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Tri-C ire Recycling Work Order <br /> 15 East Kentucky Ave. <br /> Woodland, CA 95776 Date W.O. No. <br /> II/l/2007 1593 <br /> Name/Address Location-, <br /> City Wide Towing City Wide Towing <br /> 810 South Munroe 810 South Munroe <br /> Stockton,CA 95206 Stockton,CA 95206 <br /> TPID Phone# P.O. No. Terms <br /> 1372521 209-957-5757 Due on receipt <br /> Item Description Quantity Equipment# Rate <br /> Pick up Tires Pass-Scrap tires per Roger called in on 11/01/07 t Z S` 1.50 <br /> Comprehensive Trip Log Number Load Informat ion Facility Tire Program ID Site Suffix <br /> ._ ADick Up Delivery I3644359 ❑ E1 <br /> E[d/ Facility Telephone Number <br /> Hauler Tire Program ID SiteSuffixDATEoa <br /> / � <br /> y 1:44 3267 REH-NEHNN <br /> s 1 <br /> "= <br /> Tri C The ��y tiiif�g <br /> 1500 E K hitt icvv Ave ULI hole Tire Count Weight in Lbs. , <br /> aiitait3r "1va9'i <br /> W dl n CAS1,15776 } J <br /> Volume Cubic Yds.❑Weight in Tons lI I ae1Ad~,-;►Mv r.2,..o e_ <br /> ^ .c)OWVCAd -jS 2&-e <br /> E Hauler Name <br /> 3 u Stamp or Label OK <br /> : yi�ler'Ttphorle Number a Z ■ U C-� Address Same as Hauler Initials <br /> 1 CERTIFY THAT UNDER PENALTY OF PERJURY OF THE <br /> (N/A fors) LAWS OF THE STATE OF CALIFORNIA THAT THE <br /> Whole TireINFORMATION PROVIDED ABOVE IS TRUE AND CORRECT. <br /> JT <br /> ^ � <br /> Driver Signatur ����� - <br /> Thank you for your business. Terms net cash unless prior arrangements are made. A finance <br /> charge of 1 1/2%per month charged on past due accounts. ANY CHARGE UNDER$100 <br /> IS SUBJECT TO A$20 HANDLING CHARGE. <br />