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N W TRUCK BROKERS INC. <br />. . <br />339 NORTH COLUMBtA BOULEVARD • PORTLAND, OREGON 97217 <br />(503) 286-7999 • FAX 503 283 <br /> ( ) -2454 <br />CARRI ' YRUCK <br />~ <br />~ # TRAILER# START TIME DATE <br />~"~ ' Z~~A Y~~ INCLUDING P/T ~~ AM PM - 2 . NW TRUCK <br />CONTRACTOR JOB / PO# ENDING TIME/ TOTAL ON DUTY/ ACTUAL BROKERS INC. <br />J~S ~ j'~U ~ Q J/~'{ Er +f~ l A~, TRAVEL & FUEL AM PM NOT DRIVING DRIVING TIME 339 N• Columbia Blvd. <br />BEGINNING MILEAGE/ ~~ ~ Jb~E TONS TOTAL HOURS (T'OTAL HRSlTIME) Portland, OR 97217 <br />` <br /> YARDS ~ <br />~) 2~'~ <br /> MILEAGE <br />~ <br />' LOAD SITE <br />~. <br />~ , <br />H~ <br />r coMMOOiTV~ UNITS TIME IN TIME OUT DUMP SITE TIME IN TIME OUT DELAY/REASON <br /> <br /> <br /> <br />, t <br />. ~ <br />~.,~, `~ ~. . <br />~. ~ , <br />~ <br />~, <br />- :b. <br />~.~ . , ..~ <br />i <br />,~. ~ <br />~ ~ ~,. <br />~ .,. <br /> <br />~ ~ ~~~. ~~ ~ <br /> <br />~~ <br />~ <br />~ <br />, .., ~~ -_~ <br /> <br />. <br /> <br />, ~ <br />. _ <br />~ <br />~ <br /> <br />~ -~ ,~,,,~ , <br /> <br />~ ~ ~ .. ~ ~~~ ~...: <br /> , ? ~ f s <br />~ dy <br />~ ~~ `~ ~ ~~~ `3z ~~ ~ s F~ ~ <br />3 .~~• tl 11ZU ) <br />~ - <br />! <br />4 ~~~ ~~: 1~ ~f}S ~vu ~~~. <br />5 <br /> <br />6 <br /> <br />7 <br /> <br />8 <br /> <br />9 <br /> <br />10 <br /> ~ <br />11 ~ ;~. <br />12 "~' <br />' <br />~;F. # <br />! t <br />~ : <br />13 <br />r~. <br /> ?~ <br />14 ;.- <br /> <br />15 <br /> <br />16 <br />,~~~ ~ <br />~ <br /> " <br />' <br />17 ~ ~ <br />;~ <br /> _;~. <br />18 ~~~~:: ~; <br />,~ - <br /> ~ <br />`` ~;r - <br />19 ~~; :=~: <br /> ~ <br />2O k ~;~ ;~ <br />END ING MILEAGE / OUT OF ST <br /> ATE MILEAGE: <br /> WA ID UT "OFFICE USE ONLY" <br />"SPECIAL INSTRUCTIONS" ~ PRIVATE ROAD MILES TOT. HRS. AVE. CYCLETM. MIN. <br /> TOT. YDS/TNS X s = a <br /> TOT. LOADIUNLD. HRS. AVER. PER HR. S <br /> TOT. MILES FUEL GAL. MPG <br /> <br /> as~-rcH nMe <br /> TO AHRIVE JOB SITE A~p~ <br /> <br /> NWT8001 <br />