Laserfiche WebLink
WILSON WAY TIRE CO., INC. FLEET SERVICE RECORD <br /> U.S. TIRE SALES ENTERED TPiD,1000837• 187686 <br /> #01 Wilson Way Tire Wilson Way Tire ReWp #02 Connell Trre 14&47'M'9 923 US Tire Sales #24 US Tire Sales <br /> 221 N.Wikson Way 1535 Market SL 12.11 N.Wilson Way 2600 Yosemite Blvd. 1915 National Ave. 6530 Franklin Blvd. <br /> Stockton,CA 95205 Stockton,CA 95205 Stockton,CA 95205 Modesto,CA 95354 Hayward,CA 94545 Sacramento,CA 95823 <br /> 209-465-0281 209-465-3262 109 466.258.1 209-571-5611 510-887-1282 916.395-2245 <br /> CUSTOMER �—� P.O.# DATE <br /> PHONE VEHICLE# <br /> l3:-'A <br /> LICENSE# <br /> LOCATION OP SERVICE ` STATE. ZIP CODE <br /> CUSTOMER TPID l 31L/i r,f 0 ( j -DECAL171— <br /> ;— ^— <br /> I certify that under penalty of perjury under the laws of the State of California that the information provided above is true and coned.In addition,I am aware that falsfcation of <br /> this information may result_in suspension,revocation,or denial of renewal of.the Waste.Tire Hauler Registration pursuant to Public Resources Code section 42960 and may <br /> result in civil penalties up to$25,00D per day,per.violation of administrative penalties up to$5,000 per violation per day as described in Public Resources Code section 42962. <br /> DRIVER NAME -DRIVER SIGNATU DATE <br /> CUSTOMER VEHICLE INFORMAI ION 4 <br /> MAKE TRUCKITRAILER# Q`b gs 0 LICENSE STATE ODOMETER/HUB <br /> �ffLGola �p <br /> >erao <br /> ZD 7 <br /> .�7i• � � _ z��1�YDR��- "�- - ��SCi1J�I�i� f� fa6PLET� - � R71�.T(�TIV f�F�Et�t�CDA#R i <br /> SERVICE CALL MOUNT!DISMOUNT(S)ON VEHICLE / BRASS VALVE STEM(S) <br /> FLEET INSPECTION MOUNT!DISMOUNT(S)LOOSE ALUMINUM STEM(S) <br /> AIR SERVICE LOOSE MOUNT(S) VALVE STEM REBUILD(S) <br /> FLAT REPAIR(S) = LOOSE DISMOUNT(S) ALLIGATOR CAP(S) <br /> REPAIR MATERIAL(S) TIRE(S)BALANCED METAL VALVE CAPS) <br /> WHEEL SWITCH(S) RECONDITIONED WHEEL(S) O RING(S) <br /> ��<:.: a s - - . >_. _.e •. 7 .:. FINISH MILES: (c.,S <br /> n START MILES: <br /> TOTAL MILES: <br /> STARTTll Z A PM <br /> ON SITE TIME;r ey, � <br /> OUTTIME:L•O 0 AM 6 <br /> FINISH TIME: AM <br /> LOAD AMOUNT - ., •k�i' °',,.; 47L3�8r;# 4fi{C Via.: ;'•,� :�, <br /> ❑GOVERNMENT ❑ LEA EXEMPT ❑OTHER L ' <br /> L — ❑AGRICULTURE. ❑COMMON CARRIER/BACK HAUL <br /> JA PICK UP <br /> ZI IMPORT FROM <br /> ❑ DELIVERY ✓✓✓-- /' i ❑WHOLE TIRE COUNT []WEIGHT IN FOUNDS <br /> C:) EXPORT TO ❑VOLUME CUBIC YARDS C)WEIGHT IN TONS <br /> Uatq I certify that under penalty of perjury under the laws of the State of California that the information provided above Is true and correct.in addition,I <br /> moa i am aware that-faisiflcation of this information may result n civil penalties up $25,0011 per day,per violation or administrative penalties up to <br /> m .� 5,OOOperviolatlonperdayasdescribed inPubOcResourc desecion42952. <br /> w • <br /> CUSTOMER PRINT NAME USTO ER SIGNATURE DATE <br /> _,. _ fl. <'$�68fi PLEASE CIRCLE STO E L CATION AT TOP <br />