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<br />DATE
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<br />Beginnlng
<br />Ending
<br />Accident Yes
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<br />Selland Constmetion, Ins.
<br />TOTAL
<br />Gallonssf Fuel; On-Hwy- Off-Hwy-
<br />lf AccidentwasTruck/IrailerLoaded: Yes..--"--_ No--
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