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f <br /> w <br /> ESTABLISHED 1 8 8 0 <br /> .. CLARK WELL lNC. PR07ECT UNDERGROUND WATER <br /> •`� <br /> WEIGHMASTER CERTIFICATE SOME DF THE PRODUCTS THAT WE SELL COULD CONTAIN CONTROL NO. 27193 <br /> THIS M TO CERTi F';tn.[In,1oifu111,2 de—load—I racily WAS WA'yhed Mas—d. L—^ ONF CNH MORE CHEMICALS KNOWN TO THE WATE OF A <br /> n• anted by.yeipmm�slm.whoa.aipnatwe Is on th+A urtificate, he+.a Iecep,imd CAL,FORNIA 70 CAUSE CANCER.MIRTH DEFECTS OR OTHER LODI READY MIX AND DRIVER OF TRUCK are released from <br /> au IAOrl ly a!ucvrsar'.sa V,..,,bed u,Chapta T Icolnmen.+np wAh Sanion 121001 al REPROnUC71VE HARM. <br /> thO,ion 5 0l In.C+I+—i.E--z and Prolessioni Code.Ad.JM.Imed by me nivlaicn CAUTION:freshly mixed concrete may cause responsibility of addition to colors due to variations in cemerd <br /> et Mealemr ISt.—e,0th.Cm:I�.nA Depenmea of t Dost and Avric0t— aggregate materials or admixtures, and for damages which me'. <br /> 1l■ Skin Irritation on prolonged exposure.hold incurred in delivering materials across the curb or property line.Ciain:. <br /> �.,0�1 Ready Mix direct contact where possible and wash shortage will not be allowed unless made at the time this material <br /> TRANSIT MIX;k BUILDING MA.TERI:.LS exposed akin areas promptly with water. any ADDITIONAL WATER ADDED TO THIS CONCRETE WILL REIN <br /> cementious materials get into the eye,rinse <br /> 661 i ODI AVE. A P.C.BOX 3 a LODI,CA 95241 • (209)366-2794 ITS STRENGTH. AN W TER'ADDED IS AT CUSTOMER'S O <br /> Immediately and repeatedly with water and gal RISK. <br /> I <br /> j SULb TGt: prompt In allentIDn. <br /> If Keep out of reach of children. RECEIVED BY:X � <br /> LODI READY MIX JOB SITE CYLINDER TEST: ❑ NO <br /> CL.,ARK I<1E 1 .!_ ?'. EQA WEIGHMASTER water <br /> Added Gals,to full load ❑ YES <br /> • ,.I�..�.t. [ i' r�`,P:va`lar.' 4 J <br /> I � NEICI ED AT: III On Job <br /> At Gels.to 2I3 load YES <br /> Customer's <br /> I CC,, �ty4 `' Request Gals.to VD load ❑YES <br /> + i:3 r5 A L L.L I A.A f V <br /> __ __ __ __ I BY; !-I [',•. f s' y DEPUTY AUTHORIZED BY: F- <br /> DATE. i 7;idE I JOB CODE TRUCK 3+ip. DRl'fER AN NIJMB TRUCK LIC.k MAX.ADD WATER G.� <br /> I I _ � 7 J f� <br /> u <br /> NO.OF LOADS - I AF,CUM- AR.^�5 I CU.YDS.THIS LAkD k� MIX NO. � Mik DESCR�PTIOw WATER SLUMP <br /> SPECL.I PHGC5UCr PIZ, 0T Dx'SC.�!PTlOt! W — CASH SAL.r <br /> I <br /> CU.YDS.THIS LOAD t <br /> PRlCEICU.YARD <br /> i PRICE/LOAD <br /> MIN,LOAD CHG. —. <br /> f � REASON FOR DELAY TIME: SUB-TOTAL <br /> .— <br /> Leave PIflT# Time On Job _ Min. �1 <br /> I Job Nut Ready SALES TAX <br /> lREV.COUNT + J- _ <br /> I v( <br /> Arrive Job Overtime Min. ❑ Job Broke Down TOTAL FOB PLANT <br /> HEV.COUNT <br /> Truck Brake Down SPEC.PRODUCTS <br /> Start Pour Rate of X$ Per Min. ❑ <br /> TIMF ON JOB Adding Water TOTALTAXABLE <br /> (_il eaC <br /> Stop Pour S ❑;wartime Ch�•ge Arrived Job Early SALES TAX <br /> ❑ Slow Placing Method OVERTIME <br /> _Leave Jib Five(5}min•per y7..(pre unloading limp.alluweli. <br /> Additional unlcading time charged at current ❑ Cther,'EAplain) TOTAL <br /> I <br /> a.rrlve Plant hourir'ruck rete. <br /> 1 <br /> 2024 EAST CHARTER WAY, STOCKTON, CALIFORNIA' 91520517095, TEL: 209/462-7676, FAX: 209/462-5597 <br />