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INVOICE <br /> WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity <br /> was weighed,measured,or counted by a weighmaster,whose <br /> signature is on this certificate,who is a recognized authority of 41763579 <br /> accuracy,as prescribed by Chapter 7(commencing with Section <br /> 12700)of Division 5 of the California Business and Professions ZZCC—MC—X <br /> Code,administered by the Division of Measurement Standards <br /> of the California Department of Food and Agriculture. CA 95377 <br /> yy <br /> Excess water is detrimental to concrete quality.Increased water in concrete mix reduces strength and durability and increases shrinkage. <br /> NOTE, <br /> Buyer accepts responsibility for water added on job site,which exceeds accepted water/cement ratio and workability specifications. <br /> Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: <br /> /0 `-) s'/&? / / 0'�' <br /> Total Amount for This Ticket Not Including Standby Charges: <br /> Cash Check#I Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect <br /> Without Standby Charges: <br /> Check <br /> Charge <br /> Customer Code: Customer Name: Customer Job Number: Order Code/Date: <br /> Project Code: Project Name: Deputy Weighmaster: Order P.O.Number: <br /> Ticket Date: Delivery Address: Map Page: <br /> Delivery Instructions: Ticket Number: <br /> Due On Job: Slump: Load: Truck Number: Driver Number: Driver Name: End Use: <br /> LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT <br /> QUANTITY QUANTITY QUANTITY <br /> Water Added Curb Line Crossed At Owner's �- SUB TOTAL <br /> IN GALLONS: Agent's Request: X -- - <br /> AILTHORmmB&If NATHRE <br /> TAX <br /> Print Name: Date <br /> O O Signature above signifies receipt and acceptance of the listed materials and acknowledge- TOTAL <br /> INITIALS INITIALS ment of and agreement to the CEMEX terms and conditions. <br /> BATCH DATA: w .1 r-7 <br /> � i ��,�11�1I <br /> i006bi,:�ti7 41:. D2 10: 15:52 81/ 16/18 <br /> _oad Size 141 . s_;nde <br /> A-iter .AIDes i.G?t y504Recll_r:ired 13atcri !hloistt.,rActl_rawat Tot. wart-im <br /> 212@,80 lb 21117.99 lb 21220.00 lb 102.02 0.48% 4.86% A 117.76 gl 117.76 <br /> 1034.00 1 b 9823.00 1 b 9900.00 1 b -•23.00 -0.233 <br /> 60.00al 348.31 gal. 346.00 gal -2.31 -0.66% 346.00 gl 346.00 -11.06 gl <br /> a� <br /> Num Batches : 2 Manual 10:06:3+t <br /> ,d' Tntal• 33907 lb be,sign 0,.4RG� WatP,•l�Qe�nt �, � A n =tan "0.@ rrl Actual 463.A a' -v Add: 195.2 <br /> 80UNIVERSAL Rev 4/12 <br />