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04/01/2008 TUE 13: 21 FAX 2099836122 2004/006 <br /> +, WILSO. JAY TIRE CO., INC. AEET SERVICE RECORD <br /> U.S. TIRE SALES (�(Cj 2�, TPID 1000837. 106121 <br /> #at wflaon Way T" Wilton WRY Tire Recap toe Connatl Tire'`• vas Wilson Wa_v r1re i t A31 US Tiro Soleb 113 US Tiro Shies cae its Ykr$Was <br /> =N.Wlfson Way 7$35 Markel St. 22f f N.Wilson Wer f 139 W.Ewonrh 61. 2a00 Yeeemlty afvd. 1915 National Ave. 6630 Rr—libADIVC <br /> Stockton,Ca.09299 Stockton,a.95209 StocMan,Co.911204 TTaav,"99376 Mallosso,Cd_SE364 Heyward,Ca.946411 Becramenity CA.05921 <br /> 209.465.11261 2004"-7282- 20"044e1 20a-e.is•do97 soes7+•sstt 510-e07.1287 9M.U5.92es <br /> CUSTOMER P.O.!t � � �� � DATE <br /> PHONE VEHICLE <br /> LICENSE,# At <br /> LOCATION OF SERVICE STAT 2;..CORE <br /> CUSTOMER TP1d —_... _-) _�-- i DECAL# `I a�CJ � <br /> I cantly that under penalty of par)J." <br /> ar Iha ws of the State of California that the Intorme. vided a e run na correct dition,I am aware that%131fieatlon of <br /> this information miry reeult to aua ,sev ca(ion,or dental 0 re re H er Aegistr ion ursu to P Ree rcee Coda section 42960 and may <br /> result to e1v11 penel[les up to$26, <br /> day.pat violation er s Inlatretive pena(lioa o per alio y a rscrtb public flasoureea Coda section 62962. <br /> DRIVER NAME D IVER ATU DATE <br /> MAKE TRU(X/TRAILEA 9 1 fcIlmsti STATE 000iwPTEA/HUB <br /> SPECIAL INET UCTIONS .. i ;::' OFF . . <br /> __T-4tAJ16 - .�_._..._. .__-..-_ _ �._.. ...__.. <br /> (06 It?Le ------- -- -- - . ------- <br /> 471.' 0ESCAlPT101J:OF WORK COyrfALETEO, PTY; DESCR/PTIQI;CQF WORK CQMR! D OT DESCRIPTION OF WORK COMPLETED <br /> SEFIVICE CALL LPMOUNT I DISMOUNTS)ON VEHICLE BRASS VALVE STEM(% <br /> FLEET INSPECTION MOUNT/DISMOUNT(S)LOOSE ALUMINUM 9TEM(S) <br /> AIR SERVICE LOOSE MOUNT(S) VALVE STEM AEWILD(S) <br /> FLAT REPAIR(S) LOOSE DISMOUNT(S) ALLIGATOR CAP(S) <br /> REPAIR MATERIAL(S) TIRE(S)BALANCED METAL VALVE GAP(S) <br /> WHEEL SWITOy(S) RECONDITIONED WHEEL(S) O RING(S) <br /> QTY SIZE MFG DESC. P N FINISH MILES: 41 <br /> G� 1 E ( START MILES: <br /> TOTAL MILES! <br /> START TIME: � �YM <br /> ON SITE TIME: AM PM <br /> _ OUT TIA1E: AM PM <br /> KNISH TIME: •. A6 <br /> LOAD AMOUNT ;.HAULER EXEMP IQN:IF APPLICABLE <br /> ❑GOVERNMENT Ll LEA EXEMPT \Q-OTHER <br /> ❑AGRICULTURE ❑ COMMON'.CARR IERIBACK HAUS. <br /> PICK UP <br /> LgAD TYP>i <br /> IXa IMPORT FROM �Ct(\,� HOLE TIRE COUNT O WEIGHT IN POUNDS <br /> TML IVERY p d / ` e-� p VOLUME CUBIC YARDS ❑WEIGHT IN TONS <br /> LJ EXPORT TO l'✓ (� l <br /> I cetlHy that undo penalty•ol pe1)ary ugder ilia taws of the state at calitornle that the InfoAlletlon J�1o111d it above Is we and correct.In addition,I <br /> a�O Do/p yr am aware that talsIfIcellon of this Inrormetlon may result In clull penallles u0 to$25,000 pet day,per via tion or edminlstrcltive penalges up to <br /> e 19,000 per vlolatlon per day as deacdbod In Public Reaouroas Code se on 42962_ <br /> CUSTOMER PR' AE CU8 MER Std E DATE <br /> FSR Kj%Z •d)f; tt b '`NI 60Z 03 3fl1 ><yf NU iN <br />