-111 TOLD TOWN DEPT SOLID WASTE 01 01369803 Liz H
PO BOX 962/6155 COX Lane _DATE IN_ DATE-OUT=" TIME IN TIME OUT .- VEHICLE ROLL OFF
Cutchogue, NY 11935
06/07/18 06/07/18 09:03 09:03 111 14T
009316 Town of Babylon REFERENCE ORIGIN,
Scale 2 Gross Wt. 94660 LB Outbound-Charge ticket
Manual Tare Wt. 38700 LB
Net Wei ht 55960 LB
QTz=, UNIT,, r.,,- DESCRIPTION=z•: -` RATE ,EXTENSION FEE - TOTAL
27.98 TON DUTGO.MSW 0.000 0.00 0.00 0.00
tP
Operating hours 7:00 AM to 5:00 PM 7 days a week `'". `°�` ? °" ` r :e r'1
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.«' " —�_w_ - 'fl e f _0.00
TENDERED
r
NEXT HOLIDAY: Memorial Day, Monday, May 28 _ "° =t
&';.:`/1 ;-.ill}'?
CHECK NO. .-
SIGNATURE
"DUPLICATE TICKET" SITE' TICKET - ,'GRID `.WEIdHMXSTER,` .
SOUTHOLD TOWN DEPT SOLID WASTE 01 01369803 Liz H
PO BOX 962/6155 COX Lane "'DATE IN,, "_DATE OUT- : '''TIME tN: TIME,OUT. ' _:' VEHICLE.',`'w.-" ~ ROLL OFF =
Cutchogue, NY 11935
06/07/18 06/07/18 9:03 09:03 111 14T
009316 Town of Babylon �.
Scale 2 Gross Wt. 94660 LB Outbound-Charge ticket
Manual Tare Wt. 38700 LB
QTY°" UN DESCRIPTION RATE EXTENSION FEE; = TOTAL
27.98 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week. Ve
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. .' n nn
NEXT HOLIDAY: Memorial Day, Monday, May 28 � ,�" ` . ,:-�` ', ` z `-TENDERED
r_CHECK NO.
SIGNATURE
NO. 8695
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: Ipl 1 J
LOOSE: s `� j (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: P ` 1 L GROSS
TARE
` p r 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. t I'•)
TRUCK NO. _; LICENSE NO/STATE:
TRAILER NO. 1 r) 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)
el DESTINATION, ' t
• I ��
DISPOSAL LOCATION: �� �'' t'.tfr;
} A s j' ;j 't DATE DELIVERED:
ADDRESS: 1 i
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, kWEIGHMASTER
SdrUTH66 TOWN DEPT SOLID WASTE 01 01370090 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 ""'-DATE IN°;':,', -'DATE OUT- =TIME IN'_TIME OUT " ;',VEHICLE .`"' =ROL°L OFFLL
06/08/18 06/08/18 12:16 12:16 11 104T
009316 Town of Babylon
REFERENCE
Scale 2 Gross Wt. 98900 LB Outbound-Charge ticket
Manual Tare Wt. 38700 LB
Net Weight 60200 LB 7
QTY UNIT, ;DESCRIPTION" - 'RATE'„ EXTENS_iON `-FEE TOTAL
30.10 TON UTGO.MSW 0.000 0.00 0.00 0.00
Operating Hours o ays a wee °:` WIN
w `—a;
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.�`�� `�� G,.,. ��'` 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 = R`'° Ip" .R {g{ �,;�p �\'V, TENDERED
r J' CHANGE,
CHECK NO.
SIGNATURE
**DUPLICATE TICKET** Srf _ TiCKEI'',�--,' ` '-GRID wEtGHniiA's,TER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01370090 Liz H
PO Box 962/6155 Cox Lane
°TIME IN TIME OUT a'r „,;rUEHIEI E
Cutchogue, NY 11935 ,DaTE,IN p aTl=,ouT Ro�> oFF
6/08/18 06/08/18 12:16 112:16 11 104T
009316 Town of Babylon
Scale 2 Gross Wt. 98900 LB Outbound-Charge ticket
Manual Tare Wt. 38700 LB
Net Weight 60200 LB
QTy' . " a _ RATEEXTENSION
FEE TOTAL=UNIT" c;. DESCRIPTION
30.10 TON CUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours :0 to :00 PM 7 days a wee .€- s~
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-768,5. " `` - `M '" °;_ 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 :- `=�fy`�/{/ a4 ; —; >e _._ #�' TENDERED
CHECK NO.
SIGNATURE
8269
.- ,-r , _` � 'x',.:.,;• - d GENERATOR -
THIS MAN IFEST�IS.FOR REFERENCE,, QR POSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TI.T.LE OF ANY CARGO OR MATERIALS
BEING SHIPPED ANDS DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
=" COMPANY: SHIP DATE:
COMMODITY SHIPPED: ',
(CU YDS)
BALES °(COUNT)' =�
_ "TRCICK•WEIG�FiT: ' '`: GROSS
c. TARE
NET -
I HEREBY GERIFaY THAT THE'ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID AS DEFINED'BY 40 CFR PART 260.10 OR ANY �.
APPLICABLE STATE LA1 1,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
sr i� GENERATQR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE) _
TRANSPORTER '`
.,,-~'TRANSPORTXATION/FREIGHT-CO,.
TROCK NO. `r LICENSE NO/STATE: 3
' 7TRAILER NO. LICENSE NO/STATE:
-
THE'RE'BY CERTIFY TH4�T THE ABOVE NAMEDiAATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS', '
, DELIVEREI'WITHOUT I4CIDENT TO THE DESTINATION LISTED BELOW. t. _
(PRIP1T NAME) (SIGNATURE)
l
` 4 ''e • DESTINATION
Z.- ,DI$POSAL-LOCATION: _ DATE DELIVERED:
= ti
ADDRESS:
I HEREBY CERTIFY THAT THE ABOVE MATERIAL HAS BEEN ACCEPTED AND TO THE BEST OF MY KNOWLEDGE THEINFORMATION PROVIDED
-IS TRUE AND ACCURATE: '
'��..�� _ _ _ -- i a _` } q �•-s--•'- - -_ '• pax _ _ -
a �,�.::RECEIVED_BY: �- '-=•;�;�`''-;- .�„�:1.--�-._� .. -
" - .. AUTHORIZED AGENT(PRINT NAME) ' Y SIGNATURE%DXT,E
KEY,_- : loL, ITE TO DISPOSAL LOCATION r _
GREEN_TO TRANSPORTER t '
YELL=OW TO TRANSPORTER. --
:PINKJO,GENERATOR -
` :GOLD TOTGENERATOR DISPOSAL LOCATION TICKET NO.
"DUPLICATE TICKET" SITE TICKET GRID WEIGI MASTER A'
.SOUTI4OLD TOWN DEPT SOLID WASTE Di 01369994 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT TIME IN I TIME OUT, 'VEHICLE;"" `- ROLL"OFF'
6/08/18 06/08/18 8:39 8:39 11 104T
009316 Town of Babylon
REFERENCE 7
Scale 2 Gross Wt. 85220 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 49220 -LB -
Ow UNIT„ DESCRIPTION=- RATE EXTENSION r FEE TOTAL
24.61 TON 0UTGO.MSW 0.000 0.00 0.00 000
z
� 0A�
'7 ,
Operating fiours odays a wee!(4), kms; -.:� ,` I W-11 LVA•
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.L r ,g_`� 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED =
=CHANGE
CHECK-NO
SIGNATURE
*"DUPLICATE TICKET" rPITE1 TICKET GRlla ;,'wEiGyMAST�R
SOUTHOLD TOWN DEPT SOLID WASTE 01 01369994 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATE OUT> T►ME IN,TIME OUT VEHICLE ROLL OFF
06/08/18 06/08/18 8:39 08:39 11 104T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 85220 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 49220 LB
�,." +QTY' ;UNIT',,'';,: DESCRIPTION RATE EXTENStON„ FEE TOTAL _
24.61 TON UTGO.MSW t 0.000 0.00 000 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week v i�` f-, _ � '- Ar •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.E z .�'
_...__..--° �.�, ,.�° 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 t` v�,._.-�;�# t 3 TENDERED_.
CH CK NO. ' "
SIGNATURE
NO 8259
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
STRANSPORTATION/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** YGRID'° �_�'�e�WEIGHMA8Ttft _� _��-_�_,•_--
SOUTHOLD TOWN DEPT SOLID WASTE 1 01370282 Steph
PO Box 962/6155 Cox Lane DATE IN DATE OUT, _ TIME.IN, TIME OUT VEHICLE` ROl L OFF _ f YF
Cutchogue, NY 11935
6/09/18 6/09/18 9:55 9:55 11114TC
009316 Town of Babylon
REFERENCE
Scale 2 Gross Wt. 83940 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Wei ht 47940 LB
CITY._- UNIT DESCRIPTION RATE EXTENSION FEE` TOTAL
3.97 TON C UTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week. ' r Y'"`, " ;sa` €V WIN
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. } $ _ '- �' =,>' 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 p �q = ', TENDERED-,r
CHANGE
CHECK O° °
SIGNATURE
SITE TICKET GRID"
NO. 8696
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOJ'ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE:
COMMODITY SHIPPED:` !
LOOSE: > t } (CU YDS)
- BALES: (COUNT):
TRUCK WEIGHT: ` ? `z 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 TO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) �' -(SIGNATURE)
TRANSPORTER J
`TRANSPORTATION/FREIGHT CO.
r
TRUCK NO. `J LICENSE NO/STATE:
TRAILER NO. L L/ LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SITE LISTED ABOVE, AND THAT IT WAS
j DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW. -�
DRIVER:
(PRINT NAME) Fes- (SIGNATURE)
DESTINATION
DISPOSAL LOCATION:` ;/ ,^ d! c , ' ' $ r �' . ,� g DATE DELIVERED: '
i
ADDRESS: 1
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 1 01371126 Steph
PO BOX 962/6155 COX Lane DATE IN`- DATE OUT TIME IN`TIME OUT , VEHICLE _= ROLL OFF ,
Cutchogue, NY 11935
6/11/18 6/11/18 [12:37 2:37 11114T
009316 Town of Babylon REFERENCE ORIGIN
Scale 2 Gross Wt. 79920 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 43920 LB
QTY,, UNITS 4DESCRIPTION - NAT5EXTENSION;; FEE'' '-'TOTAL
1.96 TON UTGO.MSW 0.000 0.00 0.00 0.00
'-''� a, did �r l °r. �•�rr
Operating hours 7:00 AM to 5:00 PM 7 days a week: _ : =.";µ✓';a' , NZ •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.^': �. X T 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 `. r ;f} , fir' t� TENDERED-
t � Y;.+ .,.
