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2013-06-10 14:01 '�SI Fax 1 209 333 8623 2094688392 P 6/6 <br /> Toll Free 1=866i896.Q6.001 www:ciwmb'':c'a govlTires/ <br /> CA ComprehensiveTrip Log and•Receipts �;1'0002Ctlllolnlplolo0fatidw.�friM•nip•menl8odnd <br /> 'p;0,Dox @6D,Surtwn•nld,CA Obt)T2-1969 <br /> o 3 <br /> Com rohonslve Tri Number <br /> '9c^9ga <br /> rnsvnsmlranq INSTRUCTIONS ON BACK OF PART 2 D4 NOT TAPE,_S_T_APLE OR p��p�.ICAT <br /> ay.I•nrnyrht.DACmpr h—N.TdpLoa•radat•d AO,•elynr(r1ryua.Ite.lleawormaooapeovld.donN4f«mvnia1-19 i•dW.rldanllat,proprl.Wyand(rrd.•►CML InrseordenawAm�u•,�elccR,a.ouon <br /> Mill at Sep•It a rpe.al la rude for discl•iW of til•wonn•dan,Ne C"11 WI ConleCt Na•lanorta)of Pile form■l the address sod Wpean•rii bar proekad on NII brtn orrec•IpL.`; � I <br /> Hauler Address <br /> BU.singss NArrie <br /> Z D Address G %3ay o ✓ I <br /> City, State and Zlp <br /> y G Common <br /> I CrH parwey W pWflwr Under do Parra of Or State at O W"that o,•Mforwodon proIld•d•peva Is eve•M comet.In a MU I,I•n,.+•r.MI ot CA Worm n-mat,r 41 W sp•rotx r.yottb^d 4"1 W ren•wd or to <br /> IYuI&TY•Nww R•glst'ongn pwavnf to FWd R.Kw fi OW...r�arr d ZM mild may revert M cM pen••Coo up 10 S 26,M per day,Per vb4Tan•r�nnzitu.ro.',. <br /> stea Up 1.AWA per✓�n per day•e kKModA PA4o Kaeouras <br /> Coda e•cowDrivor'fs Namo rint ,,,'r earl; .,I" mil ,i:,'}r <br /> 3248838 --' - <br /> Haulor Tlro Program ID / SIto'Suffix - Facility Telephone Number <br /> m `f> eS - <br /> Hauler Nomo <br /> Haulor Telephono Nu boa _ d '•�'I ddross Same as:Haulor <br /> I CCArn T"T uroeml►a it or rehmer or nm <br /> LAWS WINC GTAT00FGWPOmmm,rmtimm <br /> 't •A' r 'n b nr'Att CT, 1 <br /> 2.48838"'',*' <br /> Houlor Tire Program ID / Slto Suffix Facility relf3phene.Numbol': <br /> ' . ora �ao � d © o <br /> CC <br /> NaTrff (ct � dr;.�t <br /> Haulor N ape DIY � o oh`O' c�i�i•cM. `_ <br /> ' 'vim Sh+441'I_ab t7Vt ' <br /> Haulor Telephone Number � `� 0 Addro9e Some es Haulor ,A <br /> C� 11 COM"TNA►UaOeK►dwd.ir of PdRJVAY OP M9 <br /> (a-157-) 1J1W W INN CTAIrW G+uvORKIAMATMd l/� <br /> I ORMAT04 PROMAM AflM ISTRUMAND e6RANCIr. <br /> 3248838 N- ,A <br /> Hauler Tlro Program ID / Site,Suffix , Faclllty Telephone Numbor <br /> Hauler o ..� C ' �0? 1llP� Yli'l <br /> Hauler Tolophono Numbo�' "� Addross Same as Haulor <br /> f M <br /> ^ •.. r A , rent ^� I calm THAT LrNCLR►;NALTy ooPCRJVRV OP TN■ <br /> 1 O� �a� � � � O�PM N �V�� r.- .,...r gesso-Y I`.r..n•u.t,v.r err <br /> Received Time Jun, o. <br />