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EXPECTED DATE/TIME OF RETURN: EQUIP DISPATCHER’S SIGNATURE: 1ST OPERATOR’S SIGNATURE: 2ND OPERATOR’S SIGNATURE: OFF POST AUTHORIZATION: DISPATCH OUT REMARKS: END ITEM USAGE DATA EQUIPMENT NOUN M/H/K CURRENT READING READING AT RETURN FUEL USAGE (IN GALLONS) COMPONENT (S) USAGE DATA COMPONENT SERIAL NUMBER NOUN M/H/K CURRENT READING 10 READING AT RETURN FUEL USAGE (IN GALLONS) .

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