OU
CHANGE
CHECK,NO:
SIGNATURE
SITE ° TICKET_ GRID; WEIGHMASTER-
SOUTHOLD TOWN DEPT SOLID WASTE D1 01371126 Steph
PO Box 962/6155 Cox Lane DATE IN ' DATE-'OUT -TIME IN TIME OUT VEHICLE `' ROLL OFF.
Cutchogue, NY 11935
6/11/18 06/11/18 12:3712:37 11114T
009316 Town of Babylon •.
Scale 2 Gross Wt. 79920 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
OTY>',° UN '�''''" DESCRIPTION "' RAT"E' EXTENSION FEE',,T 'TOTAL,.
21.96 TON CUTGO.MSW 0.000 0.00 0.00 0.00
it w
i
N .j.• - e gM1 f tel,
e
j L %!
Operating hours 7:00 AM to 5:00 PM 7 days a week. •
- � .
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.=.' - 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 ;( � 5 '; = r TENDERED',,
•CH NGE-,
CHECK N
SIGNATURE
NO. 2599
GENERATOR
THIS MANIFEST IS FOR REFERENCE PURPOSES ON!Y.GEN:RATOR 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: i '0,- t SHIP DATE:
COMMODITY SHIPPED:
I '
LOOSE: WO (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: ; Li # GROSS
TARE
LA 17 7_0 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.
i
GENERATOR AUTHORIZED AGENT(PRINT NAME) F=f j^ (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.
F�I_ CCEPT RESPONSIBLITY FOR THEDRIVER: �0 F ANSPORTATION OF THE CA12G0 AND(PRINT NAME) EIGHT AS DESCI:IBED ON THIS
TICKET&ASSERT THAT ALL THE
PROPER PERMITS AND LICENSES HAVE
E,EEN OBTAINED.
DESTINATION
DISPOSAL LOCATION: r Ar I !A --f"A 6Y --'!" DATE DELIVERED: i -
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 ->— w TICKET` 3=< ' GRID 'WEIGHMASTER °
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371017 Steph
PO Box 962/6155 Cox Lane ro TIM -POTDATE;OUT ' YIME;IN TIME-OUT VEHICLE ROLLOFF
Cutchogue, NY 11935 -
06/11/18 106/11/18 08:51 108:51 11114T
009316 Town of Babylon✓
REFERENCE I ORIGIN
Scale 2 Gross Wt. 86660 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Wei ht 46260 LB
'CITY UNIT , „„ _`:E.DESCRIPTION n - " *."" RATE :EXTENSION.` _FEE
TOTAL.
23.13 TON UTGO.MSW 0.000 0.00 0.00 0.00
t,
Operating hours 7:00 AM to 5:00 PM 7 days a week.a . yE: ` ,V-_ tell]
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.,E�y 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 - ,`.;. � � ,' _ _- TENDERED
r. - CHANGE
'C ECKNO:," -
SIGNATURE
SITE TICKET`. GRID WEIGHMASTER`
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371017 Steph
PO Box 962/6155 Cox Lane VERI ,,,
DA INDATE OUT .,_TIME IN TIME"OUT CLE, _'_ ,;`" ROLL OFF
Cutchogue, NY 11935
06/11/18 06/11/18 08:51 08:51 11114TC
009316 Town of Babylon REFERENCE •-
IGIN
Scale 2 Gross Wt. 86660 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
CITY UN DESCRIPTION RATE EXTENSION _-FEE TOTAL
23.13 TON CUTGO.MSW 0.000 0.00 0.00 0.00
_ t j
I
Operating hours 7:00 AM to 5:00 PM 7 days a week. `..~6s. ` :'M - t', •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.`'y�.: -- ._ ,I,; '
NEXT HOLIDAY: Memorial Day, Monday, May 28 "-
TENDERED-
'._"�i "�n�tl��
CHANGE'
CHECK-NO.
SIGNATURE
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<1A,SSUME,,ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: �-- �`- ¢ )-! �—d1 SHIP DATE:
COMMODITY SHIPPED: _5 VQ
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: -4 -` GROSS
' tr >
U= i t ' TARE
4
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
d
GENERATOR AUTHORIZED AGENT(PRINT NAME) _ (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO. f-') t F `O
TRUCK NO. LICENSE LICENS{E 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
I ACCEPT RESPONSIBLITY FOR THE
TRANSPORTATION OF THE CARGO AND
DRIVER: ,_ a WEIGHT AS DESCRIBED ON THIS
(PRINT NAME) TICKET&ASSERT THAT ALL THE
PROPER PERMITS AND LICENSES HAVE
i BEEN OBTAINED.
DESTINATION
5
DISPOSAL LOCATION: � d' � �} DATE DELIVERED- f 3
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** SITi '. - TICx�r,
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371399 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 V-AT�IN- PArEOUT'= TWE IN f!MAEOirT vEr�iclE.=
06/12/18 06/12/18 12:52 12:52 111 14T
009316 Town of Babylon
REFERENCE
•-
Scale 2 Gross Wt. 83140 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 47140 LB
QTY UNIT DESCRIPTION--- RATE EXTENSION FEE `TfliAL c
23.57 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating ours oclays a weeK, Loll]
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED
'CHANGE
CHECK O.. -
SIGNATURE
**DUPLICATE TICKET** ;SITE TICKET " GRID. _ " wEIGHMA$TER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371399 Steph
PO Box 962/6155 Cox Lane
CUtChogUe, NY 11935 DATE'{N, DATE OUT TIME 1N TIME OUT 1(EIiICLE- ROLLOFF
06/12/18 06/12/18 12:52 12:52 11114TC
009316 Town of Babylon
REFERENCE
Scale 2 Gross Wt. 83140 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 47140 LB
QTY UNIT DESCRIPTION RATE ;' EXTENSION FEE TOTAL
23.57 TON DUTGO.MSW 0.000 0.00 0.00 0.00
,operating nours odays a wee , •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685:.' 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED .
CHANGE-'
•
>CHE NO.
SIGNATURE
NO. 8697
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: t >t_f,i; LWj_ dJ SHIP DATE: C^
COMMODITY SHIPPED: m
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. �, L/ICENSE NO/STATE-
TRAILER NO. ; a LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP,AT THE GENERATOR SITE,L'ISTED ABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW. f'
5 �
DRIVER: 1
(PRINT NAME) Mme'" (SIGNATURE)
DESTINATION f
1
DISPOSAL LOCATION: .n i l 1 t/n° DATE DELIVERED: I
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 rICKET`c y_==Y GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371303 Steph
PO Box 962/6155 Cox Lane >..,
CUtChO9Ue, NY 11935 DATE"It�f, 'DAT OUT:'„ "`t(ME IN", TIME OUT ""VEHICLE ROLL OFF'
06/12/18 06/12/18 08:52 08:52 11114T
009316 Town of Babylon REFERENCE
Scale 2 Gross Wt. 104020 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 63620 LB
' FEE':
TOTAQLY � SO3
31.81 TON OUTGO.MSW 0.000 0.00 0.00 0.00
F, r
Operating hours 0 todays a wee :4� •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.-',_1,&, ~ µ 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 - `" W TENDERED_
i";T n i'4 i), .,n r 4
,
" - ,'.:�.�'• "'CHANGE
,CHECK NO:,
SIGNATURE
51TE '; TICKE7 GRID WEIGHMASTER, ,Y
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371303 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE°IN: ,DATE OUT,- ,'TINIEtN' TIME OUT, `VEHICLE ROLLOFF
06/12/18 06/12/18 08:52 08:52 11114T
009316 Town of Babylon
REFER ENCE ORIGIN
Scale 2 Gross Wt. 104020 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Wei ht 63620 LB
'=--;QTY '- UNIT " DESCRIPTION RATE __'EXTENSION `_FEE = TOTAL
31.81 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating ours 7:00 AM to 5:00 PM 7 days a week?;, I Q W.Aj kyj Lftv]
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED
CHEOWN
SIGNATURE
SITE TICKET` _`.` GRID'_=-` "WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371303 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 _DATE IN DATE OUT TIME IN-TIME OUT VEHICLE ROLL OFF__
06/12/18 06/12/18 08:52 08:52 111 14T
009316 Town of Babylon
rREFERENCE
•.
Scale 2 Gross Wt. 104020 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 63620 LB
OTY„ .__. ; 'UNIT
zDESCRIPTION °'RATE_ "`, EXTENSION,= FEE ' TOTAL
31.81 TON DUTGO.MSW 0.000 0.00 0.00 0.00
i"' '`• of/ 'a i�. �'� t4 �.-4 y �'�
Operating hours o ays a weeK' •
CLOSED HOLIDAYS-QUESTIONS CALL 6311-734-7685,-7, `' .,_ -°' ._'�, 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED-
'CHANGE
ENDERED,'CHA GE
. CHECK
SIGNATURE
SITE TICKET' '
GRID' WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371303 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN ` DATE OUT TIME IN-TIME OUT VEHICLE -ROLL OFF' '
06/12/18 06/12/18 08:5208:52 11114TC
009316 Town of Babylon REFERENCE ORIGIN
Scale 2 Gross Wt. 104020 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 63620 LB
Q(y:' UNIT ""'' DESCRIPTION' "° RATE-"'r' rl EXTENSION` - FEE TOTAL
31.81 TON DUTGO.MSW 0.000 0.00 0.00 0.00
ir
Opera Ing ours o days a wee . f L _"a -n__ %' Edi •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. E, `- T 0.00
;a
NEXT HOLIDAY: Memorial Day, Monday, May 28 Diu „ ::, ! ,yY- TENDERED'u"
CHANGE
CHECK NO:
SIGNATURE
NO. , 8698
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: ,� ; 1 z/�y l '> rte' SHIP DATE:
COMMODITY SHIPPED:
LOOSE: J (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. {� f
TRUCK NO. ry LICENSE NO/STATE: v
TRAILER NO. 1 r' LICENSE NO/STATE: >
s -
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.
