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FLEET SERVICE REC I lop V)lLSON VY Lpj)IStr•_ WILSON WAY TIRE CO.,INC. �DOpB77. AY TIRE CO.,INC. FLEET SERVICE RECORD �� U.S.T7RE SALES 7p10 12e us r^Ih'ei.* U.S. TIRE SALESTPID r ]us nn s•. s��e..m.ie. -.- '1000837• rwr Screen W ^• 02leon lSeY Tres Aral, NeYr•b�=A9e 91a-]a!-]xISLP li N W•v r•'" Cv n. US Trrt sel� SeJJ illy Yat en lei Mepe Yv 91vd a xJ vx n.�seise S] acts CA e]]s• e) 32rrkMn Ga eS4 2lfr NnMartvnWY see Yes mr. r.. LrS Nenanei 8,ee.ewn AalrnJ !9•)11' IAy3rr.lelr E — JCLAe!-e:Sr .. smrYron.CA Le2o3 eme..ro�cel9lasl �'x'�e�iJe7a er 2e to ^ i 9�eca3nr - z,P cDDe 40:.5nCN Or SEAMC'[ ATE l'{c^,CNC=SFS,.-.` -- - DECAL} I I _ ,udemnced..enp _ CUSTOMER TAIf? — ❑EGALM — C'USTDMEft TPID N .dada el. R VFE r,ryn .nd• Lln eEdlp orvry Ne, ne!ryn 'Cel real alio .ormH^nr Ra„I.m np din DP �0 m er peon pupa „ per e e LIS�nCO pa�ea TU •SIONP yr lata R IE IlrleMro ~ORI ,.Eq.HIIR mal'rt•eNlr pens IF23 Pena l• P�v i5p9 cOATE rc vd a ORIVERe51DNATlJAIE a C�n� X ODOMEI Q STATE X r]DOMETEPIHUB aL�CENSE LIGErrsE srArE - i•�ucr.�raILER e — OFF-__ TRVCtt'rRAILERe - Q s-,-,Ai•NSTRUCTIONS -______ _-- • — I __ _ _ -_ • Off( OTrr DESCRIPrrON OF SNORK -CRY COMP- Dom, I pE,sCnIPTION OF WORK CDMr•LETEO STE m- - OTY. DESCRIPTION OF'rV - -.,_r:;.: - �.;�CS;g•0.E�-"U BRASS VALVE O M1tOUNT/DISMOUNTIS)ON V ICLE - _ _ - ;prp/r .Ur� DEscalPrrDN DF'A^�RACDA4PLE'ED gRp•SS VALVE STEM(51 -- AWh11NUM STEMS) MOUNT/DISMOUNT(S)01.1 VEHICLE s'eG _CPLL REBUILD( _ ALUMINUM STEM(5) MOUNT/DISMOUNT(S)LOOSE VALVE STEM MOUNT/DISMOUNT(5)LOOSE FL ir'S�ECTION LOOSE r,ICUNT(S) VALVE STEM REBUILD(S) ' ALLIGATORCAP(S) RSETPICE LOOSE MOUNT(5) ALLIGATOR CAP(S) CL-AT PEPAIR(si LOOSE DISMOUNT(5) METAL VALVE CAP(B) _ _ -y.r cl LOOSE DISMOUNT(SJ TI -r'-:1'- METAL VALVE CAP(S) : cR,pM gIR ATERie1i5) RES )BALANCED 0 RING(S) RccarP`,'ATEn'IAL(S) TIRE(S)BALANCED O RING(S) ry HEEL SN/ITCH(S) RECONDITIONED WHEEL(5) - , FINISH MILES._— RECONDITIONED WHEEL(5) i l -_-EL SV'ITCsjzDE$H;S) FINISH MILES: f START MILES:___-- � rtt G, DESGArPTI N START MILESt - i1, �/ yam{. T TOTAL MILES.�� s ,i f' TOTAL MILES.• STARTTIME'� U A I ON SITETIME'.___� START TIME:-__—- ONSITE TIMEt�� I OUTTIME.__�I ' FINISH TIME_— . OUTTIME. FINISH TIME'. HAULER EXEMPTION IF APPUGABIa OTHER AD AMOUNT, r HAULER EXEMPTION IF APPLICABLE yr p GOVERNMENT ❑LEA EXEMPT AMOUNT - _- OTHER --- F AGRICULTURE COMMONCARRIERIBACKHAUL ❑GOVERNMENT ❑LEA EXEMPT ❑ — ] LQ TYPE- PiCY,UP HOLE TIRE COUNT ❑WEIGHT 1N POC' ]P.GRICULTURE ❑COMMON CARRIER/BACK HAUL � �” ZIs�oaTFR°M LIDOTYPE ]DEUV-Ry VOLUME CUBIC YARDS ❑WEIGHT IN TOi ]EXPORT TO aT.acv WHOLE TIRE COUNT ❑WEIGHT IN PJ JEE_�l �LUME CUBIC YARDS ❑WEIGHT IN ! I car6ty that undarpsatiry of perjury undarthe lean Of t 9lm of C Ilfoml■that the IMomution prwlded chow laws and coned' cJ TTJ fy n e... .m.wan that t.t.tecaaon of this Iniomn0 may rad It I ohu naltlee up 530,000 per day,per violation or Adminlstrativs p e $ 15owpsrvloli0enWd&yndaacdMdtn PubllaRmur nC sate 151142962. I certify that under penny o1 perjury under the],"of the State of California that the Information provided above to Uua end eon ' am swan that falsification o/this Infomsallon may result In civil penalties up$25,000 per day,per violation or It tile %4 116,000 parvlolatlon per dayes described In Public Resources Cada section 42952. j CUSTOMER PRINT NAME I,CUSTOMER SIGNATURE DATE FSR No. 175369 I CUSTOMER PRINT NAME CUSTOMER SIGNATURE+ 3�7 9 No. 175174 t-'S-'f"�ry_�..��._....... __ _ -- •----.--•� •.`t[r<R:, .'p",ur+.•.,s >s= s _ ,arm': loll-I 77 7 1 716