Laserfiche WebLink
Comprehensive Trip Log Number Load Information Facility Tire Program ID Site Suff ix <br /> .� 4 3 6 5 4 4 7 -- A Pick Up Delivery J Jr ® — <br /> Q 0 ❑ 000 <br /> Q) Hauler Tire Program ID / Site Suffix DATE C Facility Telephone Number <br /> LU ® Whole Tire Count ❑ Weight in Lbs. <br /> ~ Volume Cubic Yds. Weight in Tons <br /> ca <br /> 1 i� O a — (� ❑ ❑ 1 113`7 s_ 3+z'C J-"n s�- <br /> I oo I weer Name <br /> l <br /> U Q t��C�"'�&ii��i'57:<�S I"4u€.Ii£�i� Initials <br /> I- ■ ❑ . . <br /> ////��II (N/A for I CERTIFY THAT UNDER PENALTY OF PERJURY OF THE _ . <br /> `��� (55 l7b Whole Tires) HEWSOFTHESTATE CALIFORNIATHAT THE <br /> `J 5 I /v INFORMATION PROVIDED ABOVE IS TRUE AND CORRECT. <br />