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-, _ -'_ <br /> � —`7'_-----_' _,_- --_--,_ <br /> -- -_`--- <br /> WORK ORDER/MANIFEST <br /> McCoy Truck Tire Service Center. Inc. <br /> 1407 Lone Palm Ave. Address, <br /> TPID-,1274877-01 TPID with Suffix: <br /> Pound <br /> Load Date; —i Load Type: [j,j Whole I Cubic Yard Ton <br /> Decal # ]Pick-Up CoUnt: <br /> Sta e' Dot Code: RWDY ]Delivery Count: <br /> License COMMENTS <br /> SIZE MFG. DDT TREAD WHEEL ........ <br /> 10 <br /> 12 <br /> 13 <br /> 14 <br /> 15 <br /> 16 <br /> 20 <br /> Date: Customer Signaturp� <br /> Drivers Signature: Vi <br /> Drivers Name(print) 7, Customer Name(print) <br /> I ] Imported Load Exported Load and Location Hauler Exemption Status: <br /> Address: Government <br /> LEA Exempt <br /> city State: Agricultural <br /> Common Carrier <br /> ` <br />