Laserfiche WebLink
WORK ORDER/ MANIFEST <br /> oilrr „ ... � �9- Wil►. 1274877- S .�-; �� - <br /> Waste Tire Hauler Waste:Tire,Generator, <br /> I� r <br /> McCoy Truck Tire Service Center, Inc. Name: , , �.�1'�o a "� C)vvL \b E <br /> 1407 Lone Palm Ave. Address:-) 1'5 <br /> Modesto, CA 95351 city:�`1'l�'���`�1' " c` State:. c' <br /> 209-521-6221 Zi Phone; <br /> _ <br /> TPID-1,27487.7-01 JTPID With Suffix :1L7� <br /> Load Date: � t `� Load Type. f] Whole [ ] Cubic .Yard [ ]'Ton [ ].Pound <br /> Decal # TAI :Pick-.up Count: <br /> Lic©nse.#:�1 � 5� State:C, t, Dot Code: RWDY [ a Delivery Count: <br /> SIZE, MFG. DOT 0 TREAD WHEEL COMMENTS <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> 11 <br /> 12 <br /> 13 <br /> 14 ._ <br /> 15 <br /> 16 <br /> 17 <br /> 18 <br /> 19 <br /> 20 A !f ! � 2 Ir <br /> r, 1 r <br /> itC �' .r ^� Date; <br /> Drivers Signature.�,•� Date" Customer Signature: 1 �. `cam <br /> Drivers Name (prit]t�) �'�v �: -k'7- Customer Name (print) <br /> can ly Dwl un or pono4y of pagwy Mar we laws of ala Slaw of colhorng IPut tha Inloimullurl I carlUy 0101 urulde puuulty of part undur aha laws al Zhu.°dale of Calllonda u'uI the Inlann011011 <br /> picv dad ufiove le IWv whd earruct.In additlon,I um awnru Irml lulalllualiun ul Il hie:Inlorrnutian muy pmviduu ubavu 1;Iruo and aon'eCL In addition.I am uwaro Mai lWzJlicollon of IM;Inlornwaan may <br /> rvu4fl In=*4in7lon,rav0D41foii,of Umde1 al fwiewal al Ino Wa916 TN kIauWr H00151rGIWn puruuwd lduull in civil uwmlllor;up to$16,uuu par day,pur violuliwh ur udwlululhudvu puuulilue up lu$5,000 <br /> W Publla FWauufaa Cada auction 42900 and may rucull III civil punwllue up lu 626,0w pur duy,pur par,ylDlmlon par Day a:09r,013611 In Puulle Flo:oumo Codo saallon 4:Dti2. <br /> violation or adminImrallvo 00MI110e up la 55,D00 per vlwalfen par day:Lu d=rleoe In Puudc <br /> Rr�nninn Cnrlc <br /> W.11011 42_k'1. <br /> [ ] Imported Load [ ] Exported Load and Location Hauler Exemption Status. <br /> 04�°Data Tr Address: [ ] Government <br /> �N .1 ..];LEA Exempt <br /> . 9 m City_ State: [: ]:Q ricultural <br />