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rTrltlS r'c FLEET SERVICE RECORD <br /> WILSON WAY TIRE CO., INC. <br /> U.S. TIRE SALES TPID 1099877' <br /> WILSON WAY TIRE CO.,INC. FLEET SERVICE RECUPD <br /> t <br /> U.S.TIRE SALES TPID 10001137- <br /> 1-1—mo- <br /> 900097•T•r ^ <br /> — t <br /> DEC <br /> --- <br /> I i <br /> LocAnaN of sEPv:F J v ( i.' �.- v0 ".0-M, > <br /> / / --• v„i <br /> ' Z{' ( ��' 1 V aan"D ar��non .r _J 1G _ <br /> CLISTOMER TFO I ,,rel un rr rt"° ' OECALa <br /> vndn, .,I,rrY pin I M1cl ITI.is <br /> er.^r rFn oral• .,f^m• Weer r ve ..a.a <br /> r ceNlry lM1nt esnnry^Iv ,nd•r 1h• navnn perroellnn pe.tleY <br /> In e,npnnelnn,nrne•„nn.nr,l•nln r,n In <br /> e D Liv1E.ly..+InTUPE DDasnEYE�'JD ul I I <br /> I`ii.ear.n}tEl'p X • STPTE ^ illnn Cpe <br /> aLICEtt+E X a II-Y+hIUE <br /> OFF - <br /> 1lllJ!'KRnnL[n <br /> •I« ON --__'-_ I• .i,,. OFF <br /> [PECI'L — <br /> e <br /> COMPLETED <br /> DESCRIPTION OF WORK E <br /> -_ <br /> t D>~ VALVE STEM(5) PLEr[�- <br /> � pK COMPLETED BRASS <br /> 0= pF.SCRIPTION OF WO VEHICLE STEM(S1 Ot%GRIPTION OF <br /> 'nouoFWOPriCP.MPLErED MOUNT(51 ON ALUMINUM -^' rrc.umngll nL' c.I cnt__ _ - <br /> ]ry _ _ T101S - I•_ _ — - BP.ASS`JALVE STET+tI`1 <br /> t MOUNT REBUILD - <br /> GALLT(S)LOOSE VALVE STEMR - P.IOVNTI DIS'AOUNTf S) NVEHICLC <br /> MOUNT I DISMOUNOR CFF(Sl J -. _— I _ ALUh11NUM STEL+1151 --— <br /> FLEET INSPECTION LOOSE A10UNT(S) ALLIGA: - - h10�UNTl DISMOUNT(')/'?OSE VALVE STEtri REBUILO(S) <br /> FLEET NICE LOOSE DISMOUNTS) METAL VALVE GAP(S) �- __�11­ L— I OOS M.UUNTISI ALLIGATOR CAPS) —�- <br /> AIP <br /> FLATREFAIR(9 TIRE(5)BALANCEO I ORING(S) - :L�-R_Pa IF.S_ LOOSE DISMOUNT(SI <br /> METAL VALVE CAPI`�) <br /> BALANCED <br /> REPAIR MATERIALS) FINISH MILES. p_�'-�=A�°TERI<J.151 TIRES) O RING(ST <br /> RECONCITONED WHEELS) <br /> a I .•r.•EEL 5IYITCrr S', � PECONOITIONED WHEELfS) <br /> N.'HEELSWITCH(5) J DF_SCR START MILES: ea FINISH MILES:—� <br /> TOTAL MILES: 1 C_rp I afFO- / - DEsc START MILES•, � <br /> • r;r�J � - ] STARY TIME:�� TOTAL MILES. <br /> r,M <br /> _ ON SITE T(MEt{ STARTTIME.___----- <br /> OUT TIME:— AF,t <br /> ON SITE TIME'.__--- <br /> FINISH TIrdE'— �— OUT TIME___----r. <br /> FINISH TF.'E_ <br /> HAULER EXEMPTION IF APPLIC a OTHE _HAULER EXEMPTION IF APPLICABLE-__ — <br /> LEAEXEMPT LOADAMOUNT - OTHER <br /> `LOA pAMDUNTJ % GOVERNMENT ❑ ��L'; GOVERNMENT ❑LEA EXEMPT ❑ <br /> �'a=�G OAGRICULTURE ❑COMMON CARL IEDBTAy?E HAUL —_—_ ._= —AGRICULTURE ]COMMON CARRIERIBACK HAUL <br /> WEIGHT INP LO�HOLETYPE IRE COUNT ❑WEIGHT IN POU/ <br /> _ WHOLE TIRE COUNT ❑ PICK UP — — <br /> �JPICK UP WEIGHT IN 1 7 w aDPT FPorr-_---_ -- <br /> �. :ImpORTFROM---- OVOLUMECUBICYARDS ❑ ]DELIVERY <br /> DELIVERY D E/PORTrO VOLUME CUBIC YARDS V WEIGHT IN TON <br /> ExPORTTO <br /> u under the 1■we of the State al C■IOornls lhet the Iniortnetlon provided■hove f true and eol Owe- <br /> I canny that undo <br /> I artdY Ihd undo pend /per(ry P cemo e/f We I folder IM laws of the an tial penalties <br /> that the 00 per d ay,provided above Is true■st ativecarrect.1 <br /> this Inlomtellon may reeuit In civil pem111u up(26,909 Par dayrper vlaldlon or edminlatnlry swwe the,.6ytdcarlon a Ihle m(mmedon may naWt In civil pen■ItUa up(17,099 per day,per violation or administrative pe! <br /> Data... am aware that falsl0e I dlnpubllo Reeeures■Codesactlon 42952 $ d00perrrnl■fr-pWdeywdg$CO$dlnP-Ubllo Ps OU74wtT a�ctlon42952. <br /> G ce ls,009 perrlolatlon� I r�2 <br /> f \ a DASTOMER 816NATURE <br /> � <br /> CUSTOMER SIGNATURE C — <br /> CUSTOMER PRINT NAM <br /> J 'SR No, 175371 <br /> FSR No. 175370 <br /> 5R No 1175174 <br /> �!x <br /> a6337 5/14/2014 1002642 Les 5c "44-7r- <br /> -7 <br /> _ (Retreader1*L�rn6nucP 74 <br />