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., <br />5� V��ES <br />PETRQLEU,N MAIfVT'EAIANCECO. <br />FRESNO, CA _.� <br />me: Sv SA� P <br />Service O �r AA(r.� <br />Address:_ �'` � <br />+p�/�l r /� <br />Clt}I�1 ! , [�f l-�� [� <br />Dispenser Make <br />Dispenser Model: <br />Dispenser Serial #: <br />Pump Test: Gallons: <br />3887 N. Valentine Ave. * Fresno, CA 93722 * J559) 444.1730 E:::l Billable <br />'E= Factory Warr. <br />License No. 779267 * AN EMPLOYEE OWNED COMPANY <br />ll=l coo <br />Please Visit Our Wehslte: www.icservlces.com 10 Not Billable <br />M Bid J o b <br />SR N° 138308 <br />Date: <br />^zip: PhDne: WorkOrderp <br />rust P.D# <br />Close Confir.# <br />Purchase order # <br />DollarAmt: <br />Description of Work Performed <br />At S L n U <br />nature & Date <br />�rppeklefn a 575 00 !Be r Inpbv aaaW u msir-ny b a AYE pYt)' W oo�u4mi. 5�o Ynl Et <br />.rdurb+Adm,= wwtiaew�v�swyra�eaanumm�a�m�a ry,+�s.�eeer.u}.�orr« <br />>nHt Oe o Ifw cwnryl a iieSM Camp+. Ww Avebr grnrn m yvu n arryassV�nOefe M11'1 q rn'K} e'nplgnk�l d Nn a IXa�t fbpol m <br />a-� arr}w ar:hb iirilr fiMRrrt�t![ial otbjamn Weis aLT'eMAmL <br />r C9arnnL mbj jtJ h .Y\9 P'wL pa !-byW o9u. a Vwa gwia mn4 m"t� rhn. rNem <br />�a�Lane.,.. —IM M—h wmti a, g.-yo�L4poW js�+monaVo o-tw <br />ones cmrxaa tewurgglaw, tr sew RLsamx�i ngrenr e�peasgoisdam�sr wananees. eoerau.�seeor mpee.Intl�Arq <br />r'1'."d�d'�Tatly tl vRidiantab'YY tl SVnf tr a AarL�arNKM1a. entl naMr afl�lr 1 eaf aimenns s'i e1M1 pe'&en b aso.x <br />I, give authorization to LC Services <br />Print Name <br />to run my credit card as form of payment. <br />Card 4: <br />Card Type: filling Z 1p: <br />Exp pate:`! 1 3 Digit Sernrity Code: <br />Name an Card: <br />-Work Aatborixed by Date <br />Signature <br />A 3% CONVENIENCE FEE WILL RE APPLIED TO ALLCREDIT CARD TRANSACTIONS <br />Qty Part No. <br />Inv, Description & SIN Each Amount <br />Loc# <br />Worker PAC <br />Depart Arrive Depart Stop OIT <br />Total Labor <br />Total Parts <br />Mileage <br />Travel <br />Freight <br />Sales Tax <br />Total Amount <br />