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Comprehensive Trip Log Number Load Information Facility Tire Program ID Site Suffix <br /> .m <br /> 4054087 -' APick Up Delivery <br /> Hauler Tire Program ID 1 Site Suffix nn Facility Telephone Number <br /> DATE <br /> Qoa <br /> ul Whole Tire Count ight in Lbs �x / <br /> 1 Volume Cubic Yda. <br /> Weight in Tons FD V �t�oi, <br /> i hiO , q t L ID D g <br /> Lo r� 7 <br /> 9 Eel L <br /> " 1 CERTIFY THAT UNDER PENALTY OF PERJURY OF THE <br /> _ s _ h I.for TATE OF CALIFORNLA THE S <br /> ILAWS <br /> SOF oN-PROVIDED ABOVE 9 TRUE THAT <br /> CORRECT, ' <br /> Whole Tires) <br /> / i <br />