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a <br /> 32-C8 6 Q 4 -- A Pick Up Delivery <br /> U � <br /> DATE Facility Telephone Number <br /> m Hauler Tire Program ID I Site Suffix <br /> © of� -©a© aooa <br /> Lu Whole Tire Count Weight in Lbs. <br /> Z.3 E]Volume Cubic Yds.OWeight in Tons �* <br /> // p l'`µTo <br /> S • <br /> E <br /> puler Name <br /> N rc-c-,k�, c-AI-� '575 <br /> 3 <br /> auler Telephone Number Z �+ 1._� '%(.dress Same as Hauler mrrr <br /> NIA for I CERTIFY THAT UNDER PENALTY OF PERJURY OF THE <br /> ' ( <br /> ` WIN Tires) LAWS Of THE STATE OF CALIFORNIA THAT THE <br /> 2�(/ <br /> Com" -'` ) INFORMATION PROVIDED ABOVE IS TRUE AND CORRECT. <br /> "Sf.. l' <br /> 1 <br /> - � 1 <br /> Comprehensive Trip Log Number Load Information <br /> lity Tire Program ID Site Suff ix <br /> 4681648 -- B [,,4] Pick Up ❑ Delivery o <br /> m Hauler Tire Program ID / Site Suffix Facility Telephone Number <br /> DATE <br /> 2 1000344 01 Qo H -11 ® eM a o PE <br /> M a N[Whole Tire Count E] Weight in Lbs. <br /> y El Volume Cubic Yds. Weight in Tons <br /> E <br /> 099 <br /> N INLAND INDUSTRIAL TIRE ►- "" 1 �' <br /> 510-429-2999 (N/A for I CERTIFY THAT UNDER PENALTY OF PERJURY OF THE �] <br /> Whole Tires) LAWS OF THE STATE OF CALIFORNIA THAT THE r <br /> INFORMATION PROVIDED ABOVE IS TRUE AND CORRECT. <br /> 3 2 4 8 6 71 -- C Pick Up •• " <br /> : Hauler Tire Program ID ! SiteSuffix Delivery <br /> -- <br /> d DATE Facility Tele phone Nu <br /> / ® a <br /> mber <br /> © a� <br /> to �Whofe T <br /> ire <br /> — a Count <br /> Weight in Lbs. <br /> 3 El voluoHauler Name me Cubic Yds. Weight I( <br /> � <br /> in Tons <br /> U q <br /> uler Tele�le;, , i,i Q <br /> 0 6:2- 1577 ■ f NIA 1�E� Address Same as Hauler <br /> ( for FY THAT UNDER PENALTY OF Initials <br /> Whole Tres) <br /> LAWS OF THE$TgTE OF CALIFORNIA THAT THE <br /> PERIURY OF THE <br /> PLEASE REMIT TO: PAPE' MATERIAL_ HANDLING NFORMATION PROVIDED ggoyE IS TRUE AND CORRECT. r <br /> PO BOX 5077 SALES TAX f <br /> PORTLAND, OR 97208-5077 ' <br /> �u <br /> RETURNABLE PARTS SUBJECT TO A RETURN CHARGE TOTAL 350.76 <br /> .it <br /> - - - - FILE COPY - - - - <br /> 6-3002L(11,13) '�.ia <br />