,t
DRIVER: •�^. `' %.
(PRINT NAME) ' (SIGNATURE)
` f DESTINATION\
DISPOSAL LOCATION: :- '' ( fr / /' ;' fit ` frh, DATE DELIVERED: t 1
ADDRESS: N , �
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 " GRIDS''" - WEIGHMASTER
DUPLICATE TICKET - -
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371659 Steph
PO Box 962/6155 Cox Lane - - -
Cutchogue, NY 11935 DATE IN DATEOUT ; TIME-JN TIME OUT' VEHICLE ROLL.OFF,.°
a 06/13/18 06/13/18 13:14 13:14 11114T
009298 Universal Commodity Services,
2315 82nd Street 1 st FI REFERENCE •_
Brooklyn NY 11214
Scale 2 Gross Wt. 63080 LB Outbound-Charge ticket
Manual Tare Wt. 36260 LB
Net Weight 26820 LB
QTY- UNIT ' DESCRIPTION RATE. EXTENSION' 'FEE _,TOTAL
13.41 TON Out. Shrink Wrap UCS 30.000 402.30 0.00 402.30
f
J-1 r9 ty1jw, Ty�/
Opera mg ours o 5:Ob PM 7 days a week-
CLOSED
ee CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.z', _` ., 402.30
NEXT HOLIDAY: Memorial Day, Monday, May 28 'I° ;r '., - TENDERED
=' -
CHANGE
CHECK NO°_ a
SIGNATURE
"DUPLICATE TICKET" SITE TICKE'P °" GRID=" - _ WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371659 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 , DATEIIN- . DATE OUT.'°' " TIME INS.TIME OUT ""^VEHICLE ^ '' ".ROLL OFF
06/13/18 06/13/18 13:14 13:14 11114T
009298 Universal Commodity Services, •.
2315 82nd Street 1 st FI
Brooklyn NY 11214
Scale 2 Gross Wt. 63080 LB Outbound-Charge ticket
Manual Tare Wt. 36260 LB
Net Wei ht 26820 LB
=" 'QTY., UNIT" DESCRIPTION RATE -EXTENSION"' `FEETOTAL' _
13.41 TON Out. Shrink Wrap UCS 30.000 402.30 0.00 402.30
IJ
I
Operating hours :00 AM to 5:00 PM 7 days a week
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685 402.30
NEXT HOLIDAY: Memorial Da Honda May 28 �ur' ' ,' TENDERED a _
HANGE--
CHEQCNO:
SIGNATURE
SITE f-_-" TICKET,;:` »E GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371538 Steph
PO Box 962/6155 Cox Lane - -
Cutchogue, NY 11935 ,DATE,IN, DATE OUT = TIME IN,TIME OUT , _ VEHICLE., ROLL OFF
06!13/18 06/13/18 ]08:51 08:51 111 14T
009316 Town of Babylon
Scale 2 Gross Wt. 79260 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 38860 LB
QTY. UNIT- ',DESCRIPTION, RATE - EXTENSION=,,. FEE •,TOTAL,'-
19.43
,OTAL„ -
19.43 TON DUTGORSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week:.- 411111111111= •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-76, 5 ' ', "_ 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 n r°`qt-° '° �.,E5 „; TENDERED': _-
CHECK
SIGNATURE
TICKET ` GRID, ,!- WEIGHMASTER rr
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371538 Steph
PO Box 962/6155 Cox Lane -
Cutchogue, NY 11935 ”-'OATE,IN DATE:OU.T, TIME IN° TIME OUT ;,,VEHICLE*„ ROLLOFF.
06/13/18 06/13/18 08:51 08:51 111 14T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 79260 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Ne- e' -38860 LB
QTY UNIT DESCRIPTION 2'' '� -RATE.:a -,EXTENSION FEE TOTAL.
19.43 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week�,ss ` 'e` f -" " •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.6:y„F. - 4. ; P' 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 `'' ` � TENDERED=_
"?< — r$'.1R" CHANGE
G ECK NO.
SIGNATURE
NO. 2600
�I Z
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 A,rSSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.'
COMPANY: t.' I r101 l� SHIP DATE:
COMMODITY SHIPPED: <1 Ivi )
LOOSE: # v ; (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: µj r 1 `' 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
"t p
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE) rP
TRANSPORTER
`"f
TRANSPORTATION/FREIGHT CO. � � ' `/\JI � �/� � "t�i
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.-
I ACCEPT RES PONSIBLITY FO�THE
DRIVER: -------4 TRANSPORTATI0IT OF TILE C
(PRINT NAME) WEIGHT AS DESCRIBED ON THIS I
TICKET&ASSERT THAT ALL THE
PidOPER PERIN7ITS AND LICENSES HAVE ~
BEEN OBTAINED.
DESTINATION--_____ !
t i _
1
DISPOSAL LOCATION:
l( f' f`°� 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.
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2432
Islandia, IVY 11749
(631) 342-9673
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: t )L, LA Tt=! / . Ll) SHIP DATE: C---
COMMODITY SHIPPED:
LOOSE: i (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: %�C.�' GROSS
- ' - TARE
r
NET
HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIWFREE 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 r 1
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER '/ /�
^^ 11
TRANSPORTATION/FREIGHT CO. �^ j'' �,/ Um .ry
TRUCK NO. �� J 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. •
F -
(PRINT NAME) (SIGNATURE)
DESTINATION
( p J r'�� {
DISPOSAL LOCATION: jam✓` i�/ }�'�/ /f 1 DATE DELIVERED: (J
ADDRESS:
t
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 „ ,TtcKeT GRID wi fGHnnAsrER= h
S`OUTAOLD TOWN DEPT SOLID WASTE 01 01371763 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN DATEOU7 _TIME IN' TiMEOUT _ VEHICLE e, ROLL OFF
06/14/18 06/14!18 109:29 109:29 11114TC
009316 Town of Babylon
REFERENCE ORIGIN 2 Gross Wt. 77820 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 41820 LB
QTY =. „'UNIT. ,,'.. _.; 3,.„ 1.,DESCRIPTION,
ION. _ RATE - EXTENSION„°-,, .;` - ,FEE TOTAL
20.91 TON DUTGO.MSW 0.000 0.00 0.00 0.00
r'
Operating hours odays a wee fry, _ ;5Loll,
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.,,-,: _ `” „z.`� 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 P.._. ._—
�,,,, '-rn ,v;: � � 'r., �,,. TENDERED-:,"'
?: CHANGE
CHECK-NO: „
SIGNATURE
**DUPLICATE TICKET** SITE ':TICKET GR1D,T 'WEIGHMASTER -
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371763 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 ` DATEIN DATE=OUT , .TIME IN TIME OUT 'VE'HICLE j ROLLOFF
06/14/18 06/14/18 09:29 09:29 11114TC
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 77820 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Wei ht 41820 LB
.„ DESCRIPTION, , `, RATEr IXfENSION- FEE ,.`,. TOTAL,.
20.91 TON UTGO.MSW 0.000 0.00 0.00 0.00
1 ,
z _
°r
Operating hours 7:00 AM to 5:00 PM 7 days a week:;, s,'. ' .' t' . -' a •
CLOSED HOLIDAYS-QUESTIONS CALL 631-7344685.;` _ s-�` ? s� 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 ;, . E TENDERED-'
CHANGE--,
_-CHECK•NO.
SIGNATURE f)
li"RINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2430
Islandia, NY 11749
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE.PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT f SSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: FI O LA T IBJ U t_� SHIP DATE:
COMMODITY SHIPPED:
LOOSE: { �1 L) (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: ' `{ �' GROSS
(.t TARE
'4 'r` t'. 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
f , f ,
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 LID ABOVE, 'AND THAT IT-WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW. f
DRIVER: 'tea
(PRINT NAME) j (SIGNATURE)
DESTINATION• _
DISPOSAL LOCATION: \/At " ' , ` E, `, `}vf' DATE DELIVERED: J
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
'*Fill''LICATE TICKET"* SITE TICKET =' GRID WEIGHMASTER- „
SOUTHOLD TOWN DEPT SOLID WASTE 01 01372076 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 ._DATEIN"- I °DATE-0UT" ,TIME IN TIME,OUT VEHICLE ROLLOFF
06/15/18 06/15/18 13:11 13:11 11114T
009316 Town of Babylon REFERENCE
Scale 2 Gross Wt. 87020 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 46620 LB
='QTY UNIT = -"DESCRIPTION - RATE "_ EXTENSION FEE TOTAL'--_-
23.31 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours Tod M todays a wee r •
r' :b` 0.00
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.
> z', :.fti t
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED
� `' ;� ,r FiAY .�
'CHANGE
CHECK NO
SIGNATURE
"DUPLICATE TICKET"" SIlE TICKET'_ GRID `INEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01372076 Liz H
PO Box 962/6155 Cox Lane VEHICLE R
JJ DATE PUT _TIME,IN-TIME OUT
Cutchogue, NY 11935 ATE I HIc�E„ ,OCL OFF
06/15/18 06/15/18 13:11 13:11 11114TC
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 87020 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 46620 LB
"QTY." UNIT"„"' DESCRIPTION- RATE'' EXTENSION_ °,, FEE' TOTAL.'
