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Billable <br /> SERVICE REPORT Factory Warr. <br /> �/ � Maintenance <br /> ,7�. PETROLEUM MAINTENANCE CO. IC= Not Billable <br /> FRESNO,cn IQ Bid J o b <br /> (559)444.1730 * Fax: (559)444-1735 * 3887 N.Valentine Ave.* =resr,o,CA 93722 * License No.779267 <br /> nn <br /> Pleas Visit Our Website: www.ics.irvi ;ei,.com <br /> Name:_a1i1L (74V UZ, # Q 3 6 " <br /> Service ) Dater <br /> Address: d 7� A <br /> City: `P`>>e, "//, Zip: Phone: ?.f)Cl Work Order 0 <br /> Dispenser Make Gust.order o <br /> Dispenser Model: close confir.a <br /> Dispenser Serial#: Parts Order <br /> Pump Test: Gallons: Dollar Amt: <br /> Descripti n of Work Perform d <br /> DATE COMPLETE ve authorization to LC Services <br /> Pr t am <br /> Ilee*111 be F.WnS"1we$7500 bmmeeew.ia lm QTM''aw Rywrnls ea�nedka 1 h1 petty lw Wl.ctns Sh�Jd Wd be wet mesad t run y credit card as form of payment. <br /> to wkrw aT'M Pie I—of ade agreement me preeeena pery shall be enbeed k r—Mble dbgW f len end au!Cour10(N.Sdkew <br /> eh0,be m lyouc *)7Fe Cw4y Wehe1eby 9a1 to yoo n my a56191"the rphl k... empoymentw mn eaedlreOwlk Card Type: Card#: Billing Zip: <br /> owes mybu ebGry <br /> Ex Date-._/ J Security Code: <br /> ll wmmwcebmn be Ohne le ne e."V-WaN WMIss-k you once Cr y—as <br /> ypta.b cwlwA alma by prone II the erc p — <br /> u�ne:'�.ble.end.,—dig deck.is oWW-I measege mcy be kfi PM-dN enme end 0"—W Name on Card•, <br /> Unless cJ e w pfo.idnq by Isar.the W.ILC SeMOes teeaby.".,y dsde,ms e!nweneea,ear e,M..dw np.x d.ndude1 <br /> eny mpred wW.,ty e.—hoYb*y o!lnaK fw a prbae`XWse Fe nmlhe•euumaf nw auftc vry ot'w prwno.ssune Work Authorized b)� _ Date <br /> fait mry febLN n-bon mN ax ab ml Nd Products Print Name <br /> Qty Part No. Inv. Description & SIN Each Amount <br /> Loc# <br /> Worker Date Depart Arrive Arto/1,� � 'Total Labor <br /> Total Parts <br /> M i leage <br /> Travel <br /> Sales Tax <br /> Total Amount <br />