Laserfiche WebLink
From: 11 /01/2013 07:44 #386 P.003/005 <br /> 1-209-242-3051 13:02:13 10-31-2013 3/5 <br /> ' nrl�son► wA 'TIRE co.- INC.. . <br /> = ' , FLEET SERVICE RECORD. <br /> U.S. TIRE SALES , <br /> TP1D 10008#-:' 1261'54 <br /> w*tiI Willem way trLtr t ,a,t isay lhii ,n /al Cara,eN ar,. ,os <br /> srs rw rwaen Itrq • toss nw*,a h p2f t walicn w oftf Trra. .ar W 71ns tr lw rtes ris.rr.r+r n. ow to t+"tbris <br /> w tlsaw. <br /> to c <br /> of= "w*fty,tAr.sews t .Stora ae r,ir,rrt ratoo raa.rere.tarr� . �.re ra.rrarrr,a:. :a„�►,,,wr;arts,• . <br /> ter. as1►i7a Gbdwrro,ca VM4 Ko­G"aea ai <br /> arses . <br /> GUS70MEA <br /> DAT <br /> PHONE VEHICLE <br /> LICENT <br /> LOCATION-OF S VICE 11 ill t 1 <br /> STAT 2JP"CODE <br /> Ck C*.. <br /> CUS'TOM'ER TP . k G. UL <br /> ]j DECAL. <br /> 1-"NY Ith it underpaneW ape"under the Carrs of the t3tslo at Catlfomia that tlrs lrHortnatton. � r <br /> this tnformition max rssuirtn sbe stun provtdod above Ie true and eorraat fn addition,l am.vara that-h�1aMoRtlon of <br /> rssuh In ehrN '►avper v[O,of tlaiild of reitearal 01 the Wooers The HauMr.Raglatratlon pumaent to Public Rasourasa Code Wllon 42000-and may .- <br /> ponaWerup to 3?a 000 par.ddjr,per vloltatlon ar admirtisbaUve PsnaNas Up to-16,000 par vleletlan Per day as described in Public Reaoutaea Cods' <br /> DRIVER-N E : ..^,'•. 0099n 429M . • <br /> DRIVER SIGNA RE DAT& <br /> X <br /> MAKE TRUCK/TRAILER LICENSE <br /> •STATE ODQMETERII j Q ,i ,'. <br /> Z. <br /> SEtiYtOE CALL, MOUNT/DISMOUNT(S)ON VEHICLE SRA$S VAhVE STEM($) <br /> �I EEF=INSPF.L:I ION _ - )W1J /Dt OUNT(S)LOOSE ALUMINUM MM(Sf <br /> �. . AIR SEF]VICE LOOSE MOUNT(S) , VALVE STEM REBUILD(S). <br /> "FLAT-REPAIR(S) LOOSE DISMOL"r(S) ALLIGATOR CAPS) <br /> MOAih MATERIAL(S) TIRE(S)BALANCED METAL VALVE-C6 <br /> (S).. <br /> WHEEL SWTTCrH(S)•.. RECOND1116NED WHEEL(S) O RINB(8)' <br /> FUSH MILE8: <br /> STAN!MILES: <br /> - TWAL ASItE9, <br /> START TIME <br /> 0 ATE71M0_- PM <br /> OUT TIME t <br /> LOAD AIAOUNT •'• .• � '{ � <br /> FINLSIi TW: A1r, <br /> _ �_� '0 GOVERNMENT p LEA EXEMPT D OTHER. <br /> , r ❑AGRICULTURE El COMMON'CAARIER/BACK HAUL , <br /> PICK UP. ." - �,. <br /> . .O IMPORT FRPM <br /> DEUVERY t WHOLE TIRE,COUNT . ❑wrEIGHT'IN POUNDS; <br /> CJ EXROR7 To .. / Q VOLUME CUBIC YARDS, D WEILINT IN TONS <br /> nOt4 I earthy.that tinder pgttapy or-per)i►ry under the laws o!the to of CeOtornls that Ms tMor <br /> A, ' em Gwent that%jel loiitMh'df t1da litfornatton trw t ssuft Int rrahtaa mass pravldod abam'k this and eorisei.M addhlan,t <br /> 66.000 per vlotaMon yy Pa up M e26,b00 Psr+�Y;'psr:WolWon Qr adratnhfrativd oenaltlee Yp . <br /> par dray a eYsmtbsd in t'ublk Rss,pr Coda asatIon 1%S <br /> rr -`.CUSTOMER.PRINT NAME CUSTOMER SIGNATURE <br /> 'SR No. 1.2 O 1.5 ei DATE. <br /> Received Time Nov, 4. 2013 7: 41AM No, 0870 <br />