| Customer:___________________ |
Phone:_______________ |
Fax:_____________ |
| Make/Model:_________________ |
Tire Size:_____________ |
Drive
or Steer |
| Wheel
Size:____________________________ |
Plate
Thickness:_______________ |
| Number of
Holes:________________________ |
Plate
Location:________________ |
| Bolt Circle
Diameter:_____________________ |
Pitch:_______________________ |
| Pilot Hole
Diameter:______________________ |
Wheel
Type:__________________ |
| Bolt Hole
Size:__________________________ |
Markings:____________________ |
|
Chamfer:______________________________ |
|