23.31 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week: _�`$ •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685: '1 Iry ` s 0.00
` - * TENDERED'
NEXT HOLIDAY: Memorial Day, Monday, May 28
'-C ANGE
CHECK NO "
SIGNATURE
`TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2436
Islandia, NY 11749
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES N-OT
ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS. w
COMPANY: SHIP DATE:
COMMODITY SHIPPED: Iffs 'tom'
LOOSE: t to (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: GROSS
`d LLC TARE
C, 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
r
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
�-� TRANSPORTER
vtAf r lr
TRANSPORTATION/FREIGHT CO.
TRUCK NO. , 2.5 ` LICENSE NO/STATE:
TRAILER NO. ` t LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR,SITELISTE ErABOVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED'BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
f
rtl1OIIAA
7;\
TINATION
DISPOSAL LOCATION: ftA J ') L U I DATE DELIVERED:
ADDRESS: 1
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.
9UPL ATE TICKET"
SOUTH-11LD TOWN DEPT SOLID WASTE 01 01371988 Liz H
PO Box 962/6155 Cox Lane bATE' OUT1 I OLL OFF
Cutchogue, NY 11935
06/15/18 06/15/18 09:21 09:21 11114TC
009316 Town of Babylon
REFER ENCE
Scale 2 Gross Wt. 86220 LB Outbound-Charge ticket
Manual Tare Wt. 36260 LB
Net Weight 49960 LB
QTY.
QW.
TOTdA �
"DESCRIPTION RATE E)(TENSION FEE TOTAU-
-UNIT
24.98 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 0:06PM 7 days a weeK!
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-715
0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED
-CHANE-E
CHEQKNO::�
SIGNATURE
IKET GRID-,
"DUPLICATE TICKET" (S-IfEl-, '_* , , -- ,- 1_' r"� WEIGHMASTOR
SOUTHOLD TOWN DEPT SOLID WASTE 01 01371988 Liz H
PO Box 962/6155 Cox Lane -
7 N ,0,ATIE oL T, -%TiME IN�TIME UT
Cutchogue, NY 11935
009316 Town of Babylon 06/15/18 06/15/18 09:21 09421 111 14TC
REFERENCE ORIGIN
Scale 2 Gross Wt. 86220 LB Outbound-Charge ticket
Manual Tare Wt. 36260 LB
Net Weiqht 49960 LB
- TE -�'�10TAL
DESCRIPTION"".-' RA '__'EXTENSIONr-.` FEE",
QTY UNIT'
QW.
24.98 TON CUTGO.MSW 0.000 0.00 0.00 0.00
_LY
Operating hours 7:00 AM to 5:00 PM 7 days a week.—,);-
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-76135. 0.00
TENDERED
NEXT HOLIDAY: Memorial Day, Monday, May 28 TN,
"N
-,CHANGE--'
F-- CHECK 21:1
SIGNATURE
7
W- ITY TRANSPORTATION CORPORATION t
214 Blydenburgh Road 2433
Islandia, NY 11749 NO
(631) 342-9673
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.
ti
COMPANY: () a' % ( _�� SHIP DATE: "
COMMODITY SHIPPED:
LOOSE: I- t) (CU YDS)_
BALES:(COUNT): '
-TRUCK WEIGHT: ��,%�_.� ��j GROSS
� r 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. f t r•� ? ` I t�' f') ��f
TRUCK NO. 2- LICENSE NO/STATE:
TRAILER NO. I Er 1 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: L 7
(PRINT NAME) � (SIGNATURE)
f DESTINATION
DISPOSAL.LOCATION: � { /" -1 `� r t ( eJ 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.
SITE -_ TICKET„,£- GRID WEIGHMQSTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01372226 Steph
PO Box 962/6155 Cox Lane - -
Cutchogue, NY 11935 s DATE IN`, DATE OUT `TIME IN:TIME OUT VDHICLE -ROLL
06/16/18 06/18/18 09:39 09:39 L
11114T
009316 Town of Babylon
REFERENCE ORIGIN 2 Gross Wt. 77300 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 41300 LB
QTY ' _ UNIT " DESCRIPTION_ " RATE' `EXTENSION ''FEE= ',__`, -'TOTAL:-,
20.65 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Q
r
f
Operating hours 7:00 AM to 5:00 PM 7 days a week:F -' -, `�° ` �` ;E •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685 ¢'" 4` p- ' ''t ,� .. � 0.00
TENDERED
NEXT HOLIDAY: Memorial Day, Monday, May 28
w?r aim
CHANGE__
ANGE
CHECK O
SIGNATURE
SITE ' TICKET GRID' WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01372226 Steph
PO Box 962/6155 Cox Lane - - - -
Cutchogue, NY 11935 --DATE IN,, DATE,,,OUT.,., -,,TIME IN'TIME OUT VEHICLE„, - ROLL OFF„
06/16/18 06/16/18 09:39 09:39 111 14T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 77300 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Wei ht 41300 LB
QTY UNIT„ bESCRIPTION 4 - RATE' dEXTENSION' „ FEE” a+ ,TOTAL'
20.65 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week ",- " ; ' ° •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685'-'® `,
NEXT HOLIDAY: Memorial Day, Monday, May 28 <s `s ;"lfi �, =;{; `° � " = TENDERED
_ q - CHANGE'
CHECK N
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road 2438
Islandia, NY 11749 NO.
(631) 342-9673
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. J �
COMPANY: J) _ _ SHIP DATE:
COMMODITY SHIPPED: J i
LOOSE: ) (F i) (CU YDS)
BALES: (COUNT): ,
TRUCK WEIGHT: 1 �) 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 AP LP ICABLE 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)
TRANSP`O-RTER
TRANSPORTATION/FREIGHT CO. �
TRUCK NO. LJCENSE NO/STATE:
TRAILER NO. LICENSE NO/STATE:
I HEREBY CERTIFY.THAT THE ABOVE,NAMED MATERIAL WAS'PICKED'UP AT THE GENERATOR SITE-LISTEDrABOVE,.AND THAT,IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LIST.ED•BELOW-.
DRIVER:
(PRINT NAME)i` (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" SITEWEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01372860 Liz H
PO Box 962/6155 Cox Lane __
Cutchogue, NY 11935 DATE
IN"`'. DATE-OUT 'TIME9N TIME`OUT ,i VEHmE '" ROLL=OFF"
06/18/18 06/18/18 13:48 13:48 11114T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 79340 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 43340 LB
QTY _ :UNIT` DESCRIPTION "RATE '_} EXTENSION'__ FEE' -TOTAL:- ._
21.67 TON OUTGO.MSW 0.000 0.00 0.00 0.00
a,
Op a eOR'
- .
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685., ~` 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28
=-4 rr TENDERED
CHANGE *M -
CHECK NO. `—
SIGNATURE
""DUPLICATE TICKET * S17E TICKET,'`" GRi6, _ 1NEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01372860 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 ,, DATE,IN ' DATE,OUT,,4,, TIME IN TIME OVT " „ VEHICLE",, "'ROLL,,OFF
06/18/18 06/18/18 13:48 13:48 1 11114TC
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 79340 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 43340 LB
QTY' —__ UNIT'"^ DESCRIPTION"'„` - ”' °'° :RATE _ 'TENSION FEE TOTAL_-
21.67 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Op§1TMg hourg 7 AIVI toclays a wee _ _ f •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. LL," 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED '
--_CAGE
CHECK NO. __
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road No. 2437
Islandia, NY 11749
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE.PURPOSES ONLY.GENERATOR DOES'NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT\SSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: h SHIP DATE: �'"f� I cs
COMMODITY SHIPPED: AA < \j
LOOSE: f U (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
1 k
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 Li D ABOVE, AND THAT IT-WAS
DELIVERED WITHOUT-INCIDENT TO THE DESTINATION LISTED BELOW. . `f
DRIVER:
(PRINT'NAME)`' / (SIGNATURE)
3 ..
DESTINATION
DISPOSAL LOCATION: � /1 i'A ,L-1A 4 /\j DATE DELIVERED:.
ADDRESS: V
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.
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road 2443
Islandia, NY 11749 NO
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOTrASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: El� ( {, r SHIP DATE:
COMMODITY SHIPPED: Al, 5 yj
-
---LOOSE------- - - G 1-) (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: : GROSS <
4r 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/FR EIGHT
RANSPORTER-TRANSPORTATION/FREIGHT CO. E A) j
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-LISTEO ABOVE, AND THAT IT WAS '
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
`. s
DRIVER:
(PRINT NAME)' (SIGNATURE)
®ESTIMATION�
DISPOSAL LOCATION:-a 3i!/`a �� ti.�f 'tx f ! �:/ DATE DELIVERED:
Lo
ADDRESS: V l
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(PRINTNAME) 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" GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01373058 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 "' DATE IN Y' DATE OUT:° -TIME IN~TIMEOUT ;- VEHICLE '` POLL OFF ~,_
06/19/18 06/19/18 12:57 12:57 11114TC
REFERENCE
009316 Town of Babylon
s-
r
77
Scale 2 Gross Wt. 78200 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 37800 LB
- _ QTY_ UNIT_=' D_ESCRIPTION_=' `'_ RATE EXTENSION _ `" _FEE" `_ ".TOTAL'__
18.90 TON OUTGO.MSW 0.000 0.00 0.00 0.00
- _22
IV
'mss '.i e�`�. •!'- `- _ '� �l - '�' •e
O
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 ,..", l TENDERED'
y CHECK NO:
SIGNATURE
"*DUPLICATE TICKET" SITE I TICKET GRID 1 - WEIGHMASTER '
SOUTHOLD TOWN DEPT SOLID WASTE 01 01373058 Steph
PO Box 962/6155 Cox Lane _
Cutchogue, NY 11935 DATE i{V " ;,',Df TE IO,UT+y G1 TIME,IN TIME OUT„r „VEHICLE,^ ROCCOF.F ,.`
06/19/18 06/19/18 12:57 12:57 111 14T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 78200 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 37800 LB
QTY' UNIT' DESCRIPTION-' - "RATE EXTENSION' 'i'" "$ ', ,FEE" ;, .TOTAL
18.90 TON OUTGO.MSW 0.000 0.00 0.00 0.00
I/t tS, 4 3f
•S _ .1
Op ee -t
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. '" K tih 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED
CHANGE'
CHECK NO.
