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Pick U Deliver 5603643 A Up F 3643 I v 0 Hauler Tire Program ID Site Suffix � Facility Telephone Number DATE . WhoQe Tire Count 11 We ,n Lbs. VIER IMEEEEV Voiume Cubic Yds. Weight in Tons oI Baulcr hJr,t1, DOD E.[K _ c IIQF'Y r2�Q�`q„lao^?I�tl�� 1 6 f1'6'i71” �� Initials ,ogle Tw I CERTIFY THAT UNDER PENALTY NI PERJURY OF THE /2y W,plp T,nggl LAWS OF THE STATE OF CALIFORNIA THAT THE L X-""' /j INFORMATION PROVIDED ABOVE IS TRUE AND CORRECT. ) L Comprehensive • • • Number • • Information ProgramFacility Tire T Ll 5 60 3 6 4 5 -- A Pick Up P Delivery ® ® ❑ RL) l .. 11 Hauler Tire Program ID / SiteSuffix Facility Telephone Number y _ i 1-'�� ✓ DWATE Count Weight in Lbs./WholeTIre Volum a ❑ a - Sao ❑ � �❑ Cubic Yds. Weight in Tons C'E_.. Initials `G' 1 ie OWA� I AWS O Y THAT UNDERPENALTY CALIFORNIAPTHAT THE OF THE f. WMIe Tired LAWS OF THE STATE OF CAI� NTHAT TME 0WOMATION PROYNXD ABOVE IS TRUE AND C CRRECT Comprehensive • • • Number • • Information - Programr Site Suffix 5603668 -- A Pick Up + j Delivery m Hauler Tire Site Suffix ID Program / Facility Telephone Number � g DATE p m Whole Tire Count ❑ Weight In Lbs. L'� ~ ElVolume Cubic Yds. Weight in Tons E !� LO (N/A for i AWS THAT UNDER PENALTY _Initials = p Y Of PERJURY OF THE I Whole Tires) WS OF Tf IF STATE OF CALIFORNIA THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND CORRECT. • , •am • • • 5603673 -- A n Pick Up � Delivery LTJ - . LSI ❑ ❑ Hauler Tire Program ID / Site Suffix ^ 1 FCility Telephone Number ' ! DATE � g ❑� � F1WholeTire Count � Weight on Lbs. a ❑ oar s- ® FIVolume Cubic Yds. ❑ Weight in Tans s 1 Initials D • (N/A for I CERTIFY 7,1-�n -R PENALTY OF PERJURY OF THE Whole TireLAWS OF THE STATE Of CALIFORNIA THAT THE \ ) I INFORMATION PROVIDED ABOVE IS TRUE AND CORRECT. l