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12/14/2005 17:10 2093399097 SANBORN CHEVROLET PAGE 02 <br /> Waste*Onfloat F9rre f*r Electronic Oas%Sfer EDT <br /> CA LAKIN TME W"r, gilt <br /> 15305 Spring Avenue <br /> Sant®Fe Springs CA 90670 (gam)802-2752 <br /> E-Mail:yyfttaetlmd <br /> ®®I�cfn .0�1 )488-2782 <br /> ©Hauler [] Generator NP-7584 Prix <br /> U®g F <br /> EDT Trip Log #. 1 659 - DATt: i __- <br /> - T M onihst Ir I _ <br /> Ha r In rmo Receipt <br /> f' W'Tire ^ IHffy InfbrrTtation: <br /> S, rne: <br /> Add 15305 > <br /> Add <br /> city,� �.F�eQS�l:'QQ,.��. _ ~ t ssa, ww: r; J 7 7,�� <br /> Phone: { :lJ �� 't <br /> [ <br /> Tins Prourarn ID- r r c ��,...y ' t <br /> Un a <br /> n <br /> Haul6r Examppon ❑ GovemritO ❑ knport Export <br /> .LGA' R Comr¢st Cemir/bed Maul <br /> LOEB#IQn: <br /> HApplrcebla: <br /> load! ..Order <br /> Theis Delivered/Refumed f z rs: 9 "- �' trM1Fhete. I RNns <br /> Alternator Cores <br /> Purchase Order# 1'h�t. rGO 20"-24,5 Starter Cores <br /> I l dustrfal Tires Miscellaneous <br /> Cash Amount lrstmel. Tires Aluminum Wheels <br /> 1 <br /> Check Amount <br /> Check Number 727 <br /> Rik Total <br /> Tire Count Measurement - <br /> n'Whol@ Tire Count <br /> ❑ Cubic Yards ; Trailer Number(a)' i <br /> ❑ Weight in LBS L"nse plate Number:';%,rr 1vCy 1�.. <br /> Wei in Tons State: 4 , <br /> jyow�pd?j u.t>y«1 Deal Number, ,• <br /> I oerRY then utdsr ppwNy Of pviury undo.Iha laws d lee S`taM d Cs�fml�MIi ria Yt$lflitfltit previtNdiboya M Mae end adn,q M eddiMM.1 em ewaro stmt fetsslt�tlM of <br /> m Infomteeon may rewt,to suspension,rwocatton,or dsnlat of rw*wal of Cre Waslq Two Matter Rapfsaeesn pursuant to Pudic Reaaur M Code eemw 42960 enc may <br /> resuN M eivil penaree uo to VS.=per day.per vbledon or odminislrstve penooMas up lo 16.000 per vbWdon par day as deagthpd in Pudic Resouroee Code Seabn 42962. <br /> yi <br /> Driver/Hauler..' ' Facility Representawe/ <br /> Signature:77;:71; %'-"�-� 7 —�_Signature: <br /> Priniled f ame. .ti:4`.: r�a,t'' Ite <br /> Date: "; i`5�` / -� Date: <br /> Co�rre•Ittt4iftiy�irrr�+�r�r3 ' l `' •; t�`pdwttn,. <br /> c• 1 � �, I r r 1 � <br /> tills t4;�a 8ete�.l�p+ a' , �'`� sbghad[r�(s bt U111� <br /> �wai��'farRl• A'E F ^y I�� T �II�¢�T�, � rrl 4 �e`.,..•..i�r.;,^ <br /> ""ICY <br /> t OMER COPY <br />