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2440
Islandia, NY 11749
(631) 342-9673 r
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: C 1) IA-11I,•I () t __�) SHIP DATE:
COMMODITY SHIPPED:
�J'1 3 �,j
LOOSE: 1 y a? (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: J _ _' E '' �` GROSS
Uhf
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 JO-OR ANY APPLICABLE STATE LA W,.HAS_B.EEN_eROPERLY
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. t E � �--/
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. s �1. LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED UP AT THE GENERATOR SIT LISTED-ABOVE,•AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW /
DRIVER:
(PRINT NAME) !�/ (SIGNATURE)
DESTINATION/
DISPOSAL LOCATION: / t 1f'�,
DATE DELIVERED? is
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' GRIM- PEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01372971 Steph
PO Box 962/6155 Cox Lane _
Cutchogue, NY 11935 DATE IN, ,,DATE OUT TIME-IN,TIME,OUT VEHICLE ROLLOFF
06x19/18 06/19/18 08:55 08:55 11114TC
009316 Town of Babylon
•-
Scale 2 Gross Wt. 87980 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 51980 LB
QTY' IJNiT - y
DESCRIPTION RATE EXTENSION FEE -.TOTAL'„�'
25.99 TON OUTGO.MSW 0.000 0.00 0.00 0.00
t _ J
Opera Ing Hours oclays a weeK.
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.”- r :. ? ' 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28
"¢• r<
CHANGE -
CHECK NO,-
SIGNATURE
**DUPLICATE TICKET" SITE . =TICKET_ :'GRID_ WEiGH' MXSTER'_,,_`, _
SOUTHOLD TOWN DEPT SOLID WASTE 01 01372971 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DAMIN' DATE,0UT i ",TIME IN TIME OUT. : '-VEHICLE ',:,'s , r ROLLOFF''„
06/19/18 06/19/18 08:55 08:55 11114TC
009316 Town of Babylon
Scale 2 Gross Wt. 87980 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 51980 LB
QTY.' UNIT' DESCRIPTION 'FK `' "'^"':RATE' `>'"'' "_EXTENSION, - -FEE, -OTOTAU 6-
25.99 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week:_ _ •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.,-, 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 °E TENDERED:-.
<
3CHA GE
G H K N .r
SIGNATURE
TRINITY TRANSPORTATION'ICORPORATION -
214 Blydenburgh Road NO. 2439
Islandia, NY 11749
F r
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT ASS
,,rrUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS. j J
COMPANY: ' ( %I i ;�� ( { SHIP DATE: / ge ! i
COMMODITY SHIPPED: 1�`
LOOSE: r-' (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: , ' GROSS
ii`,"i .I U0 TARE
C7NET
HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL DOES NOT CONTAIN FREE LIQUID'AS DEFINED BY 40 CFR PART- 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. rj
TRUCK NO. ' LICENSE NO/STATE:
TRAILER NO. C 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: i,;
**DUPLICATE TICKET*" (SITE[ TICKET„-. GRID ;:; WEIGHMASTER• „
SOUTHOLD TOWN DEPT SOLID WASTE 01 01373167 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 = DATE IN-,, -DATE-OUT- TIMEfN TfME OUT=_ ,VEHICLE _. ROLL OFF
06f20/18 06/20/18 08:59 08:59 111 14T
009316 Town of Babylon REFERENCE - ORIGIN
Scale 2 Gross Wt. 81180 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 45180 LB
QTY=.`° t UNIT-:=,,:,, ,_ _f -'DESCRIPTION-,
DESCRIP7_IO RATE EXTENSION"; FEE "„ TOTAL,
22.59 TON OUTGO.MSW 0.000 0.00 0.00 0.00
fes.• -. I'd f`�f $ W.>3.»
jv
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. :; ;� ~~ 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 .,_, _ •,;lY „ TENDERED,
CHANGE
-CHECK NO
SIGNATURE
*• ** SITE `'' TICKET" GRID""' b61-I vIASTER'" 7.
DUPLICATE TICKET = - _ -
SOUTHOLD TOWN DEPT SOLID WASTE 01 01373167 Steph
PO Box 962/6155 Cox Lane
DATE9N,`' = N TIME OUT VEHICLE "
Cutchogue, NY 11935 =DATE OUT_" 'TIME IROLL_ 'oFF'-_ `
06/20/18 06/20/18 08:5908:59 11114TC
009316 Town of Babylon
REFERENCE
Scale 2 Gross Wt. 81180 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 45180 LB - 7
„ ==QTY_ UNIT- _ `;DESCRIRTIONI _ RATE EXTENSION=" = FEE „ _• ,,.TOTAL,, '-,)
22.59 TON OUTGO.MSW 0.000 0.00 0.00 0.00
r 1 .!r~ ht.• kv
Opul dul 19 F luul 5 1 Am to smob Pro t uaysa wee L _ •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.->-'i_ ` "< 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 ,' . TENDERED
CHECK NO.
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road 2442 ,
Islandia, NY 11749 No.
(631) 342-9673
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: t [AT 0 �__'; S1 SHIP DATE-
COMMODITY SHIPPED:
LOOSE: LY t1 (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: �'; GROSS `
TARE
\ d
st 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'ST{j��TE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED;AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING)TO APPLICABLE REGULATION
r
GENERATOR AUTHORIZED AGENT(PRINT NAME) lr (SIGNATURE)
TRANSPORTER ,
TRANSPORTATION/FREIGHT'CO. .
TRUCK NO.' S LICENSE NO/STATE:
TRAILER-NO. Z LICENSE NO/STATE: '
I HEREBY CERTIFY THAT THE ABOVE NAME D,MATERIAL-WAS PICKED UP AT THE GENERATOR SITTE L'•ISTED ABOVE; AND THAT•IT WAS
DELIVERED WITHOUTANCIDENT.+TO THE DESTINATION LISTED BELOW. jar
DRIVER: - `
(PRINT NAME) (SIGNATURE)
DESTINATION-
DISPOSAL-LOCATION: i�JA ? , �))A ioJy1 C o lJ DATE DELIVERED: "
ADDRESS: \� f
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"` $ITE "TtCKET" GRID _ -"'WLIGHMASTER '
SOUTHOLb TOWN DEPT SOLID WASTE 01 01373393 Liz H
PO Box 962/6155 Cox Lane -
Cutchogue, NY 11935 DATE=IN- DATE OUT*= -TIME IN-TIME OUT —VEHICLE =' -ROLL OFF
06/21/18 06/21/18 09:58 09:58 11 107T
009316 Town of Babylon
Scale 2 Gross Wt. 78680 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 42680 LB
77
Q_TY UNIT DESCf31PT_ION•;, _c ;._ RATE :EXTENSION- FEE TOTAL ,
21.34 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours :00 AM to :00 PIVI 7 days a week,. •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.,:':1? 4 T :�j' . 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 '<'r - t TENDERED
=CHANGE
CHECK NO.
SIGNATURE
*"DUPLICATE TICKET** sIT TIcKET="„ �RfD _ _ = wEIGHMAs7El3
SOUTHOLD TOWN DEPT SOLID WASTE 01 01373393 Liz H
PO Box 962/6155 Cox Lane -
Cutchogue, NY 11935 DATEIN -- -DATE'0UT;_,; -,TIME.IN`TIME OUT
06/21/18 06/21/18 09:58 09:58 11 107T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 78680 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Wei ht 42680 LB
QTY „ UNIT, ',`„„ ,,. a DESCRIPTION • ,RATE`, EXTENSION -FEE,, _ TOTAL.W-
21.34 TON OUTGO.MSW 0.000 0.00 0.00 0.00
V
E
Operating hours 7:00 AM to 5:00 PM 7 days a week:'*, t `_ _ •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.^:- , 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 -TENDERED' `° =
> -,CH NGE
--CHECK NO..
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2435
Islandia, NY 11749
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOTeASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS
COMPANY: �� �� SHIP DATE: '
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: f? GROSS
J TARE
G I = 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 TRANSPORTATIONACCORDINGTO APPLICABLE REGULATION.
GENERATOR AUTHORIZED AGENT(PRINT NAME) `" (SIGNATURES
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: fo
(PRINT NAME) j(SIGNATURE)
DESTINATION , -
DISPOSAL LOCATION: - f ;tU s 1 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 01 01373467 Pat H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935
r 'TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2451
Islandia, NY 11749
(631) 342-9673
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;AASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS. C
COMPANY: I IlJ �1 1, I C� ( 1 ) SHIP DATE: j
COMMODITY SHIPPED:
LOOSE: b 0 (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: 4`F t 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
ti G1-. Y
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„ArlD THAT-IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW. ”
'fes
DRIVER:
(PRINT NAME) /j(SIGNATURE)
DESTINATION' '
DISPOSAL LOCATIONU_j /-, ( r � DATEt
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.
",I UPLI ATE TICKET"" SITE _TICKET, "_-, GRID wEIGHMAOER_e
SOUTHOLD TOWN DEPT SOLID WASTE 01 01373560 Liz H
PO Box 962/6155 Cox Lane =
Cutchogue, NY 11935 DATE IN=_ _DATE=OUT,; -TIMEIN TIME OUT VEHICLE = ROLL OFF
06/22/18 06/22/18 08:42 08:42 11 107T
009316 Town of Babylon
Scale 2 Gross Wt. 83360 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 42960 LB
=' � ,
DESCRIPTION_. = RATE' EXTENSION:'
__QTY UNIT: FEE- TOTAL=
21.48 TON DUTGO.MSW 0.000 0.00 0.00 0.00
el
,{) x+0'1.•, A Yll. .i` 3t! :?`\i."f'.
Operating hours 7:00 AM to 5:00 PM 7 days a week'. u
T',,TENDERED,CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. :,NEXT HOLIDAY: Memorial Day, Monday, May 28 ^E
CHECK,NO.,
SIGNATURE
"DUPLICATE TICKET" SITE •", TICKET' - OR1D" -" °_ '`" wEIGNMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 1 01373560 Liz H
PO Box 962/6155 Cox Lane PATE`°►(� DATE OUT, iTIME IN'TIME 6UT 'VEHICLE ` - `"'""'R_OLL'OFFw".
