Laserfiche WebLink
State of California <br /> California Integrated.Waste Management Board <br /> Tire Program Identification=Number <br /> 1599-98-1 ,I Q1 <br /> Costa Farms SITE ADDRESS: <br /> 1430 Lincoln Boulevard 12742 South Roberts Road <br /> Tracy, CA 95376 Stockton, CA 95205 <br /> o not copy or reproduce <br /> est this certificate in a conspicuous place <br /> 026 � � �OSP OB 109175 . • <br /> • ' _ • F •. •. • • • •• <br /> 3747457 -- A► Pick Up � Delivery ME R <br /> Hauler Tire Program ID ! Site Suffix Facility Telephone Number <br /> � <br /> DATE <br /> _ Q. a Whole Tire Count O Weight in Lies. <br /> m Q Q ` ~ Volume Cubic Yds.❑Weiaht in Tons ""►" 1r <br /> E <br /> -- ;amn <br /> DODO B <br /> I CERTIFY THAT UNDER PENALTY OF PERJURY OF THE 77 <br /> �JJ (N lA1or LAWS O F THE STATE o F CALIFO RNIA THAT THE <br /> W hole Tire.) INFORMATION PROVIDED AEOVE ISTRUE AND CORRECT. <br /> Load Information Facility Tire Program ID Site Suffix <br /> Comprehensive Trip Log Number <br /> 4117440 -- A_ [KPickUp ❑ Delivery © �® � ®' P D <br /> Facility Telephone Number <br /> °i <br /> Hauler Tire Program ID 1 Site Suffix <br /> � DATE- <br /> wWhole Tyre Count ❑Werght in Lbs. <br /> 9 <br /> a <br /> L C I U Volume Cubic Yds_❑Weight in Tons <br /> it <br /> N OA for I CERTIFY THAT UNDER FENDUDEAI-TY OF PERJURY OF TM <br /> ^ ^!7 i LA s Or THE STATEDF CALYORNIA THAT THE <br /> C/ C d Whale Tres) INFORMATION PROVIDED ABOVE IS TRUE AND CORRECT. <br /> - pt 4l AYwc HA C, <br /> Z-d dZZ:ZI 6l EZ9aj <br />