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as <br /> ESTABLISH ED 1 8 8 0 <br /> tater,ati <br /> ; CLARK WELL,INC• <br /> MaPROTECT UNDERGROUND WATER <br /> `®.. <br /> WILIGHMASTER CERTIFICATE I SOME OF THE PRODUCTS THAT WE SELL COULD CONTAIN CONTROL NO. 27193 <br /> THIS 13 70 CERTIFY:that the loduwir•g described commodlp,wee wa'ghad maasurzri. I ONE CSR MORE CHEMICALS KNOWN TO THE STATE OF <br /> nr counted by a welghmaster,whose signature is on this certilicale,who or a isc,,nisad CALIFORNIA TO CAUSE CANCER,BIRTH DEFECTS OR OTHER LODI READY MIX AND DRIVER OF TRUCK are released from <br /> authority of occur"':es Prescribed�y Chapter 7(commencing with Section 12700)of REPRODUCTIVE HARM, <br /> Division S of the C'"fomla eu.,neaa and s'.olesatons Code,administered by the Divisionresponsibility of addition to colors due to variations in cemewl <br /> ofMeamn_, <br /> surPent Stant of the Cahfornls Dloirt :if dlrood and A rldutture. CAUTION:Freshly mixed concrete may cause <br /> g aggregate materials or admixtures, and for damages which me;y <br /> skin irritation on prolonged exposure.Avoid incurred in delivering materials across the curb or property line.Caims <br /> Lodi Ready Mix - direct contact where possible and wash shortage will not be allowed unless made at the time this material <br /> exposed skin areas promptly with water.If any delivered. <br /> TRANSIT MIX 3 BUILDING MATERIELS ADDITIONAL WATER ADDED TO THIS CONCRETE WILL RED;. <br /> cementious materials get into the eye,rinse <br /> 851 L ODI AVE. a P.C.BOX 3 • I_ODI,CA 95241 • (209)366-2794 ITS STRENGTH. AN �TEfa'ADDED IS AT CUSTOMER'S O <br /> Immediately and repeatedly with water and get RISK. � <br /> SULD TC: prompt medical attention. <br /> Keep out of reach of children. X / <br /> RECEIVED BY: <br /> LODI READY MIX JOB SITE CYLINDER TEST: ❑NO <br /> WEIGHMASTER Water <br /> Added Gals.to full load ❑ YES <br /> C'I'. <br /> •r r a. ."''<< t �',.. !NEICHEDAT: On Job <br /> At Gals.to 2/3 load ❑YES <br /> Customer's <br /> nV Request Gals.to t/S load ❑YES <br /> _ BY: 7-! R f Fy .1 i ' DEPUTY AUTHORIZED BY: -- <br /> DATE! T:idE TRUCK NO. DRIVER A�N'[�NUMBgF1 TRUCK LIC.N MAX.ADD WATER Gr' <br /> i I /) X, <br /> NO.Or LO•\DS - I A(-,CUM .`A6'-S CU.YDS.THIS LUNG � MIX NO. MIX DESCRIPTION WATER SLUMP <br /> SPECI,t.PRODUCT I PRG)JCT D4'SCR'PTIO?J CASH SALE <br /> I <br /> CU.YDS.THIS LOAD t ,y <br /> ' PRICE/CU.YARD <br /> PRICE/LOAD <br /> MIN.LOAD CHG. <br /> REASON FOR DELAY TIME: SUB-TOTAL <br /> Leave Plant Time un Job — Min (� <br /> I- I REV.COUNT + r;,,j�`�j LJ Job Not Ready SALES TAX <br /> Arrive Job Overtime Min. ❑ Job Broke Down TOTAL FOB PLANT <br /> REV.COUNT // .( <br /> El Truck Broke Down SPEC.PRODUCTS <br /> Start Pour Rate of X$ Per Min. <br /> TIME ON J03 fl ❑ Adding Water TOTAL TAXABLE _ <br /> Stop Pour $ — <br /> ( --- P El Job Early SALES TAX <br /> Overtime Ch—ge <br /> ❑ Slow Placing Method OVERTIME <br /> _Leave J)b Five(5)min.per yu.free unloading time allayed. <br /> I Additional unlcadiny time charged at current Other(Explain) TOTAL <br /> I hourly truck rete. <br /> e�rive Plant <br /> .Z r^" <br /> 4 CA <br /> ell <br /> r � <br /> 2024 EAST CHARTER WAY, STOCKTON, CALIFORNIA' 9-5205 7095, TEL: 209/462-7676, FAX: 209/462-5597 <br /> G-E.N E R A L E N G (N.E E R I N G -C_O N iR A C T 0 R_S.;. ---L-L.c e_n s:a _N-o.—A--32-1-5'_61L-----.-. -_.---- <br />