Laserfiche WebLink
A L 4228948 Up ❑ Delivery ® � <br /> 7Hau[er Tire Program ID I Site SuffixDATE Facility Telephonej Number <br /> ®n F-� <br /> Whole Tire Count 11Weight inLbs. <br /> AD <br /> 4k <br /> Volume Cubic Yds. Weight in Tons <br /> 0 1 1:1 ' -,*" 7" <br /> E 11 1 1 <br /> 0 7—fel'.4,Mle <br /> .5 <br /> z TOU C <br /> " &�'k!J -S�- Hw <br /> u f, In, als <br /> I CERTIFY THAT UNDER PENALTY OF PERJURY OF THE <br /> Dui/ V IN/A for LAWS OF THE STATE OF CALIFORNIA THAT THE <br /> Whole Irkes) <br /> WFORNATION PROVIDILD AUOVL IS I RUF.ANO OORREGT.40�� <br /> Shamrock Recycling <br /> P.O. Box 31146, Stockton, California, 95213 <br /> (209)933-9640 Office (209)933-9986 <br /> Customer: Iq C!I'4— (1 >`;C�-- <br /> cA <br /> C,"? <br /> Count Description Price Amount Manifest# <br /> Z111' Passenger Tires $ <br /> Trip Log# <br /> Light Truck Tires $ $ License <br /> Truck Tires $ $ <br /> Misc.Tires $ $ <br /> f rjo Wheels $ ')2 $ 50 <br /> Payment Information <br /> Trailer Placement $ $ Cash $ <br /> Trailer Switch $ $ Check $ <br /> Trailer Removal I$ $ Charge I$-- <br /> Totai Duel ✓ Total Received <br /> IN - i$ <br /> Driver Customer 4 <br /> Signature:_ Signature: li'l <br />