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AF U vcnay i ue a nCUCawny uw. WORK ORDER NO. <br /> D �7 � 539 E.Sixth Street (559)585-6585 <br /> AD Hanford,CA 93230 Fax(559)585-6588 <br /> I�-tSelray Tire&Retreading Inc. 124712 <br /> tire & retreading, inc.C. 4167 S."B"Street (209)983-3000 <br /> Stockton, CA 95206 Fax(209)983-3001 <br /> ❑ 2544 S.Cherry Ave.•Fresno, CA 93706 ❑ Delray Tire& Retreading Inc. <br /> (559)485-1761 •Fax(559)485-7848 2016 S."K"Street (559)687-3096 <br /> Tulare,CA 93274 Fax(559)687-3098 <br /> CUSTOMER NAME -� CUSTOMER BILL TO DATE ` r <br /> ADDRESS <br /> CITY TELEPHONE <br /> PURCHASE ORQER0./BY WHOM TRAI <br /> VEHICLE N0. WHEEL POSITIONS) LICENSE MILEAGE YEAR <br /> LOCATION OF CALL <br /> SERVICEMAN CASINGS FOR RETREAD WORK ORDER k <br /> QTY. SIZES/PART# DESCRIPTION UNIT PRICE EXTENSION <br /> TSFS SCHEDULED FLEET SERVICE <br /> i TRS SERVICE CALL(REGULAR HOURS) <br /> TERSOT EMERGENCY ROAD SERVICE (AFTER HOURS) <br /> TERSHOL EMERGENCY ROAD SERVICE (HOLIDAY/SUNDAY) <br /> SVCMILE MILEAGE PORTAL TO PORTAL <br /> TMDTK TRUCK MOUNT/DISMOUNT <br /> TWS TRUCK WHEEL SWITCH 41 'IV <br /> TFR TRUCK FLAT REPAIR r r C, ' <br /> TPPX1 REPAIR UNIT'-BIASC� / <br /> TPPX2 REPAIR UNIT- RADIAL r <br /> TPPX3 REPAIR UNIT-SMALL WITH PLUG <br /> TPPX4 REPAIR UNIT-LARGE WITH PLUG <br /> -- .........................._....._.._......._....._.......... <br /> __.__..._.__.._.. <br /> DISMED/DISALL TIRE DISPOSAL <br /> TIRE SIZE/BRAND <br /> CUSTOMER TIRE ❑YES ❑ NO <br /> CAUSE OF ILUREJ TOTAL <br /> D.O.T.4 ON NEW RETREAD <br /> NOTES _...-... <br /> ....___. <br /> OR D.O.T.H OFF NEW RETREAD <br /> INSTRUCTIONS --" — ---- <br /> CUSTOMER'S SIGNATURE <br /> Oft <br />