Cutchogue, NY 11935
06/22/18 06/22/18 08:42 08:42 11 107T
009316 Town of Babylon ORIGINREFERENCE
Scale 2 Gross Wt. 83360 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Wei ht 42960 LB
,QTY- UNIT =-DESCRIPTION` RATE -` EXTENSION' n FEE _ TOTAL =
21.48 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week,.-, •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.: 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 ' ` TENDERED
CHANGE
:= C E KENO:s'�
SIGNATURE
y -
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2444
Islandia, NY 11749
(631) 342-9673
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. d
COMPANY: SHIP DATE: C i. 1 6
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: semCm GROSS
4-' r: LY f j. TARE
t C_ 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 j
TRANSPORTATION/FREIGHT.CO: 3 ,tel 1, kl/
TRUCK NO:" " LICENSE-NO/STATE:
TRAILER NO. ' t "I 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)
f
DESTINATION r
DISPOSAL LOCATION: �.J � �>I fi! I.} DATE DELIVERED:- I
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"
SOUTHOLD TOWN DEPT SOLID WASTE 01 01373644
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935
06/22/18 06/22/18 12.11 12:11 11 107T
009316 Town of Babylon
Scale 2 Gross Wt. 76340 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 40340 LB
2017 TON OUTGO.MSW 0 000 000 0.00 0.00
Operating hours 7:00 AM to 5.00 PM 7 Days per Week
CLOSED HOLIDAYS-QUESTIONS-Call 631-734-7685 0.00
NEXT HOLIDAY: Memorial Day, Monday May 28
"DUPLICATE TICKET"
SOUTHOLD TOWN DEPT SOLID WASTE 01 01373644
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935
06/22/18 06/22/18 12:11 1211 11107TC
009316 Town of Babylon
Scale 2 Gross Wt. 76340 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 40340 LB
20.17 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 Days per Week
CLOSED HOLIDAYS-QUESTIONS-Call 631-734-7685 000
NEXT HOLIDAY: Memorial Day, Monday May 28
- TRINITY TRANSPORTATION CORPORATION
,s
214 Blydenburgh Road 2445
Islandia, NY 11749 NO
(631) 342-9673
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: 1 r� 1 I,.� I. �- 'i SHIP DATE:
COMMODITY SHIPPED: 1 t 1
LOOSE: f (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: 76 GROSS
CJC�0 TARE
-3 VO 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 EY 40 CFR PART 261 bR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED,AND IS IN PROPER CONDITION FOR TRANSPORTATIONACCORDINGTO APPLICABLE REGULATION
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO: ,'\ t L `'t/ i f'' A)
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
OVE, AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION LISTED BELOW.
DRIVER:
(PRINT NAME) (SIGNATURE)
DESTINATIONS
DISPOSAL LOCATION: �. ry t J . t�1 ���1 DATE DELIVERED: I b
ADDRESS: J f 1
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
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road 2446
Islandia, NY 11749 NO
(631) 342-9673
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. j
COMPANY: �� �'i ! � '-` l� SHIP DATE: ! !!
COMMODITY SHIPPED:
LOOSE: ; , I 1 (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: `" > 3 '� � 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 TRANSPOR
-T
AT
ION ACCORDING TO APPLICABLE REGULATION
r
GENERATOR AUTHORIZED AGENT(PRINT NAME) - (SIGNATURE)
TRANSPORTER '
(` IL ,,
TRANSPORTATION/FREIGHT CO. f �� �---
TRUCK NO. =-? LICENSE NO/STATE:
TRAILER NO. t 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.
i
DRIVER: t1(- (-,• `t!
(PRINT NAME) �.r'� (SIGNATURE)
i/
DESTINATION
DISPOSAL- LOCATION: DATE DELIVERED:
}
ADDRESS: u
�
I HEREBY CERTIFY THATTHEABOVE 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
**UUPkICATE TICKET** S4TE TICKET_;,` GRID > `", WEIGHMASTERh
SOUTHOLD TOWN DEPT SOLID WASTE 01 01374339 Liz H
PO Box 962/6155 Cox Lane -
Cutchogue, NY 11935 ;DATE IN, DATE-OUT TIME IN:TIME OUT VEHICLE ROLL OFF
06/25/18 06/25/18 07:55 07:55 11 107T
009316 Town of Babylon REFERENCE
Scale 2 Gross Wt. 69380 LB Outbound-Charge ticket 77
Manual Tare Wt. 36000 LB
Net Weight 33380 LB
-QTY. UNIT DESCRIPTION RATE_ —EXTENSION '.FEE __TOTAL
16.69 TON OUTGO.MSW 0.000 0.00 0.00 000
0 7,4 ;. .
ted
Operating hours 7:00 AM to 5:00 PM 7 days a week-', Pv;� 'tdN.._:- A •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 1 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 1'`<;; n- TENDERED
"CHECK NO.
SIGNATURE
"DUPLICATE TICKET** SITE TICKET,___, GRID;` WEIGHMASTER-
SOUTHOLD TOWN DEPT SOLID WASTE 01 01374339 Liz H
PO Box 962/6155 Cox Lane
DATE IN DATE ;IM" E"O=UT vEHICi E`" `' ROLL-OFF'
Cutchogue, NY 11935 'OUT' ;'TIMEJN, T
06/25/18 06/25/18 07:55 07:55 11107TC
009316 Town of Babylon
REFERENCE
•-
Scale 2 Gross Wt. 69380 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Wei ht 33380 LB
UNIT „w" DESCRiPT10N ,,,; '.z RATEc EXTENSION,y,x',' F,EE -TOTAL,.
16.69 TON OUTGO.MSW 0.000 0.00 0.00 0.00
r .
Operating hours 7:00 AM to 5:00 PM 7 days a week:. f`, •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685--",,,3` z,
NEXT HOLIDAY: Memorial Day, Monday, May 28 �.''
_TENDERED
CHANGE
-CHECK NO.
SIGNATURE
TRINITY TRANSPORTATION CORPORATION '
214 Blydenburgh Road NO. 2447
Islandia, NY 11749
(631) 342-9673
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. 612 -COMPANY: �� (A I �/ ( { } SHIP DATE: 6 1 2 j F
COMMODITY SHIPPED:
LOOSE: > (CU YDS) F
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) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO. M.
v /
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. 7 LICENSE NO/STATE:
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL WAS PICKED,UP AT THE GENERATOR SITE LISTED ABO E;AND THAT IT WAS
DELIVERED WITHOUT INCIDENT TO THE DESTINATION'LISTED BELOW.
DRIVER:
(PRINT NAME) r% (SIGNATURE)
DESTINATION
DISPOSAL LOCATION:.(h (12 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 01 01374416 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE 1N --DATE OUT TIME IN,TIME66T 'VEHICLE 'ROLL='OFF '
06/25/18 06/25/18 11:43 11:43 11107T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 80840 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 44840 LB
QTY.-- ,- -UNIT- v; -- DESCRIPTIONRATE EXTENSION, FEE -TOTAL '
2242 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating Hours rud Am to TubvIVI 7 days a weeR. •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685..', 0.00
NEXT HOLIDAY Memorial Day, Monday, May 28 TENDERED
- CHANGE
CHECK NO�j
SIGNATURE
**DUPLICATE TICKET** SITE TICKET '- GRID I WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01374416 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN ,,DATE OUT TIME IN TIME OUT VEHICLE ROLLOFF
06/25/18 06/25/18 11:43 11:43 11107TC
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 80840 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 44840 LB
QTY UNIT', 'DESCRIPTION
RATE EXTENSION' FEE TOTAL
2242 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Opera Ing hours Tud AM toclays a weeK. •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED=_
CHANGE
CHECK'NO:
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 B lydenburgh Road NO. 2448
Islandia, NY 11749
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO R MATE IALS
BEING SHIPPED AND DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS. � �� j
COMPANY: b 1 L .,
l c ) L 1 1 SHIP DATE: r
COMMODITY SHIPPED: M <, W 1 f
LOOSE: (CU YDS)
BALES:(COUNT):
TRUCK WEIGHT: �'� �Y GROSS
TARE
L( C� NET
I HEREBY CERTIFY THAT THE ABOVE NAMED MATERIAL'DOES NOT CONTAIN FREE LIQUID AS DEFINED BY 40 GFR 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 TOAPPLICABLEREGULATION .
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:- ,.'�
l
DRIVER: 7• /` '
(PRINT NAME)- � ,!' (SIGNATURE)
ES. INATION-
DISPOSAL LOCATION: y I } A > f 1 MV ANDA A E DELIVERED: • - t I
ADDRESS:
t
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 t
GOLD TO GENERATOR, DISPOSAL LOCATION TICKET NO.
