Laserfiche WebLink
it5T 'rF <br /> FLEET SEMCE RECORD <br /> 17 499 <br /> TIRE CO-, INc- Yotn�00083T h <br /> WAY_ _.. �� u.•` <br /> WILSON <br /> p,. INC. FLEET SERYICERECORD <br /> CO., s: <br /> WILSON WAY TIRE rP(n,000as7 1:�4919 . . <br /> �I�p r S <br /> us. TIRE sp�� sae FI TA a <br /> sv us N TI..sei.s es7e i,.,,w/BAa- 'f`1 ; �• <br /> r /71 Us nre Salo+ 1917/1aUorral A15. �enl.eaL�97e <br /> - e07 Ce .Ii Ill. 7690 yo+emll.Blvd. M✓ a.d CA 94717 Yebee7c?a17 1 ' <br /> eyl Wlh,,,r WnWy lrn IY!+ We <br /> Way r(a 77111/.Wy Modesto,CA 97741 714aeT-17211 <br /> ii y 17m MaryH Sr 4, 7,1¢571.5611 <br /> i.I N Iv+n'A 11'+r DcaMn,CA 9!197 <br /> A 9e]n9� yu,cirun,GA 91704 DATE <br /> I i ;rnrYl r.� 709J4674e1 Y 'f' <br /> d f lr19'Ina DLII �f ]n9.IE617r17 _ PO.b - <br /> .r, VEHICtFP ). // <br /> :'•' -- -' - PHONE <br /> ( `i � 1 <br /> - —_ LICENSE",11 i/ 7 V34: <br /> 0 <br /> STATE- ,.:.:G"4v i;:':'•) <br /> nnr fil�iir.IL <br /> r W„ <br /> �— DECALS <br /> It' cmXkM <br /> f119TOMCIt TPID � ' �•'• YT� nl Dv10ad.bwela Wand corncL ln.dddlnrl,terrl o/ <br /> Uon pr <br /> bitc "Our <br /> a Cod.1'� eetUoda2Y61r <br /> 1 I nh.levo of the Otale DI C.IIf.mla 11,.t th.InlDrma 1 Uen p.r day as d.acrll>ad In PUI>1tC D <br /> FF <br /> I,eriti Ural"0.,Welty M 1'arJury ur Y n r UenlYt nl anew.!DI Ih.Weal.Tlra Hauler RaglallaUon pursuant m O . ! <br /> 11:1•II�',,.I nn mI11Ya'In In dnY'P.r vllnlellnn DI edminl.tretive pen* <br /> uD ID f7.0 �. <br /> re p... --_ DRIVE/ _ _ - (' <br /> I rl','I,if NAM/ <br /> ,•^fr f �� 1 I)Y, r(/�GI a •- a . .. STATE .0 - o r' <br /> LICENSE <br /> rrr AtAkl ._„ TRUrKITRAILL11 B 7 <br /> 11 d' ON'';` 7 dt.0 <br /> — -- ---- <br /> — pCGIAC IN9T1iU('TIONS. . <br /> .DESOWPtl, co m <br /> DESCRIPTION OF WORK CO <br /> Qn , <br /> ury i�fSC{71F'rl'uvu!'WDI�K c_Dn+r [TED _ _Qn BRASS VALVE STEM(S) o <br /> SLI�VICIi CAl L _ MOUNT I DISMOUNT(S)ON VEHICLE' <br /> . ALUMINUM STEM(54 <br /> MOUNT/DISMOUNT(S)LOOSE <br /> F T IN=;Pb CI ION <br /> —_ VALVE STEM REBUILDS) <br /> LOOSE MOUNT(S) <br /> SIR 5ERVICt. ALLIGATOR CAPS) <br /> ---- <br /> 1 I\T RFPAIRIti) LOOSE DISMOUNT(S) , • <br /> -- METAL VALVE CAPS) <br /> TIRE(S)BALANCED <br /> REPAIR MAI t_RIAtIs) 0RING(S) <br /> i4tItEL SWITCH(S) RECONDITIONED WHEELS} <br /> ImEr..e e r FINISH MILES: <br /> DESCRIPTION <br /> START MILES: <br /> "• —.._._. --^---- ------ — TOTAL MILES: <br /> 1 <br /> — -- START TIME. AMPM t <br /> -- -- ON SITE TIME: AM PM <br /> OUT TIME: AM PU <br /> FINISH TIME AM PM <br /> 77 <br /> LOaD AMOUNT--u _ _ ... ..-----�-HAULER EXEMPTION IF APPLICABLE ' <br /> t <br /> _J GOVERNMENT Q LEA EXEMPT ❑OTHER <br /> t' • :J AifiCU:TURE ❑COMMON CARRIER(BACK HAUL <br /> ry LOAD TYPE <br /> i <br /> WHOLE TIRE COUNT WEIGHT IN POUNDS <br /> VOLUME CUBIC YARDS Q WEIGHT IN TONS <br /> uni <br /> nt pa u:1 L^Der the I,"0l the State o)Calijemia that the Information provided above is true and tiveoffCi In ad�U p <br /> a111"0 this inlor•na:Ion nvy ITsu1S I,CMit pena;te3 up SZ$,000 Per day,per violation or admtnlstraive Peitahkts UP <br /> �araaMscNbedpiPvtjwReSole,ce>Coda!Isct)Ln42961 <br /> ilta >�>, • t:US'OMER SIGNATURE DATE <br /> ! <br /> S , - <br />