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2011-10.19 14:51 Goldenroducts 209+6690tiZ '°N>* IIN 61 '100 21 !1 P�A123 <br /> -t-n.Ju 1 alga SI;"P TIREI COMPhIm i( <br /> P.O. BOX 1 / 13000 NEWPORT RD. INVOICE <br /> BALLICO, CA 95303 (209) 668-4855 <br /> EDT TRIP LOG#: 1003314- osr� R�2o11 EE I uOT MANIFESTO: 1003314- 00075898 <br /> DAT$ ORIV[RS INIT RUN r♦, <br /> SHIP TO: ACCT#: EVER BILL TO: TERMS: NET30 <br /> GIANT TOYOTA TOWN EVERGREEN OIL, INC. <br /> TOT001 2415 CAMPUS DR. STE 225 <br /> 2150 E HAMMER LANE IRVINE, CA 92612 <br /> STOCKTON.CA 95210 <br /> TPID# 1026678-01 <br /> PHONE: ()- PHONE (610)600-0159 <br /> HAULER/SHIP VIA: GOLDEN BYPRODUCTS 13000 NEWPORT RD, SALLICO <br /> STATE CA <br /> rr;ucK 0: GBP086 LIC PLATE 9855421 QECAL�: 11-04382 <br /> HAULER EXEMPTION; GOVT ❑LFiA EXEMPT ❑COMMON CARRIER �UNREGISTERED HAULER <br /> TRAILER: PU DEL SPECIAL INSTRUCTIONS: <br /> FYRE COUNT UIM U T PRICE EXTENDED AMOUNT <br /> PAS NGER TIRE EA <br /> PLEASE PAY FROM THIS INVOICE.NO OTHER INVOICES WILL,BE SENTI <br /> Invoices over 30 days are subject to a late fee of 1 112%per month, <br /> which is 18%annually,or a minimum of$1.00 per month. TOTAL <br /> I ell,",thin oanal y or -dor me{on rQ are Slato of Californialifornia Ira" hmoto Providw P u <br /> It. o wlr pc�ollloa 4 to 5,000 Per day.Por violaull a eadminletrwivo ponaltlee uo Id 55,000 .felnllnn WRv ddWar�I am ayar ya1 lalolllreden of Ihle Fmkrmalbn <br /> r-r tlay ae mod euro.OaOe�liVii ai'W2, <br /> ' o>-R6•I <br /> Foolllry Ropy rrrotiv 'e Nomo(Pr4rq mr�eltlty Ro gme <br /> tote <br /> MCHARGE PAID CK# <br /> WEIGHT CERT �� NET WT TON$ <br /> I—i!y fol under Panal:y al Poquey unodr IM lave or Iho 8m1e of CNllemia Thal the informmlon pfovidod wove i■Ingo—(orroet. hn a,Jdlnarl ran&arra awl faoifieotian d Ins Infarr„elion <br /> moll h ev.00rWo,,Iuvarvdon.ar ybnbl a wne.rar or I-e Wmlo Tiro tlaygr RoBwl/aur PUf7Uan4 t01'Yead Reeau c"Cede.odhn d7MW and may re.Vh in ave penaillap uD la <br /> X000 Por day oat vwwaa w awini.lrallw po Aws up l0 37,000 Por vlo+al,m pot Cy ao dewipo r ul Public fi0 a �;, <br /> (\ r „ -A� <br /> Drlvaeo Nomo IPrtntl Drtvar6 Slgnamuro nate <br /> Confldontlullty Claim fappllkable to all Ponies tlsted on abovol: The Information wovidod In Part I,Part u,one P"III m thio form ahoula be oa„laorod <br /> 4�a�prP rr confidunli�l,propnaary,anoior vada eecre� m accordance with Tole ma,CCR,SoctlPn I7041 el,seq,ohovld any montberof the Public request dlscloauro <br /> of IN;Inflmnoiien.I rpqueel that CIVYMS contact me of the 311dte5s and telephono number above, <br /> �. Eloetronic Reporting to CIwMBi Golden arprocuaIt,hao been auvwryecl by CrIWMB to Participato in the Wamte end Uaod The Menlre:t COT <br /> °Iccuonw wyyrttn8 plaprar, un canal[at the mslornw Ilatpd cn thl3 <br /> Informallon IrGm IN*monVoat form. form.Golden By PrOdUCt:mil alaovanlrahy Iransmil to CNuMt3 alt rOqulred <br /> Original - Office C'ppy <br />