Laserfiche WebLink
W08/2013 10:04 209-52? '.81 MCCOY TRUCK TT PAGE 03106 <br /> WORK ORD19F2!MANIFEST <br /> --� Q <br /> 1274877—) 168 <br /> 8 <br /> McCoy Truck Tire Service Center, Inc, Name: <br /> 1407 Lone Palm Ave, Addrels: <br /> Modesto,CA 95359 Ctty&q i Stat 'y <br /> JUG 13 RECI 209.521-6229 Z10 S2730 <br /> -7- TPI11Da 12,74877-01 Tplp with Suffix: /.-R 1L+O lir <br /> Load Date:f)r+'^ � .3" I f Load Type;, hole f 1 Cubic Yard f ]Ton f ]Pound <br /> Oecal#.l •. .� j'>tPsk-up coulnt: <br /> License#:7 ?Q1 stat©('c\_ Dot Coae: RWDY [ ]Delivery count; <br /> I[ EGULAR TIME f OVERTIME [ f CALL OUT CUSTOMER POO <br /> FLAT REPAIRS WHEEL,SWITCHES MTIDISMT <br /> LICENSE NO. p 4•VEHICLE MAiS MILEAGE492-Q CIQ V_ CLt <br /> LOCATION: cjo <br /> )r m +�,, I I N <br /> K PERFORMED: MILEAGE fN � <br /> L-_„EAOE,. T <br /> .- 2 <br /> TOTAL' <br /> TIME IN <br /> - <br /> �h av`� - OI TIME OUT 1 L-- L4 <br /> SIZE MFG. SOT# ! -rREAD WHEEL COMMENTS <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> _8 <br /> Drivers Si natur f r to 0 Y-- mer SiAnaiur u " �-1/1&1, Dote; <br /> Drivers Name(print) Aire Customer Name(print) <br /> I r�Klfy Inns unuar pnnalry of por,ury unanr 1 e hwe ar tna 3Mtn M Ce vrttr�t.11ha!nf,�mmrllon f coolly i tAl UntlOr ppnptO cf MNVrY unCM ttM IeW�o�Iha 31MA A}CAI�fePNln Ant ton!nm r atbn <br /> prDvtl�d obovA Ip title Pltd crrrbcl,In gMillefl.I am nwaltl thnt ftl�alrcatlat OI flltn ttthl"Illnklan Toy pravldetl a�ova In In�ynnd eerra�l.ln nddlllan,1 nm swam Ina11�IIeIGetlAnn a tN9lnmmnllan mnv <br /> Mnu I n nunpwkii,ravoow�aa,At rJnrt; lannv+Al M ilio IAIIIek T ro WAVY R, IA tion uruant �oWl chill pan�If�gD up to i2G Opo pn�dc+y,per vblAllon nr AQM1MI;tr,014o Pnnnhl"up fa 56,00D <br /> Ie ton Pupl!c Resourao Cada aACt btl A%1n00 ono may MOUn In civil endltl(I V�(d�O.dDD pilar any, oar vromnnn pnr dry as dcr.+ar�nwf rrl Pbl�Fa�aurew coAo ooQlon A21p6, <br /> pnr vIo191Fan or adminiatr9tivn�i!r•tnldaa up m R�.tJ99 pllr vlo�rtllan�4r R (M flntvebnC to Public <br /> Reeoume Catln aanflgn 4200. <br /> [ ]-frnportod Load ( ]Exported Load and LOCation ( Hauler Exemption Status: <br /> Address: [ j GovernmelM <br /> [ ] LEA Exempt <br /> City 4tote: [ ]Agricultural <br /> f 1 Common Carrier <br /> Received Time Jan, 8. 2013 2, 25PM No. 0409 <br />