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<br /> '"Q CARRIER (NAME OR TeRMINAL F<<:, CON~ MJMBER) _. ) <: -, <br /> L) /' '"TV QI- Pl.;~A>p.,-..' \ DN PAGE - <br /> '- ~ \ -' OF -,' <br />DEPARTMENT OF CALIFORNIA HIGHWAY PATROL INSPECTION ADDRESS <br />VEHICLE/EQUIPMENT INSPECTION REPORT "'5"5":?"""; ..... jr " l~b <br /> ! -;\...- ~._-) c: 111 <br /> L. f _ f I . ~, . <br />MOTOR CARRIER SAFETY OPERATIONS OJ.TV OI3..COUN1Y DATE -. _. <br /> r-\...J'I:' A Sr':"r-J'7"'iJ(.J C' '" <br />CHP 343A (Rev 4-91) OPI 062 , . '.' .' <br /> . <br />Cltd~E .;rra; Trailer MAKE EOUIPMENT NUMBER LICENSE NUMBER VIN \0 Oq ! q ODOMETER lYPEFUEl <br /> I a _ r t-o ~.;:r'~ 1.3() \ 1 _"')......0 i".-<. __> q .)5'~ <br />Tr ", { BUSP Dollv . ~ \., '...l ',::::",VU~ ;'t) G <br />CIRCLE ONE fuctor Trailer .....E-. 'eet:llPMt:I'fr"NtIIDI9ER """""SE'N._ VIN OOOMETER TYPE FUEL <br /> '""M'"- ..->9c' }...., /'7WG..- <br />Truck Bus Dollv -i..L. 1:: _. .' j l..; (,.. <br />TANKlCONTAINER MAKE I SPEC.JTYPE SERIAL NUMBEHfUNIT NUMBER or NUMBER VRS <br /> o Test <br /> OCel1if1ed witnessed <br />CERTIFICATE TYPE CERTIFICATE NUMBER DATE ISSUED REINSPECTION DATE ODOMETER <br /> SECTION ' .U rt ~~'\;;L.:: \-i .A \ E:: _. 7::,0 <- <br /> l--.'; r\ 1......\ .-)' <br /> . <br /> . <br />CIRCLE ONE Trailer MAKE EQUIPMENT NUMBER LICENSE NUMBER VIN ------ ODOMETER TYPE FUEL <br />Tractor <br />Truck Bus Dollv <br />CIRCLE ONE Tractor Trailer MAKE EQUIPMENT NUMBER LICENSE NUMBER ~ ODOMETER TYPE FUEL <br />Truck Bus Dollv -- <br />TANKlCONTAINER MAKE I SPEC.lTYPE___ SERI NIT NUMBER CT NUMBER VRS Test <br /> - o Certified o witnessed <br />CERTIFICATE TYPE CERTlFIC ER DATE ISSUED REINSPECT10N DATE ODOMETER <br /> ----- <br /> SECTION <br /> '. .' . <br /> . <br /> . <br />-. <br />'INSPECTED BV ". ., . 1.0. NUMBER <br />.-r- ~ t: ,7,,~~-; f f' .-~; '~'., ..-_, <br />, :'} ~ \ '~...? '-"1 (~I IX <br /> , ... . . , . . <br /> .. <br /> <br />~l.' <br /> <br />Use preVIous edltions.until.depleted. <br /> <br />.~.. <br />.(.., I' <br />-' j .._J <br /> <br />9296121 <br />