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CA, LAKW <br /> 11 '14 „e3 <br /> Pickup ROceipt <br /> PICk <br /> IV Date. 09/22/2015 <br /> BDT Irtaai£tst: ].1014703d3 <br /> 'iDT T-tiP L09: 634779 <br /> Stare No: 036.76 <br /> r-� <br /> 940 CENTRAL A`E LAKIN TIREI wFST, itv <br /> TNC. <br /> '),'RACY CA 95376 '15305 5pr.ing Aw) <br /> 209/221-7164 ;Santa Se 5prina;i, CA 90670 <br /> L,PID: 169Q054-01 "PTD: 7.000659-Oi <br /> Truck: 423568 <br /> Trailer: 53750 <br /> l:icengje plumber: 9F34829 <br /> pmgis'tx'r><tioraa 15-06936 <br /> SCate: cA <br /> T'tem <br /> Tire; Picked Up: aty <br /> 17E <br /> °"^eYaCor <br /> i J <br /> �d <br /> Con1'lcgentxality CLai�n: The a r EO A Ation proti idea on t'),zya for.M should be <br /> considered confid,an.tial, proprietary' <br /> Tit1c� 14, CCR, SectL orn '1704 p req, aRCI/oY. trdtde 59Cret• In a4_Ozdanpm witr,i Data J' <br /> disclosure O'C•SGgi should any 'member of thcs public.. xequ®st <br /> ere of tha sf infoL�natiGli, I xe esC + '� <br /> addrq�s and 'telephone ,q P qu that C;ulReca`ule contact me at the <br /> x above. <br /> tleatroni,cforting to cam <br /> Calpncycle to participate in t��WastekandTUSad�Tire Manbeen authorized by <br /> reportirf,cS program, an behalr of EDT <br /> th51: wall 4bt.2leQtla,cally tran©mite1'toCCalRmayclasall ied ,equi�rcat'1 information from <br /> Lakin Tire <br /> this manifcm�t. CdJRecyale ha-3 aPpr0Ircd the Lakin TinW'rost ,EDT form Xor use <br /> within the Waste 171,re Man„I,fest SYstem ,IDT program. <br /> Questions? Please l�ontact Your Customer SttVic <br /> custoncnrse,rviCe@lakintire.com. Repre;9dntai jvyc at GOO-4$8-2752 or email <br />