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CA LAKW <br /> 7.015614 A <br /> Pickup Receipt PicJc� n� r c f�2/09/2016 <br /> EDT ffanlfAn-4: 1101561490 <br /> EDT Triip Log: 554941 <br /> store No: 0a6J'6 <br /> 2anPratnr <br /> ��ifi���iIGL <br /> FIRESTONE TRAcy <br /> 940 CED7RAJ AVE .Lakin Tire west <br /> TRACY , CA 95376 15305 Spring A"- <br /> 209/221-7164 Santa Fe springs, CA 90670 <br /> TPID: 1694e54-01 TPID. 1000659-0.1, <br /> Truck: 9239619 <br /> T.r.Ziler.: 53390 <br /> T.icensenn.un,Uer: 9]+34025 <br /> Registration; 16-02349 <br /> 51_a,te: CA <br /> tfM - <br /> SttY <br /> TiX4 .Picked. LpT 197 <br /> Szuuaiu Ha or <br /> �� !,,' :I UI�� I! �Vi;C I����. �ISI�'�i I�,•�'n: <br /> `JSP.; ;u ���jsp I �•Ily�,' i,u,�; <br /> Coz jd�q;taa7ity Ma.LM: Tbo. ;;.7formation pro-,,iLdorl on this form should be M <br /> �v'o-Qa <br /> Connid,5red con'f'd"t:ial, p,r_r."rp.tietarY, and/or Grade sccre't. In c�cco.tidanco witih 6 t f <br /> Title 14, CCR, Section 1701;1. ez-seq shou]d Ari,! member of the public request rt r► <br /> disc]o3urc of th�p infosmaL'ior�, Z 2egtye3t CalRndYcle contact me_ at the �~ , <br /> Address and telephone number. above. �► ,, <br /> Ele-ct:.rn»Iic RFrpe,ti ting to Ca -R <br /> ayeJe: Lalcxn T:I.zw we t k�as been �tuthox�ged by <br /> reportycle to ram. Ci,pate j.�? the TgAlgte and Used Tlr6 Manifcnt EDT pilectranic <br /> zeporl �nq proC�r�m, On beha--ij! of the Ctt5tout1cl; 1i.atOd on 'th,19 fora, Lakin Tire <br /> West Will eler_1 Lonicnl �Y tx�n.a,mit 1 o Ca1RQCyale all requ;tred inRczmatio,rt from <br /> this m,rAtZ fest. C8.1.Rooycle hTs approved the Lakin Tire Want: EDT fear, `ox use <br /> within the Flan:e Tire; Mani 4Tnt SYstwm EAT pxbgram_ <br /> Qu"ta.ons? Please Contact your CLUtome•r Sete✓�:on Aepre-,-img,tativ4� at <br /> 600-488-2752 or emEtll <br /> �.usto¢nr�,a:scrviap.@Zalcinta re.ccar,. <br /> —�..,. <br />