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ILCATION
<br /> y 17 13 02;58p C AND C AUTO QEPAIR 2094767075 p.1
<br /> 17/2013 14:34 5032401992 TDR + WRW PAGE 01/01
<br /> IJUL�$ 8 RECDrFA�T ri'f11lnQ3974 !-171'0 AUG 0 1 201
<br /> 4554 S. EI I:tlradu 51. Nc�,1dn 019 IsAk."a`N FLEASE REMJAOo
<br /> wa WMI00038 -•?e- ,aaa,a. tag:„ 1,A). Box Srutktun, GAv520es =-''.° 83328
<br /> Stockton & Seirramcnto Area (2n9) 234-0700 WASTE RECOVERY WEST.IMC. Purttantl, OR,97293
<br /> Redding Arc 11 (530)275.11b0 '�I� I.877-OLD TYREwsTlauter (]Gcnerator (�nd Use facility
<br /> Invoice Datil )—! l/+ -fLoad Date_ /=tJ Phone# Pickup
<br /> Customer Name
<br /> Acct 4.•____--
<br /> 31te Street Address Z04C2 /�7�.+ -
<br /> — state Zip-----„------
<br /> t7 I tcrtirve,nr wn,la puvlty of perj,nl.anon the leer.l(the Sete of GNfpni;t eba the Inform.tdnn Provided 1.Ince And CoroPAJ.to-ddirio.) 1.11T.
<br /> a.nrc Thal Polrlfao
<br /> ttln or lhic;nrvrmnr'-may—lit i:%awptmion,rew,.alion,or denial n{rrnc.ol or the Wwc Tire Haola Rc fiswrit.n purauur ro
<br /> f u01it Re..ti.rcer CtK1e setJnn�jy6n e.xf m.y r•nnrll in civil penalda nr to fLi,Gtkl tr da
<br /> _ vi nl.w.n Ivr day na r(ercri be.l in han,;q„n.,n�y
<br /> (.',dc rl per violminn to.tdminlerrfdve pendda,.y.to 3G,OQf1 per
<br /> -- I dc:ccr)nn 4:94.2• _ —
<br /> ►lauler&umption o(S,rrTtrinonr MMA
<br /> rKUCKIFe 1 y�IUIEK TRLA
<br /> +V W S 1.CCATION
<br /> AfAtultVn: motnR C,
<br /> arrie
<br /> . MANIFEST AA1RF�J LIC PLATE I DECAL 0 L(C i IMPORTU CDs1 MERTPIDk TRIP LOC 0r
<br /> LOAD AMOU11T FJIrOR7 n C O
<br /> 'uAXTtTVDescription TYPI
<br /> y. Rate Amount
<br /> Passenger TiresJA 14'
<br /> (�
<br /> Passenger Tires an rim® .o
<br /> Manifest Fee 1,50 1.50
<br /> Customer Signature total Am S
<br /> I ccrt[dr rho un ty of pperlury,mder d1e bwn nftfle Sum or Gllrnrnin 6141 tMe inFnr Mrrign provided rbrwt:f o4i:and uq-
<br /> rc7.hi eJt{Ition, „�d aurora t11n hhlllnnnn r,f rJ1i.inFormatiml rnty rtenh in null ennitiu n r, (25,000 b
<br /> +dmin4l radve peran(ee tip in SS,II00 Ivy vl�lm!on per Jay as dr.cmi Ltd In I'ubfC Ro<m reea rp Irw'• Y.ptr vinl41lnt, C 159400
<br /> .tr1e rKrion♦21t.7, B,INVOICE
<br /> Electronic Reporlitl.,�; to (:al Recyele: Wl2W It:,.s been autlt0 1'iZL;Ll by (:LII I'tecyCl(: f.Q
<br /> participnte. in the Waste iin(l l.lsed 'Tire Mi1.njK ,..t EU'I” (aectroitir. reparlirl,L: prooralli. Gri,
<br /> bebtAll'oPtlrr Cw. tc/titer Ii Led Okl this l(►irrrt_ WRW N011 eaet;lrc+liica[ly tr:3n,49iit tc! C:<►l IZe.Lyt,le
<br /> all rt,yuircd iuturmttticin f-4:►r►Z this m,,ulifest farm when WRW is :tcling :r and iti so
<br /> tnarkc(i curl the 1rE,utt u'f rhiN fOrTtt.
<br /> C-".nnfirlt;ticia)il.y l faini: The inl.'u,'nlalir)lt ilr(]vi1,,lc-(I an this fCtrn,1 sltilulcl bC 1:urvsidet•cd
<br /> conf dential, proprietary, illid/tu tfaLle ::eCret. Ill Z1CC0rklx11Ce with Title 144' C("'R, $eo.1ot7
<br /> !7(1�J•f r`:I,.sC(l, tilU�uicJ :toy t114n1bCi't7l't'ht' puFtlic rc.que�,;t r1.i�:clrsure <►.t this inl�>rntati<:It1, 1
<br /> ret.luesl.61111 teal Recycle cun.I,:Ic,t me at the ICI.Cl.11'tonr..01.1011101-011 tluT 1'rttut (�I
<br /> 1.11k I'urlll
<br /> �r
<br /> C Count
<br /> T Toms `,- ���
<br /> Y = Culbio Yards %�• T
<br /> P . Po't4nds
<br /> Received Time May, 17, 2013 3: 02PM No, 0646
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