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Comprehensive .. Number Load Information Facility Tire Programr, Site Suff ix <br /> 5757662 -- A Pick Up ❑ Delivery <br /> Hauler Tire Program ID / Site Suffix Facility Telephone Number <br /> d DATE as ao o0 a <br /> o00 o©oaoo <br /> CL Whole Tire Count ❑ Weight in Lbs. <br /> i ~ Volume Cubic Yds. Weight in Tons �Il'�Litik <br /> E wler Name 150 W SI N CLAI R &IJE7 <br /> v �C jlQrlP.r7 r t STbU--rD N i GA Q52,15 <br /> ruler Telephone Number ■ i J Address Same as Hauler Initials <br /> (N/A for I CERTIFY THAT UNDER PENALTY OF PERJURY OF THE <br /> Whole Tires) LAWS OF THE STATE OF CALIFORNIA THAT THE <br /> INFORMATION PROVIDED ABOVE IS TRUE AND CORRECT. <br />