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CAI
<br /> LAKIN Tim
<br /> Pickup Receipt Pick P Date: 0612812016
<br /> EDT manifest: 1101697-904
<br /> TDT Trip I og: 5 732 43
<br /> 8toX-C& No: 03656
<br /> F-TRI51UONE,, TRACY
<br /> 940 CEJ.dTPAL AVE Lakin Tire Wncmt
<br /> TRACY , CA 95376 15305 Sprinq Ave
<br /> PHONE: 209-221-7164 Santa Ft SPr•%ngn, CA. 90670
<br /> TPID: 1694654-01 PHONE: 900-460-2792
<br /> T.PIZ: 1000659-DI
<br /> Truck: 423466
<br /> Trailer: 53647
<br /> Li.ca_nsn 1AImbP : Q,T348PS
<br /> RPglst•ration:i �6-02345
<br /> stu,to: CA
<br /> Ti,•t:eS 84ched Up: 127
<br /> DRIVER: SOTELO, JORG,F, N
<br /> " I anr'..lt'}• r,hn,I; unJnr p�noJ.ty of par;l+lr,y v.nclae the, .t.nWa cf rna Stat
<br /> I,.it .S r•`i jt i :'! 1 �I`0 " r., r:� -jPl�ll= aE Cg11lnrntn that thrn do Cor,Innr,Aon ptcvl.tloq nL,nra le trvo atd cor rnct,
<br /> t I, 4 :n ncJ�,lltaon. 7. nm fliviC thmi. fnlni.rl.�.nelot n,Y this lh:nrmnr_tr>n may
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<br /> 7WIN;� ' ,t 11! ' �' T�l,ra tiou.6�r Rc,91,q'Crr,C7.em I,nur,ottnn, L'o Public Aannureo CMn Ecdta.nn
<br /> "1' i it 1 '"UI:
<br /> �i fj�''YIIIt d29LD end may ramw)z 1,n p1'0,1, ronn.LtinT u>? to 0,U'boD per da',
<br /> 1 I '1 IJ I I�k�Y41 v.'.cinCicm or $dminlnt.rnt3vrt 1 Pmr
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<br /> ' do en doacri..ed ],n a �
<br /> - Publ.,c Rnnovren !:cdo nein 9ilcn �'.nR^•
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<br /> til�I�� II. i i�' 1141 r ' 1'fi 1 I l•111 :I Y'i
<br /> IJI� `'�'), �LNLIA,?1TOr�c J.AkIli1S
<br /> Y I J (�11•q�itI��A L �1{. 16�I•I.
<br /> Lc,i;,, i'b;•. :Ilr,`.•, t.a 'h.` 1, II iNllil t; "r I;artiW t pQ p'r1ur• )1tdor tnr! loran Oo CI1P fl l,nCa
<br /> - i :. �ill�.�•.1t14�I�;1 t1.' Y that vn6es nnJay ec �
<br /> OE C111.1j'arnit thst tha informntien provided nhnve �� I;r4o ➢Rf7
<br /> Dater Coz't'1d"- ti'111ty Cla-im: The i..nformatio
<br /> n provided az} t,hi„^ fOrm should be
<br /> con ide,rod, Confidential, prop,raetary, an,d/or txgd, 9oCret. In accordance w�'tpl
<br /> Tits 14, CCP., Section J.7041 et.2eg, alaa,�uld any member
<br /> cLi. of the public rqu
<br /> �e�
<br /> mr Qi' c,c.1o211re of this information, .1 > nV"t that CalRecycle conta,c.t♦ =a
<br /> addrt,nt� And telephone number a,botm. Zt the
<br /> Elect..ro"c. R+2pokting to CAM#r�ci.e: Lakin Tire went hA3 been authorized by
<br /> CalRecycle to participate in the Wa9te and u,aed TIr'e Manifest EDT olec-tronic
<br /> reportIng j X'ogram_ On beh4jf of tho customer listed on this form, Lakin, Tire
<br /> West will 03,ectkonica.1ly t..r4n-sMj't 'ro Ca1Recyc!je all r2 aired info.
<br /> thi-3 maz}�i,fas.j:. Cal Recycle has A t©;7ed the Lakin Tire West EDT f'c a£I nu�rom
<br /> within the 1MT{!cg„p ,jy
<br /> '_ lire I ani fes'C Symtiprn EDT program,
<br /> Questions? P1f_'A'l0 contact your Cu,tltnRler servd-ce Repre:,tneRt9,�re at 800-488-2752 or email
<br /> cu3'IOlnerar�� �y,ce@lakintire.corn,,
<br />
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