Laserfiche WebLink
12/30/2014 01 :50 IFAX isacraw @eastbaytire. com @ianne Amaral 1A011/015 <br /> '" t Toli Free 1-$66-896-0600/ Ynmca1reCyr1e-ca.gov/T_!m_sJ <br /> Dapt,of Reeourooe Flearling and Rir9Wary <br /> 04 -CA Comprehensive Trip Log and Receipts 10009 RO.aux 12D9,9ecrermnf9,CA98812-1280 <br /> Cam rehensive Tri Number <br /> � ydg E X A M P FL FE 1 2 3 ' <br /> fro)INSTRUCTIONS ON BACK OF PART 2 PO NOT TAPE STAPJ.E QR PURM 11Z� <br /> By.lgntnp th!e OA OempreMrnke THP Loy and 1010c0l,ar..[pner(s)r.queatlhetdu l.fm Ilan p,vtlded on tM.term MITI be 0onfld.nd oonedsndd,pMpr!etary end"do worm.In 00owdi•ms with TNI,,10 COR,aoatlon <br /> 17017 at eap.,N e t"Uga it Mede r9r di.da-m of We Interm.aon,OelReoyole vele aont.ol the willmrM rit sty fens.t the eddreM and LSlsphoM nwr6.r provld.d en this tom,or rwa0l. <br /> Hauler Address � � M l re �` a <br /> Business Name <br /> Address x,; 0n <br /> Q Q City,State and Zip (.A 9 1-1 <br /> Common I J <br /> Carrier 1� <br /> I verily Undo panelty of penury under 1M,4"91 ins 9tw d Galfornls tea <br /> tut the Intwnmion pmy[M ee .Ie true and <br /> c0ne0r.In atldl0on.I em t>,'era 1M11.I.Iles 6 lyderined0n m.y nrxnt In euepentl0n,pv9c.Lan,a denhl<N,wuwsl of <br /> the fte"The Neuter Iel,etlm Purevelll W PP ..ours"Ove"anon 42689 end may M*%Al In 01v!1 pen.11l..up to i 9 O�N'�'Re,�'I la,Ot idm rtire neXbs W r0 65.E Per Nolelldt pM day Ff de.drlbed in"10 R..eUrOae <br /> Cede <br /> ...11.n 62282 C`� './( -1—I <br /> I I <br /> Driver's Namo KIM verse Daft <br /> 4848991 . -- X 1 . ® . L <br /> a } <br /> Hauler Tire Piidgfam ID / Site Suffix Facility Telephone Number <br /> ® oa ©oaQo � a <br /> Facl"Ifte Tire Company <br /> 7 $ 7 NamelA <br /> a 1 ' city, stat is Rvenue <br /> Hauler Name SORTQmonbo, CA 95838 <br /> EB 13 N A Stamp OF Label QK <br /> Address Same as Hauler <br /> Hauler Telephone Number IonrieyTHAT umenPer+AmOFFER,4WOFTHE <br /> LAWS OF THS STATE OF GAUFORNIA TKAT THE <br /> „FOUATIOty ABBE 19 TRUe AND GOR99 <br /> 48-4 , � ::t.7i>1„il Sys 9r�nHrtE ,�. �c)lixx, r �;.t •, � :I i;, �!, I rr. <br /> {4i d^1 �1„trai II fl>)rre l n.11'• ,; <br /> Hauler Tire,Program ID / Me,Suffix a ti ecilityI-elepholne,Mumber I' <br /> 0 <br /> Hauler Name ,; J , _ t rr�0i-v.t' <br /> is +rill,:;i Y.�il•I'�.��;,T C l .fl'�: 1..5�IL ;r'1.T r,rt n 'J r;.rc” -1 •' 4+e e y��- <br /> {�Tp or'Liii; V <br /> •..1:' s i '���!' T'ul'.� �! fljj it-. ;,..,•.1�, <br /> Haul rtelephone Numbergr. .Naular <br /> �'as' <br /> [,` '9igfgrYl 'Ul A R OR r TH#TN9PTHE t <br /> IN <br /> n1. o• Y,i1 l rT., <br /> 4848991 <br /> Hauler Tire Program ID 1`Site <br /> r`��J, �.. ,kr $�,� c+ '-;,fes �h s`�-'t• <br /> r•.,,,-, rp•,•�,,;IL'°rt'tl ICF 8 ffr3\t' 7�ll4 ',CI' C W .,•t'. <br /> .. 1'>r �'•rrritl i r. I j��' , "-_ ,Vit_ � ��'L.,,1 <br /> lIri'r rd bRt•i .�'rI`1;] f� 11".1 �) t.2i.Y2 �(•1 a+L1'J 1•� <br /> Hauler RAW, <br /> L �� i a Td1tfe s a-S <br /> Hu e T 1 hdii r 4 _ ATii( sa Sarr1v Mauler_ <br /> .,t p. _ ... .,. .. .,. �,r'••r.wrwsd��inc�l7aa':il��(i.iY",lira,"S` <br />