""DUPLICATE TICKET"" SITE TICKET--»`. ' GRID- = WEIGHMASTER"
SOUTHOLD TOWN DEPT SOLID WASTE 01 01374576 Dan
PO 6nr.962/6155 Cox Lane
Cutchogue, NY 11935 _`_ TE IN DATE OUT TIME 1N= TIME OUT - VEHICLE ROLL OFF
06/26/18 06/26/1808:59 08:59 11107T
009316 Town of Babylon
REFERENCE
Scale 2 Gross Wt. 82980 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 42580 LB
,QTY. UNIT DESCRIPTION RATE EXTENSION FEE TOTAL
21.29 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating nours odays a week. F."v..a •
7, r�
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685`,,`,y0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 :;,rfis `F- e=a s.= TENDERED
S" CHANGE
CHECK NO
SIGNATURE
"DUPLICATE TICKET" SITE I TICKET GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01374576 Dan
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE IN "DATE OUT TIMON TIME OUT w '_VEHICLE ROLL OFF
06/26/18 06/26/18 108:59 108:59 11107T
009316 Town of Babylon
REFERP
.-
Scale 2 Gross Wt. 82980 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 42580 LB
QTY `" UNIT DESCRIPTION ' ' RATE :;EXTENSION ' „FEE,,,, TOTAL'^
21.29 TON DUTGO.MSW 0.000 0.00 0.00 0.00
y,4-
.s
Operating ourso ays a wee - - _ - •
�. ,vW
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.�) ., "` a "� 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 � p�11rprAy,:f � ? E' TENDERED
CHANGE
CHECK NO _
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road 2449
Islandia, NY 11749 NO
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.-GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOTiASSUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS. +
COMPANY: b ( A 1 L I 1 1 1 SHIP DATE: j C �
COMMODITY SHIPPED:
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: % "tai GROSS
TARE
�5nNET
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 2.6 OR ANY APPLICABLE STATE LAW,HAS BEEN PROPERLY
DESCRIBED,CLASSIFIED AND PACKAGED.AND IS IN-PROPER'CONDITI6N FOR TRANS PORTATION)ACCORDING TO APPLICABLE REGULATION
GENERATOR AUTHORIZED AGENT(PRINT.NAME) (SIGNATURE)---,.,_` .,
TRANSPORTER
TRANSPORTATION/FREIGHT CO. f i 1ti� t -1 J `✓ f � ' i
TRUCK NO. J LICE, SE NO/STATE:
TRAILER NO. C( ) 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. r
DRIVER:
(PRINT NAME) r (SIGNATURE)
DESTINATION
DISPOSAL LOCATION: - 4MIQ ! �� i �' 17 J �-�t N DATE DELIVERED: f`� r �
ADDRESS: , 9
I HEREBY CERTIFY THAT THE ABOVE-MATE RIAL,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 WEIGHNIASTER.}
SOUTHOLD TOWN DEPT SOLID WASTE 01 01374784 Steph
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 ' DATE IN -' . DATE OUT TIME IN TIME OUT ', VEHICLE . = ROLL OFF
06/27/18 06/27/18 07:23 07:23 11 107T
009316 Town of Babylon
REFERENCE ORIGINr
Scale 2 Gross Wt. 86980 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 50980 LB
QTY - .UNIT„ .. DESCRIPTION , -RATE EXTENSION - -FEE _ TOTAL
25.49 TON OUTGOWSW 0 000 0.00 0.00 0.00
Operating nours o ays a wee •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-'7685;_-, s - _ 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 `TENDERED
:^ CHANGE,
CHECK NO:
SIGNATURE
`*DUPLICATE TICKET`" SITE ,TICKET7,, GRID, ` WEIGHMASTER-
SOUTHOLD TOWN DEPT SOLID WASTE 01 01374784 Steph
PO Box 962/6155 Cox Lane DATEI(V - EIN TIMEOUT *1H11 ROLL-,
Cutchogue, NY 11935 - '"�ATE6 - TINI, E' LL-OFF, --
06/27/18 06/27/18 07:23 107:23 1 11 107T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 86980 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 50980 LB
QTY- ' UNIT ,,DESCRIPTION, >,RATE EXTENSION FEE TOTAL -
25.49 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Opera Ing nours odays a week::
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 �`` ~:TENDERED ;
CHA GE= ,
-CHE K NO.-
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2452
Islandia, NY 11749 ,
(631) 342-9673
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: ( p? L. I 1 SHIP D
)
COMMODITY SHIPPED: � s \A r
LOOSE: 0 U (CU YDS)
BALES: (COUNT): ,
TRUCK WEIGHT: GROSS
� _�j r f Y;CJ TARE
_7-)'_I 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 CONDITIONFOR RANSPO�RTATION ACCORDING TO APPLICABLE REGULATION
GENERATOR AUTHORIZED AGENT(PRINT NAME) r/ / (SIGNATURE)
f_.,_�RANSPORTER
TRANSPORTATION/FREIGHT CO.-
TRUCK
O.TRUCK NO. - 4 LICENSE NO/STATE:
TRAILER NO. L i 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..,
i
=-�--
DRIVER:
(PRINT NAME) / (SIGNATURE)
DESTINATION `
DISPOSAL LOCATION: i }._,J j f rA) T }� 4(CAL, �� ,", �� f DATE DELIVERED:
ADDRESS:' ` l
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 e DISPOSAL LOCATION TICKET NO'
**DUPLICATE TICKET** slrE ncKEr,, t,, ,GRIb .T ,;wEIGHMASTER
SOUTH TOWN DEPT SOLID WASTE 01 01374887 Steph
PO Box 966,3155 Cox Lane
Cutchogue, NY 11935 "°'°DATE IN DATEOUT _TIME'IN-TIME OUT ,'VEHICLE ROLL OFF+
06/27/18 06/27/18 12:19 12:19 11 107T
009316 Town of Babylon
Scale 2 Gross Wt. 87240 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 46840 LB
QTY " _` UNIT, - = DESCRIP710N_ '_ ° RATE ==_EXTENSION FEE_' =_TOTAL'-'
23.42 TON OUTGO.MSW 0.000 0.00 0.00 0.00
1 _nr
Op e _ •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. ` '`. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 : .,- :-. '.TENDERED-
CHECK NO:::j
SIGNATURE
**DUPLICATE TICKET** sITE -j!C`KET, GRIo, wEIGHMasTER '
SOUTHOLD TOWN DEPT SOLID WASTE 01 01374887 Steph
PO Box 962/6155 Cox Lane -
Cutchogue, NY 11935 DATE,IN ;;;DATE OUT y,, TIME IN. TIME OUT „' r„VEHI6LE `ROLL OFF
06/27/18 06/27/18 12:19 12:19 11 107T
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 87240 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 46840 LB
UNIT'°ur_. <DESCRIPTION "' RATE: ;EXTENSION,' %"i ',FEE` "" TOTAL_
23.42 TON OUTGO.MSW 0.000 0.00 0.00 0.00
a
e `
Op a s a wee [Iliff-mV519111011
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7.68.5.. .' 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 _ " .TENDERED
-CHANGE
$_ CHECK NO.
SIGNATURE
PWNITY TRANSPORTATION CORPORATION
214 B lydenburgh Road' 2489
NO.
Islandia, NY 11749
(631) 342-9673
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: 1 i 1 { t�j j SHIP DATE: / ) f
COMMODITY SHIPPED: c W e r
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: f`'s, �r' GROSS
{o 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) �(f `(-SIGNATURE)
TRANSPORTER ,
TRANSPORTATION/FREIGHT CO.- • - ! 9 �.., `�,j d
TRUCK NO. f 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: V
(PRINT NAME) (SIGNATURE)
DESTINATION
DISPOSAL LOCATION. 11't 1/ � �I A ll � ���'+�;�'( �`�1 �
DATE-DELIVERED:
ADDRESS: / !
I HEREBY CERTIFY THAT THEABOVE 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"" 51TE ,,,,TICKET„ ` - „GRID,. WEIGHMASTER „
`SOUT01OLD TOWN DEPT SOLID WASTE 01 01375087 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DATE-IN __ •13 E_OUT'- `TIME IN TIMEOUT VEHICLE':,. f ROLLOFF
06/28/18 06/28/18 11:39 11:39 11107T
009316 Town of Babylon
a-
Scale 2 Gross Wt. 80640 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Wei ht 44640 LB
QTY. _ =UNIT, DESCRIPTION- _ = >RATE '. EXTENSION FEE„ TOTAL
22.32 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week+:
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685:w 'r 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 _ x TENDERED'.,`
1
.,
CHANGE
CHECK-NO
SIGNATURE
""DUPLICATE TICKET"` SITE -,„,,TICKET. - GRID' WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01375087 Liz H
PO Box 962/6155 Cox Lane TE IN - DA7E`OUT VEHICLE ROLLOFF
Cutchogue, NY 11935 = DA TIME N TlnnE our
06/28/18 06/28/18 11:39 11:39 11107T
009316 Town of Babylon ORIGIN'
Scale 2 Gross Wt. 80640 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Wei ht 44640 QTY_F UNIT - DESCRIPTION ” =RATE EXTENSION _ —'FEE '' = TOTAL _
22.32 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week':' Colo]
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.`" _ rn no
NEXT HOLIDAY: Memorial Day, Monday, May 28 y ;, ,:TENDERED
CHANGE
CHEMNO
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2458
Islandia, NY 11749
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOT4S/SUUMjE,ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS.
COMPANY: SHIP DATE: `` t
COMMODITY SHIPPED:
LOOSE: �� J (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: v GROSS
r o u 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
`S
''rte
GENERATOR AUTHORIZED AGENT(PRINT NAME) `,.-_(SIGNATURE) -
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. I < 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: r �
(PRINT NAME) f (SIGNATURE)
DESTINATION '
DISPOSAL LOCATION: �+/ / 3A 6:/) VL-0�� DATE DELIVERED:
ADDRESS:
HEREBY CERTIFY THAT THE-ABOVE MATERIAUHAS 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
'DUPI.a'CATE TICKET*` SITE TICKET' GRID" " ' 1NEIGHMASTER"`
SOUTHOLD TOWN DEPT SOLID WASTE 01 01375030 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 E -DATE IN,; DATE OUT; TIME IN TIME OUT y =u VEHICLE, __ROLLOFF
06/28/18 06/28/18 07:13 07:13 11 107T
009316 Town of Babylon
REFERENCE •-
Scale 2 Gross Wt. 73020 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 37020 LB
2' =QTY. -'UNIT. - DESCRIPTION _ -RATE' `; EXTENSION' 3FEE=_ __ TOTAL
18.51 TON OUTGO.MSW 0.000 0.00 0.00 0.00
j
t '
I - �J
Opera Ing oursmd AM todays a weet". �• ; ; Itaff Annol a" 11
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 'S � 0.00 •
NEXT HOLIDAY: Memorial Day, Monday, May 28 y 3 _ f '. -TENDERED,„
CHANGE
CHECKNO.
