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WORK ORDER <br /> 81- 1-11-NN- <br /> ON �� 3730 N.WILSON(80014 WAY STOCKTON,CA 95205 M5 <br /> PF401J�18f1t?1-",BFi-9�'?2 FAX?�Ml AF's ,1�'�5 r-a u's tt i"+'o <br /> ACCOUNT NO. TODAY'S DATF _ <br /> CUSTOMER DATE PROMISED <br /> ROANVOICE# <br /> ORDER BY: RECEIVED BY-. -�— <br /> -CK Aim .. _ TIRESiZE _r�lAK& TRF DE at_t: oF-�� -- AFRA(li _c()na�a__ <br /> 1 i 1 <br /> I <br /> 2 <br /> 3 3 <br /> 5 I 5 <br /> -— — ....__...... <br /> r . v •.: _ �_�. .�; �- i � _:. �'s�t a�iltlis�tltc:'1i s(. ii" <br /> _._ <br /> r <br /> ur'!l T) A L J L . �.: L i I 1 LLJ I .� t_I'-i lJ Li <br /> — _ _ ___— <br /> Facility Telephone Number <br /> Hauler Tire Program ID / Site Suffix � �--� <br /> DATE t) ,� / o ! ! ! /71 Flj[� <br /> ,, #� i I i - I :'.! !�P �� :;A s !` ''I ,c*!_ <br /> -- - - ---: 4 u .0 L% L' [A � U U <br /> = wo hole Tire Count Weight in Lbs. <br /> O S <br /> v,h:;,,_ Sa nl,t t.,?f in Tons pc� _ ( �i <br /> c- l ` <br /> 1iln,c�i i ! SII L F <br /> 1 <br /> v v ,.1 <br /> 1 <br /> -,14A-. TH <br /> ZRJURY OF E <br /> (N(R for LAWS OF THE STATE OF CAORNIA THAT THE f <br /> } Whole Tires) INFORMATION PROVIDED ABOVLIFE IS TRUE AND CORRECT. <br /> —F,18 18 <br /> 79 <br /> 20 <br /> �o <br /> t _ L <br /> �1f �(J1t t 1CJ J rv=TJYF� <br /> CUSTOMER SIGNATURE: _ INSPECTED eY: <br /> NOTICE! NOT RESPONSIBLE FOR TIRES LEFT OVER(30) DAYS <br /> Note: All credits are subiect to inspections. ^0 .� <br />