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WEIGHMASTER CERTIFICATE a' SOME OF THE PRODUCTS THAT WE SELL COULD CONTAIN CONTROL NO.44255 4 5 <br /> THIS IS TO CERTIir Ihcommo <br /> el the}allowing 10PRcrIbed dity r wolghed,meas C. t� ONE OR MORE CHEMIn ALS KNOWN TO THE STATE or <br /> or 1a� d by a weyhmesler,whose algr eture is on Ilia ca rtlli0aie who Is a recognired CALIFORNIA TO CAVSE LANCER,BIRTH DEFECTS OR OTHER <br /> awnorier of a==1,=e�y.ee area=nbee <br /> by cneoler i 1=omm«r,cmg wRn s=ml=n IZTom,pl REPR9DucnvE HARM. LODI READY M,X AND DRIVER OF TRUCK are released from any <br /> orv1.., §01 the Ca110o 1e Rlelo e11 ProlaeeiO C=de,adm111etere0 by the Division CAUTION:Freshly mix responsibility of addition to colors due to variations in cement and <br /> oe Meaauram¢nl slendardaof the Cal�Fo,nia DePenmanl bl Food a nd Agrl=wryre, Y ed Concrete may cause <br /> skin lrrilallon on prolonged exposure.Avoid aggregate materials of admixtures, and for damages which may be <br /> 4.. incurred in delivering materials across the curb or property line-Claims for <br /> Lodi Ready Mix direct contact whera possible and wash shortage will not be allowed unless made at the time this material was <br /> TRANSIT MIX&BUILDING MATERIALS exposed skin areas promptly with water.It any delivered. <br /> 851 E.LODE AVE. P.O.BOX 3 • LODI„CA 95241 {2f}9).368-2794 cemenlious materials get into the eye,rinse ADDITIONAL WATER ADDED TO THIS CONCRETE WILL REDUCE <br /> Immediately and repeatedly with water and got ITS STRENGTH. ANY WATER ADDED IS AT CUSTOMER'S OWN <br /> 7� - <br /> : RISK. <br /> }�- prompt medical attention. <br /> Keep out of reach of children. RECEIVED BY:X <br /> LODI READY MIX JOB SITE CYLINDER TEST: ❑ NO <br /> I. WEIGHMASTER waterAdded Gals.to fulf load YES <br /> �E(..i C R I FaI ?)YiOhlT WEIGHED AT; On Job <br /> I- D I At Customer'sGals.to 2/3 load ❑ YES <br /> _ _Request Gals.to 11a load ❑ YES <br /> BY: r.-M a r''f.� "r ,IDEA TY AUTHORIZED BY: <br /> DATE AV'- <br /> TIM JOB CODE TRUCK NO. DRIVER AND N'dABER _ TRUCK LIC.# MAX,ADD WATER GALS, <br /> NC.OF LOADS ACCUMn YARDS CU.YDS.THIS LOAD MIX'NO. MIX DESCRIPT WATER <br /> LLfMP <br /> SPECIAL PRODUCT PRODUCT DESCRIPTION <br /> CASH SALE <br /> •„r. CU.YDS.THIS LOAD - <br /> .. <br /> PRICE/CU.YARD <br /> PRICE/LORD <br /> MIN.LOAD CHG. <br /> 'Leave Plant Time on Job REASON FOR DELAY TIME: SUB-TOTAL <br /> , <br /> REV.COUNT �- Min_ ❑ Job Not Ready SALES TAX <br /> —1.�. Arrive Job Overtime <br /> REV.COUNT Min. ❑ Job Broke Dawn TOTAL F08 PLANT <br /> - <br /> ❑ Truck Broke Down <br /> Start Pour Rate of X$ Per Min. SPEC.PRODUCTS <br /> TIME ON JOB / l'”) ❑ Adding Water TOTAL TAXABLE <br /> Stop Pour =$ - <br /> �7 Overtime Charge � Arrived Job Early SALES TAX <br /> Leave Jab Five(5)min.per yd.free unloading time allowed. Slow Placing Method OVERTIME <br /> Additional Arrive Plant unloading time charged at current. El Other(Explain) TOTAL <br /> hourly[ruck rate. <br /> C r <br /> '. .. _ <br /> rw $ T <br /> —r I <br /> INSPECTION COPY II <br />