SIGNATURE
*"DUPLICATE TICKET"' SITE TICKET,r,a' GRID: WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01375030 Liz H
PO Box 962/6155 Cox Lane _
Cutchogue, NY 11935 "DATE IN.; '_=DATE OUT ' TIME IN' TIME OUT VEHICLE„'' ROLL OFF
06/28/18 06/28/18 07:13 07:13 11107TC
009316 Town of Babylon
REFERENCE
Scale 2 Gross Wt. 73020 LB Outbound-Charge ticket
Manual Tare Wt. 36000 LB
Net Weight 37020 LB
QTY UNIT` =, DESCRIPTION - r„°-” RATE' 2>''EXTENSION, FEE' TOTAL'_
18.51 TON OUTGO.MSW 0.000 0.00 0.00 0.00
i'
Opera Ing ours o ays a weeK. - __ o” , •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685..;_:° 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 _TENDERED`
r^. C AN E--
4 CHECK-NO.
SIGNATURE
Ar
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road NO. 2488
Islandia, NY -11749
(631) 342-9673
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. f r
COMPANY: E 1t } ?� ( - I ) SHIP DATE: 6 �2-e'
COMMODITY SHIPPED: } S LAI 1
LOOSE: U S V (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: , t 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: i ` °� f�► €
TRUCK NO.- 4 LICE' SE NO/STATE:'
TRAILER NO.,• e 12- 3 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 TOTHE-DESTINATION-LISTED•BELOW.
DRIVER: -----3
(PRINT NAME) (SIGNATURE)
DESTINATION'
DISPOSAL LOCATION:- A A f A ,?%A /2 V �(— V 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.
. I
*:DUFf_IDATETICKET" SITE_ , __TICKS'_., GRID,,. 2 Ai EIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01375180 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 - DATE I,N `DATE-OUT . TIME-iN TIME OUT VEHICLE ROLL OFF .
06/29/18 06/29/18 07:18 07:18 11107T
009316 Town of Babylon
ORIGINREFERENCE
Scale 2 Gross Wt. 84320 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Weight 43920 LB
QTY` DESCRIPTION RATE - ENSION- `,FEE:, TOTAL
21.96 TON DUTGO.MSW 0.000 0.00 0.00 0.00
r
t
f
Operating riours /:UU AM 00 PRI 7 days a wee > up- ,: .MAY •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. ; 0.00
TENDERED,'
NEXT HOLIDAY` Memorial Day, Monday, May 28 `i.`
-` . CHANGE
CHECK NO.
SIGNATURE
=TIC"KET'' 'GRID''_ 1NEIGHMASTEP-
"*DUPLICATE TICKET** _ _
SOUTHOLD TOWN DEPT SOLID WASTE 01 01375180 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 DAA4N 4DATE'OUT ,TIME'9N`'TIME"OUT ^ VEHICLE _ "'ROLL,FFA
06/29/18 06/29/18 07:18 07:18 11107TC
009316 Town of Babylon
REFERENCE ORIGIN
Scale 2 Gross Wt. 84320 LB Outbound-Charge ticket
Manual Tare Wt. 40400 LB
Net Wei ht 43920 LB
=OTY = UNIT, .= : DESCRIPTION__ _ `_`•RATE EXTENSION --FEE--, _ TOTAL
21.96 TON DUTGO.MSW 0.000 0.00 0.00 0.00
Operating hours 7:00 AM to 5:00 PM 7 days a week.
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685., 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 TENDERED
CHANGE`
`-CHECK NO.,
SIGNATURE
-�"'TRINITY TRANSPORTATION-CORPORATION •
214 Blydenburgh Road NO. 2457
Islandia, NY 11749
(631) 342-9673
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: NO U-1 " G L t SHIP DATE:
COMMODITY SHIPPED:- s- w
LOOSE: b (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: f GROSS
0 TARE
LlNET
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.
4
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
TRANSPORTATION/FREIGHT CO.
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. l LICENSE NO/STATE:
I HEREBY CERTIFY-THAT-THE,ABOVE NAMED MATERIAL WAS PICKED'UP.AT THE GENERATOR SITE LISTED ABOVE, AND THAT ITWAS '
DELIVERED WITHOUT INCIDENT TO'THE-DESTINATION LISTED BELOW.- ' -" _
DRIVER: , `
(PRINT NAME) /�� (SIGNATURE)
DESTINATION'.
_ j s
DISPOSAL.L-OCATION: � ' f`� A .�'l if C DATE DELIVERED:
ADDRESS: 1
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. '
MbTETICKET** SITE TICKET - GRID WEIGHMASTER
SOUTHOLD TOWN DEPT SOLID WASTE 01 01375272 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 `DATE`1N DATE OUT'` TIMEIN'TIMEOUT'_ VEHICLE. "_ ROLLOFFr"
06/29/18 06/29/18 111:33 111:33 1 11 107T
009316 Town of Babylon 11
REFERENCE ORIGIN
Scale 2 Gross Wt. 86320 LB Outbound-Charge ticket
Manual Tare Wt. 36620 LB
Net Weight 49700 LB
QTY. ri~, UNIT ,. ,_ DESCRIPTION = = RATE - EXTENSION ,.,; FEE_a = -�.<,TOTAL .--
24.85 TON DUTGO.MSW 0.000 0.00 0.00 0.00
cr
S 4 '
Operating hours 7:00 AM to 5:00 PM 7 days a week:-
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.,,,�-" 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 =r; TENDERED
C ECK O"
SIGNATURE
**DUPLICATE TICKET** sIT ;Tlct<ET, `GRIq ry vUEtGHivlasTeR x
SOUTHOLD TOWN DEPT SOLID WASTE 01 01375272 Liz H
PO Box 962/6155 Cox Lane
Cutchogue, NY 11935 .-.=DATE IN DATE OUT_ TIME IN TIME OUT, VEHICLE; ROLL OFF=
06/29/18 06/29/18 11:33 11:33 11107TC
009316 Town of Babylon
Scale 2 Gross Wt. 86320 LB Outbound-Charge ticket
Manual Tare Wt. 36620 LB
Net Wei ht 49700 LB
QTY UNIT DESCRIPTION
EXTENSION';" „'FEE TOTAL'„
24.85 TON DUTGO.MSW 0.000 0.00 0.00 0.00
,3 _
-
s 4,
Operating hours 7:00 AM to 5:00 PM 7 days a week", �,' `: •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685.; . 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 w TENDERED
177
SIGNATURE
'WNITY
TRANSPORTATION CORPORATION
214 Blydenburgh Road 2450
Islandia, NY 11749 NO
(631) 342-9673
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 AASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS. )
COMPANY: L 0 1_1 i _ I 1 SHIP DATE:
COMMODITY SHIPPED:
1
LOOSE: (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: co 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,ACCORDINGTO APPLICABLE REGULATION
GENERATOR AUTHORIZED AGENT(PRINT NAME) (SIGNATURE)
TRANSPORTER
J jot
TRANSPORTATION/FREIGHT CO.'
li 6 r� f t^ ; s
— ,
TRUCK NO. 4{ ~t 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. y
DRIVER:
(PRINT NAME) - (SIGNATURE)
DESTINATION
Ml\j ! 5� 1�DISPOSAL LOCATION: 0 f a i� � 1. DATE DELIVERED:
ADDRESS:
i
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 01 01375407 Steph
PO Box 962/6155 Cox Lane b
Cutchogue, NY 11935 +ATE.iNs ,DATE OUT, `TIMEdNF TIME-OUT .VEI1lGLE'
06/30/18 06/30/18 07:15 07:15 111 14T
009316 Town of Babylon
REFERENC V011
Scale 2 Gross Wt. 89060 LB Outbound-Charge ticket
Manual Tare Wt. 33980 LB
Net Weight 55080 LB
QTY UNIT' DESGAIPTION=_ RATE `_" EXTENSION'=` ' FEE
27.54 TON OUTGO.MSW 0.000 0.00 0.00 0.00
/: t ,tom \h E+ ,ry. V °•,:
Opera Ing ours o ays a wee •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 == TENDERED
1 CHANGE"
CHECK NO.
SIGNATURE
_ **DUPLICATE TICKET*` SITE ' TICKET - ` Alb' wEiGHniIAsTER`
VSOUTHOLD TOWN DEPT SOLID WASTE 01 01375407 Steph
:PO Box 962/6155 Cox Lane
p N"`, ,,pA„ M VEHICLE ROLL OFF "
Cutchogue, NY 11935 ATE I TE.PUT TIME IN TIME,OUT,
06/30/18 06/30/18 07:15 07:15 111 14T
009316 Town of Babylon REFERENCE ORIGIN
Scale 2 Gross Wt. 89060 LB Outbound-Charge ticket
Manual Tare Wt. 33980 LB
Net Weight 55080 LB
QTY UNtT 7 - DESCRIPTION „a — rr:- FEE;,, .TOTAL.
RATE EXTENSION
27.54 TON OUTGO.MSW 0.000 0.00 0.00 0.00
Op o ays a week. •
CLOSED HOLIDAYS-QUESTIONS CALL 631-734-7685. 0.00
NEXT HOLIDAY: Memorial Day, Monday, May 28 -TENDERED"'1£
-CHANGE---'
'CHECK NO.
SIGNATURE
TRINITY TRANSPORTATION CORPORATION
214 Blydenburgh Road 22 2441
Islandia, NY 11749 NO
(631) 342-9673
THIS MANIFEST IS FOR REFERENCE PURPOSES ONLY.GENERATOR DOES NOT TAKE POSSESSION OR TITLE OF ANY CARGO OR MATERIALS
BEING SHIPPED AND DOES NOTA 3SUME ANY LIABILITY ASSOCIATED WITH THE SHIPMENT OF SUCH MATERIALS. �{{
COMPANY: SHIP DATE:
I f
COMMODITY SHIPPED:
LOOSE: 9 U (CU YDS)
BALES: (COUNT):
TRUCK WEIGHT: > .L' (' 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.
e
TRUCK NO. LICENSE NO/STATE:
TRAILER NO. L 1 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: _x_> � je Ir ' ` 1 f �`� '
�'`� 1 i � ���'.) ' '� \� ``-'� ! DATE DELIVERED:
ADDRESS: j
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