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0 10/11/2011 08:12 2094615F-P6 GOLDEN STATE LUMBER PAGE 01/03 <br /> L 3 9 0 9 5 5 2 <br /> Pick up !�e9uv'°�+ <br /> OPP <br /> Hauler Tire Program ID t �Sfte Suffix Facility Telephone Number <br /> r <br /> � ®,�4TE <br /> IBJ a o ; <br /> W.kf Whole Tira Count F1 Weight In Lbs. <br /> R <br /> m <br /> 7 `,I ❑ Volume Cubic Yds.❑Weight In Tons <br /> E y �C57 �1'� •� <br /> sawl$RP: lla%&I r N <br /> IN/A for I OERTWY TNAT UNDER PENALTY OF PERJURY OF THE <br /> 7 -7 V?L�) Whole Tlmnl LAWS OF THE STATTI OF CALIFORNIA THAT THE <br /> NFORMATIONFROMM AMOE A <br /> a 3909. 30 . . <br /> Rack IU�p Delivery <br /> � Maul®r TIe�Program Ib / SIg®SuffixDATE i=aoility Tele one Number <br /> awl Whole The Count ®W®ight in Lbs. m G <br /> �--7 <br /> L_.I Volume Cubic Yds <br /> E - <br /> Weight In Tons J - <br /> '•may r+. A IJ <br /> v �'�].) (N/A for I C7RTTFY THAT UNDER PENALTY or PE Bh �" <br /> -_ hula Tlrun) LANA OF THC STATE Or CALIFORNIA THAT 711,OF'ME <br /> W ^ ' <br /> • - - . • • , FO ONEDA TAU . <br /> �- , 909536 �i�k � <br /> .!LX � � � Delivery <br /> �, oo � � a <br /> Mauler Tira Program ID <br /> g / site Suffix <br /> DATE <br /> Tei®pia®ne Plut�tber <br /> ry Lu Wholo Tire Count w l ht in Lb a a <br /> g s. I w <br /> �► Volume Cublo Yds. Weight in Tons F. <br /> r f <br /> ate. §•iEurV;g{;�? C "^ <br /> 16 <br /> �Vr�•�_j <br /> 1' �J /� OT/b�/c <br /> 0 `' ✓ 7 % �lam- (N/A fOr I CERTIFY TT4AT UNDFIR PENALTY OF r1+R,luRY or TME <br /> Whole-D NW9 OF TMq STATE OF CALIFORNIA THAT THE <br /> INF PON ROVIDP_ ISO P TRU p CORM, <br /> 3909525 Rick Up Delivery <br /> O1 Hauler <br /> IX Tire Program ID / Site Suft'ox FeCiliPlorr®Number®ATE %'�'� / �Te9e� <br /> wWhole Tire Count <br /> []Weight In Lbs.. <br /> Volume Cubic <br /> $ Y1S• Weight In Tons Nainn a <br /> Com. A <br /> ,qEp <br /> �� 1.� <br /> FI.`at.ev l?ir'l2paGalai`c`s3,�F4�rtl3^�T,_•, 4 C +''. !e i'�. (r, �)•�Z J� <br /> L—IReceived Time'0 c t, 11. 2011 1: 5 8 AM N o, 2 3 6 3 (hI/A for I OcRnFY l"AT UNDFR PENALTY OF PEHJURY Or THE <br /> Whola T rang I.AWB of THE STATE Or CALIPORNW THAT THF• <br /> W ORMATION PROwnrn•nrn��.....,..--�.. IC 'i.�•. <br />