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3301 Broadmore Street <br />KlamAth Falls, OR 67603 <br />(641) SM-0682 or 686-423-2722 <br />' <br />From <br />I <br />OR <br />At <br />Low <br />To <br />At <br />M-az . <br />Gallons <br />Inches <br />Product <br />Gallons <br />Inches <br />Product <br />TRL <br />Gallons <br />I <br />h <br />P <br />nc <br />es <br />roduct <br />Gallons <br />Inches <br />Product <br />Gallons <br />Inches <br />Product <br />Total Gallons <br />SHIPPER: <br />Gross M. <br />Gross Wt <br />Tare Wt. <br />r <br />Tare Wt. <br />Net Wt <br />Net Wt. <br />REMaRtcs <br />017-7 <br />Gat. <br />Gat. <br />Gal. <br />Excess Mile & i 4 4 <br />Spread Hou r <br />hIMMt„ ~ <br />Dem. Hours <br />Other t+l 0~ <br />THE ABOVE <br />34GNED: <br />_ Total Hours Spread Time: <br />_ Total Hours Demurrage: <br />_ Loading Driver <br />_ Delivering Driver <br />'RECEIVED IN GOOD CO MON <br />DO NOT WRITE BELOW THIS LINE <br />MILES <br />FUEL <br />OR KF-SHOP <br />OR OR-PP <br />CA OR-CFN <br />NV <br />CUSTOMER <br />54020 <br />PO 0 <br />Job M, <br />ShlpWs N <br />8hipper's N <br />Date? w Z3 <br />I <br />Time Due_ <br />Arrived <br />Finished <br />Total hours <br />Grnw. %m4j p0 <br />~v <br />