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jc!! <br />9 <br />Fuel Services <br />Phone: 1-800-215-4839 x2 <br />Fax: 1-305-629-4288 <br />FSR#: 7079 Balch Petroleum <br />Contractors and Builders <br />FSR FAX#: 448-942-0131 <br />Work Order # 337392 V <br />site: 1071A Ryder Truck Rental <br />3633 Duck Creek Drive <br />Stockton, CA 95215 <br />Phone: 209-9433213 <br />Work Order Summary <br />This form must be COMPLETED & ATTACHED to all invoices submitted for payment. <br />Trip # Date Arrival Time Departure Time Travel Hours Miles Traveled <br />Description of Work Performed :(Requlrea) <br />HMO 20, h= I L1llI ,► <br />5=10 t <br />I verify that any dispensers put in the override mode during service have b returned to the normal operating mode. <br />_k�t�'NLb ,�,gttvfl <br />Tech. Name (Printed) Tech Signature Date <br />If additional trip is required call 1-281-647-8900 x2 and request additional "work order summary" <br />Material Used (Attach list if required) <br />Part # Serial # Description Area/Location Date Installed <br />Customer Comments <br />I verify that all work was performed as described above. <br />-C � \,Sb \j a\\x <br />Customer Name (Printed) Customer Si nature Date <br />Page 3 of 3 <br />