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Oct 26 11 05: 47a Joe MAWhe,sotti Co 2099824464 p. 2 <br /> _ E'fiURVIGE':RECORD'- <br /> fl�/I LS:ON: ::T1RE"CO :1NG:: <br /> '- I U& TIRE SALES TPID 1000837 151862 <br /> s.: . #24 US Tire Sales <br /> - . #23°USTiretalpr. <br /> ' #02,Connell ': <br /> #21 -770:Sales 6530'F.ranklin alvd. <br /> Wi13on.Wj Tire Recap . 2600 ' samlte Blvd.. 1915.NatlonalAve: ' <br /> 1.:Wilson INay:Tire Y 2271'N...W7/sbri;.Way,• Sacramento,CA 95823 <br /> 7`N.'yyilson.Wa 4535 McCketSL " illedesfo.'CA 95354 Hayward,CA 94545. .' 918.-395622.45 ..:. ? <br /> y' Stot kton;'GA'95205 ' <br /> StocMori;=CA'95205 <br /> xkton,.CA:952tl5- 4ti6=258.1: .: 209-5..77'-5611 .:: ..: 510 <br /> -887.1.282 <br /> 9465-0281x...... ' 20 ;465=3262. DATE' <br /> P.O.A <br /> 1ST MER :• :'. <br /> PHONE'. VEHICLE:: <br /> / A <br /> LICENSE K <br /> ZIR'CODE. <br /> STATE< <br /> SCAT ON: F SERVICE <br /> ..DECAL# ' 1- <br /> { !'^ tion of <br /> " <br /> CUSTOMER TPID l <br /> thabunder pdnalty of Perjury under the{awd May <br /> s of the:en{ai of erllew8f`otfthe Waste r6 Haulrnaijon-arRegisoavon pursuantastat the Inforlo'F nSpublic Resourcest�Code settionn 42962. <br /> I certify. rviolallon per y <br /> this Infotmation may-resulf in suspension're4osca oiation of'administrati4e:penalties upto.SS DATE <br /> result In-civil penalties•upto•$25,060 pet day,p <br /> DRIVER SIGNA RE .1 <br /> DRIVER AME <br /> • oDOMETERJHUB <br /> LICENSE STATE <br /> MAKE TRUCKITRAILER# <br /> (� ,atop. =x• , r, ,j'' �X�:�9[� �3•t F r ' - �:its 4� Cn?W'w..� <br /> r <br /> ORec'e"Ived Time—Oct 26: 2011 7 52AM No, 2426 <br /> L i a <br />