Laserfiche WebLink
DESTINATION <br />�ti%0 <br />CUSTOMER'S ORDER NO. <br />REMARKS <br />r /e. vlc_ dr L /rte DATE: r" <br />j DELIVERY: <br />EOUIP./47- <br />TIME: <br />f <br />o 7� <br />TOTAL DUE <br />UNLEADED GAS <br />; <br />✓ <br />4/ � a 3 � <br />`?^�' <br />UNLEADED PLUS GAS <br />1 <br />PREMIUM UNLEADED GAS <br />DIESEL <br />5 jh <br />�� �(a�! <br />ly <br />% q 7clw2y <br />&f <br />TANK CAPS OK YES ❑ NO J <br />TANK TAGS OK <br />YES ❑ NO ❑ <br />FLAPPER VALVE OK YES Cl NO ❑ <br />END MILEAGE <br />a �` <br />% <br />RECEIVED IN GOOD'\ <br />CONDITION BY <br />— '� <br />LOADINGUNLOADING <br />DRIVER <br />% <br />�(f f rl ` <br />. r DRIVER <br />i ,} <br />/ `1 ! <br />START MILEAGE <br />TOTAL MILEAGE <br />` <br />'�_ <br />CUSTOMER <br />