Laserfiche WebLink
FROM (FR I ) JAN 21 2ni 1 'Q :OF '°T, 13 :04/No. 6661196751 P 4 <br /> VII TIRE CO., INC. 4ET SEF;VIc�RECORD . <br /> U.S. TIRE SALES TPID 1000837. 38 3 , <br /> #01 Wilson way 19ne WAson Way Tire Recsp 002 Conrail Tire 021 US The Saha 023 US Thy S+dea #24 Us T�■�ee-� <br /> 221 N.M�kon Way 15361farkot SL 2211 N.WMmn Way 2800 Vosanft fllVd. 1816 Nstkm4d A0e. 0590 FrartAd a 61w1' <br /> Stockton,CA 98205 StocAColr,CA OROS Stotkl0n,CA"M Modesto,CA M54 Haywwwd,CA:WW Sawunento,GA 95M <br /> 20"6"281 208.486-2981 2094714611 618-887-1282 91#4XI-1245 <br /> CUSTOMER , P.O.# E DAT <br /> PHONE' VEHI LE# <br /> - cI Clc-.' i., LICENSE# <br /> LOCATION OF SERVICE STATE ZIP CODE <br /> CUSTOMER TPID �;� -� DECAL# <br /> I eettity rod under oehatb of perlray under ow lawns of the Stab of C■uarnt■drat dw kdornwdon prodded above Is tma and eorreet.In addlt><.+,l am swan enc fatettintlon of <br /> Mlle fnfvrmation may lywlt In euspeneloa,revooatbn,or denlat of yawn of the Mheta Tire Hauler Ralilstnt{on pur,wnt to Publk Reaoumm:Cock aetibn 42M and may <br /> ME <br /> puit M olvll pet"*$up to$29,0011 Per day,Per violation of admMlefraYw penakfes up to S%060 per vlolaMan Per dry otb <br /> se described In Public Rewurtae Code een 42864. <br /> DRIVER NAME R NATURE DATE <br /> MAKE TRUCK/TRAILER# LICENSE STATE 000METER/HLI9 <br /> 61 <br /> ullnui <br /> ' --- - - - - -- ----------------- <br /> t- <br /> ' SERVICE CALj y/ MOUNT/DISMOUNTS)ON VEHICLE BRASS VALVE STEM(S) <br /> FLEET INSPECTION MOUNT DISMOUNT(SK009157ALUMINUM STEM(S) <br /> AIR SERVICE LOOSE MOUNT(S) VALVE STEM REBUILD(S) <br /> FLAT REPAIR(S) LOOSE DISMOUNT(S) ALLIGATOR CAPS) <br /> REPAIR MATERIAL(S) TIRE(S)BALANCED METAL V4LVE CAP(S) <br /> WHEEL SWITCH(S) RECONDITIONED WHEEL(S) O RING(:1) <br /> FINISI- MILES: <br /> L START MILES; <br /> TOTAL MILES: <br /> STAFT TIME:_;7- AM PM <br /> ON SITE TIME: AM PM <br /> OUTTIME: AM PM <br /> FINIS i TIME; �J AM <br /> LOAD AMOUNT z ( c)� E`: <br /> ©GOVERNMENT ❑LEA EXEMPT Q OTHER <br /> AGRICULTURE Ll COMMON CARRIER/BACK HAUL <br /> QWf <br /> C Q <br /> IMPORT FROM � � ' -- ( L-- �.,.—_ U-WHOLE TIRE COUNT �; . C1 WEIGHT IN POUNDS' <br /> CQ DELIVERY <br /> Poor TO �iJ - ( .� Q VOLUME CUBIC YARDS Q WEIGHT IN TONS <br /> I csrtlly Mut under penalty of psrJury under Moe laws of the b&CSM"k teat tAa Ntfornntfen prodded aaove h:Into and comet ie.sdditlol(:1 <br /> am aware that 1ale�kaNvn of We Womwtloa mr result w dv11 <br /> y w tss,oM Pe►vlol.non or.aoil ntetraev.o•n.lws w to <br /> t6,000p+rvbiadvnperdayaadesorlbedlnPutuk HeeourceeCode 422. <br /> CUSTOMCR PRINT NAME CUSTOMER SIGNATURE DATE <br /> FSR No. 138375 <br />