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Work Order# 375750 <br /> er: <br /> Fuel Services srts: 953 Tracy Fedex Ground <br /> 5655 Hood Way <br /> Phone: 1-800-2154839 x2 FSR#: 7079 Balch Petroleum Tracy, CA 95377 <br /> Contractors and Builders <br /> Fax: 1-305-629-4288 FSR FAX4: 408-942-0131 Phone: 209-839-2060 <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 /> r <br /> zK: 09445 Our: Ioi51S <br /> Description of Work Performed t ;(Required) <br /> LIZ f f -roAJ <br /> i,ilj At l <br /> I verify that any dispensers put in the override mode during service have been returned to the normal operating mode <br /> 69L L, 4�h <br /> 77 <br /> Tech.Name(Printed) Tech Signature Dat <br /> (Required) <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 /> MAf U5 iNMLL\A 0A j A1/] Jo -t3 � <br /> Customer Name(Printed) Customer Signature Date <br /> (Required) <br /> Page 3 of 3 <br />