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WILSON WAY TIRE CO.,INC. •lit WILSON WAY TIRE CO.,INC. FLEET SERVICE RE FLEET SERVICE RECORD CORD yL.e t• U.S.TIRE SALESP Dr`)A U.S.TIRE SALES }` I% I 'LI � /':� TPID 1ODDB37• 17 O A q1 . .' '^OODA371 s n,n sNn,o]•]] l �. �r-T w+r+er w.r nr.L.•.n .o>cn.n•n rn. r vs nr.s.r.. n.m .1>!r�fn:R.nn roT renn•n rrn of us m.s.r.n rn us n,.s+r.] .......m•n �L JI M""c"u� ar�n.r sr "n�c. >na �+cn n. ros a.rb,•.<•. nr.. ':131r.Mn1 Sr Tt11H Wllaen W 1!011 Yo•+mnn alM. v13 NNinn•IAv. Svf] inv�.3.e>.i G OS>99 era Ov ti.2 vta n3•]]1aCn 'e w>m - 2M I,q CA My Mne•nrn,Cn v3]]I Iln aNN CA 91145 Sfq,91]]43LnJ- nn.MrSN >9■•1eSJT.t I 9 ]fat anW.v . Tmn9,103 r I ,p�aA^3•K ]oR.4ee->se] an9:s]t•seff s >.t]D/] ) I 1,{G7�riI f /l t-_f _ r--'' ..-- - - • � �� nU q —L—IEv /"7 I'./ �, I�--� �� -_—___. .I �"JC1�--�� •----- �- -- EHIGLE M ��. nHUNC L: L ___—.._.__- _.__l._-�_�_._ __ -- LICENSE• crRv CY I •Iv 1 Ir 5 /' CUSTOMER TPID 2L� III L I/ I uv OEe ol.r.Nn.,I.�lo�I°1n• •�`ii lnl.ln..uen of 1; ^ DECAL q I =''L' (/ �^Mwn�w+ w��•er»hon ne?n R.ao. man CLISTOMER Tino G( f �' nntlrnrael., ee�lon elbn 0111 knM wiw rro l^rt]l ,1e r n •i nvr eOwiE c �nlp•rtury une+,IMI.+t eItM1+Sule of Callfaml•tn+.INn+++Innen N•aet Rapier bevIslru• lvvuene Re vurwa Cetl••a i'4]94n•na.............. 'u:.IVEH WM1Ic +reUP.NER S�rol tarts°�Imde O+w•Rv me�lmn.er e•n,NernnawNatto n,•Ibn vunu+rel tla•cnE+tllnnudlc Rn•m,rc+n Catla a+cllan N] L �/�v�vM•rnlNlnn X T.a eN.r..•res....r,awne b+rvambn +.n,e sspn99•r.Imm�on 9«ear++ pnTE - r+�,n e1e a<n.11r+.w NfTf plOvr env.Tr•Inlallen el•nmmr•,rvn••n•nnee STnTE OUOME'fERmUO UHIVC•N EIGNntURE +I•ICENSE ._S nAMC X lwlE f.TUL:IVtRAILEN N STATC CICJU,.IEI CHH�JH ON - •LIGENSE - OFF iRVCKTRn!LER. SPECIAL INSTRUCTION _ ON L_OF CJ"Y DESCRIPTION OFWORx COM11PLETEp OTY. OE+CRIPTIOIJ OF WORHCO�L�_TED RK COMPLETED _ - BRASS VALVE STEM(S)`_. _ _�rLL rIIOUNT/015MOUNT(S7 ON VEt IICLE Ory DESCRIPTION OF WORK - -- .,� TEM(S <rRIRi10]J OF WORD COAIFiIACL VALVE STEMS) j _ ALUMINUM S ) OTr -^` - - BRASS ---- I ==-INSPECi1nN MOUNT/DISMOUNT(S)LOOSE --- MOUNT I DI SMCUNTISI ON VEHICLE_ LOOSE MOUhIT(S) VALVE STEM REBUILD(S) f,LUr.41NuM STEMS) - _. ALLIGATOR CAPS) ----- -_-_ - RAOUNT/DISMOUNT! (S�L003E VALVE STEM REBUILD(G) -_-_,_ _ LOOSE DISMOUNT(S) ----- LOOSE LIOUNT(S) _ c.,. TIRE(S)BALANCED METALVALVE CAP(S) --- _ --_ -- _ ALLIGATOR CAPIS) -.-_..IR FAATERIAL(S) ORING(S) LOOSE DISMOUNTS) _CHfS1 RECO'JDITIONED WHEELIE) '- __---- - METAL VALVE CAP(S) � ---- — I TIRE(S)BALANCED START 1dILE5. - -••9 - FINISH MILES. ----� _ O RING(S) ntcs =___ DES klPrlor-r RECONDITIONED WHEELS) _-_-----' FINISH MILES: TOTALMILES'___� -- I O J START MILES: i p1FG , 1 � START TIME AI' TOTAL MILES __ ON SITE TIME._ N _--. AM PIA 1 START TIME:�� -�— OUTTIME: 'I ON SITE TIME._--AM --'--- -- FINISH TIME _-- OUTTiME_1'm1 __HAULER EXEMPTION IP APPLICABLE .CADAMOUNT _. _ _ _ ___ -- - -- -- - FINISHTIME. J GOVERNMENT ❑LEA EXEMPT ❑OTHER AUL HAULER EXEMPTION IF APPLICABLE J — — ❑OTHER �(;'s, -- -- - -- � ,I MICR Uo -1 AGRICULTURE C)COMMON CARR IERIBACK H L AD TYPE J GOVERNMENT U LEA EXEMPT , ,I%POR man - HOLE TIRE COUNT ❑WEIGHT IN POL� a- -- ]A GRICULTUPE ❑COMMON CARRIER/SACK HAUL ?O_LI EERY �� ! D TYPE __ J E, ;-C ❑ OLUME CUBIC YARDS ❑WEIGHT IN TON :/ WHOLE TIRE COUNT d El(1lX - I cen,ry th0 under penalty of psr(ury and.,the I■Nn of the Stele of Ca itfornle that the Inlormetlon provided above In"a and eorreef� LUME CUBIC YARDS .C3wF-1G "'! am arers that lois nuuon.1 this Inform■tlan mey r.,.It In civil penallbe up 225,000 per day,per violation or admin btnthe pl -' °° 37000 pervlalMlen perdry■s dnarlb.d in Pubne Resdura■Code SaM.,42052 _ c.ndy 1-1.4.P■RNty of pe.(ury U.dv IM lave of the State of California that the InlormaOen provWad abd�r� '"^, sm arran.mmaa//GI■5icatlrm d Ma Inlormstlon'Ary result In civil penawas up f2'm W day wylolattoh6f' o� s;,5ar pervid■ ';;'drysTdeecrtbed Jn Rubllc Resotnce■CadnectlonAM2. �- CU$TOM�'PPRtAZLdYB ---- CUSTOMER SIGNATURE R No, ? lb 9 CUSTOMER PRINT y4R11"/" CUSTOMER SIGNATURE _e. fNo � �