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M <br /> Flying J Inc. -Ripon,CA Plaza <br /> Fuel Receipt Certification <br /> Revised, March 2, 2006 <br /> Delivery driver certifies that split buckets and staItl vapor buelcets for <br /> the following product tarilcx are clean and dry as of the date and time below. <br /> DATE TINE Frel t Bill# Diesel#1 Diesel#3 Diesel#3Re alar Mi Premiums Va or Name(print) A Si mature <br /> U- <br /> 1 <br /> M <br /> Go <br /> 1 . <br /> Co <br /> +-) <br /> -, LLA- <br /> 0 <br /> 0 <br /> a r , <br /> I � .�:� -76 q2 <br /> M <br /> N <br /> N <br /> O ' <br /> I <br /> d <br /> O <br /> O <br /> O <br /> N <br />