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05/16/2008 08:31 2099431854 TDM MAYO CONST PAGE 02/02
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<br /> WILJON WAY TIRE CO., INC. FLEE, OVICE RECORD
<br /> U.S, TIRE SALES 7PID 000837• 106180
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<br /> CUSTOMS DATEr � `O
<br /> -� PHONE VEHICLE#
<br /> LICENSE#
<br /> STATE ZIP CODE
<br /> LOCATION OF SERVICE
<br /> �,�� �... 1_I—• DECAL4I ire �?.L_.i.l..l
<br /> CUSTOMER TPID
<br /> I cerlily IM.9t under PanM7y M perWW vAdel 1ha leve Al the Stale or CeHloraia Inst IhB IMArtaatlan provided etwve Is trve er,d corr.ct.In Adds lor,I em aware bid 1abAkellon of
<br /> ...1i In civil pe alA-c uP o S25,WOpernde�pertiviolatinon.or o OdmhdntrAll"Pennhlae UP to$5,00°rparvi violation parrtUfAi doy end Ptilblic MxerIW len hrblic NAINAnau Carla n Coda"at..4 42"Q and 2"2,
<br /> DRIVER NAME DR1Vfi4,$IGN6TZE DATE
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<br /> TRUCK/f RAILER
<br /> LICLHI iE STATE ODOMETER/HUB
<br /> NAK[ u / G
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<br /> OTS.....•.:;DEScaliTiON:DFFYOAK d'•; P
<br /> OUNT r DISMOUNT(S)DN VEHIrX BRASS VALVE sT>rn(s)
<br /> FLEET INSPEUTON MOUNT!DISMOU )LODSE ALUMINUM STEMS)
<br /> 1118 SERVICE
<br /> LOOSE MOUNTS) VALVE ST15W REBUILD(S)
<br /> RAT FIEPAIFI(S) LOOSE DISMOUNT(S) ALLIGATOR GAP(S)
<br /> REPAIR MATERIAL(S) TIRES)BALANCED METAL VALVE GA )
<br /> WHEEL SWATCH 5) RECONDITIONED WHEEL(S) o RING 3)
<br /> • yi 1,.:.«I ,+, :ae.; !Pry FINISH MtlfL�`
<br /> z 9TAF1T MILES
<br /> YOTAL MtES
<br /> PM
<br /> START TIME:
<br /> ON SITE TIME: AM PM
<br /> OUP TN& AM PM
<br /> "-. 111,1111 INE t AM
<br /> •It a>' r1• ,I',dn,, ;, .,.. I - .�,-1,�.,.21,n•1 'hwra}, :Y7a',>Iel';•
<br /> LOAD AMOUNT :0 GOVERNMENT Ij LEA EXEMPT E-10—ER
<br /> y
<br /> --� ' ❑AGRICULTURE ❑COMMON CARRIER/BACK HAUL
<br /> ❑ PICK 0 IMPORY FROFA UP p WHOLE TIRE COUNT WEIGHT IN POUNDSL
<br /> Q DFLIVERY ❑VOLUME CUI3 Y OS ❑WEIGHT IN TONS
<br /> ❑ EXPORT TO
<br /> I ceirlty Itml Milder peMtT at PallurT under OIB lows of tin cnntn .IQ. A IAnt 'n1 a Aai 1a true nn---I.
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<br /> $B,DOD pnr 2611" par clay o7 daeorttMd In Puedt:R/eauraee 9-n aeellAn 92
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<br /> CUSTOMER P1 .ME C ER S ,AE PATE
<br /> FSR 14[/l''I6.ESC9'°N .,..150E—btiZ 601 '00 38I1 AN NOSI IM O85 6 800b '904W
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