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Iery Tog.,- <br /> CALAVERA' J tt�p <br /> ;iEIDEIeERGCEMENT�-: FLAN <br /> t�A�NRA�� R� <br /> Calaveras Materials Inc. g �b7�"3'2{ 1. Arrive P <br /> 7673 N.Ingram Avenue Leave Job <br /> Fresno.CA 93711-5838 <br /> Phone 559-277-7060 End Pour <br /> - Sat rt Pour <br /> Toll Free 800-726-5615 — Arrive Job <br /> d— Leave Plant — <br /> custo <br /> �, <br /> -- a weightmaste <br /> Gallons Signa ture r r <br /> J was weighed, measured.or counted by of Division <br /> Water Added eq Job at described commodity with Section 12700) Agriculture Customer's Request as rescribed by Chapter 7 (commencing artment of Food and Ag <br /> THIS IS TO CERTIF that of follow ter <br /> p � - <br /> WEIGHMASTER CERTIFICATE: niZed a horny y • <br /> the Division of Measurement Standards of the California BP <br /> s gnature is on this ceniticate,who is a reco9_ . , <br /> Calrfomia Business and Professions Code,admimstere by • <br /> • • --- <br /> • •' Date <br /> •. T 15- eb- <br /> _ __ — Sofd To: �R I#C I t� — <br /> Plant T ckel No Orde; a Customer No. HENN DIGS BROS.4 549462b 102 6647323 ------ Zone Driver <br /> — --- ROPERT PRflflflFflflT <br /> Delivery Address <br /> AT�Y <br /> 12501 GRAVES RD MANTECA Project No. <br /> $Peciat Instructions <br /> 1500119, SUMP I WELL SEAL 11I4MILE WEST OF JACkTONF L�Ir�'t Job Number <br /> Spe st <br /> Truck No. Load Size Mix Code s+.urrtp a;Air %Ca!_ Project Name <br /> 4401 9 �613045 10.00 2 -- <br /> Load Cumulative Ordered Unit of Product j Product Unit Amou <br /> Quantity Quantity Quantity Measure Code Description Price <br /> 9.00 9. :_ 18.00 yd b13(x_}5 I 10. 3 SK SAND i <br /> 1..00 0.00 ' ea CACARB I CA. CARBIE>`t IROt�.Ml t� T <br /> 11 <br /> l <br /> i <br /> CAWYERAS MATERIALS INC.ASSUMES NO <br /> RESPONSIBILITY FOR DAMAGE INCURRED IN I CERTIFICATE OF COMPLIANCE: — <br /> DELIVERING MATERIALS INSIDE THE CURB LINE Portland cement,chemical and mineral admixturesTIFF conthat the in <br /> the material described below are brands stated and comply with <br /> CALAVERAS MATERIALS INC. specifications: <br /> CEMENT BRAND:_ <br /> TYPE: 11 MILL LOCATION - <br /> r1F.` <br /> --�rrgCHEMICAL ADMIX BRAND: '— Sub total <br /> �i <br /> ,,.. rl-__- ----- <br /> __ MANUFACTURER:_ -- T`YPE:_^ Tax <br /> MINERAL ADMIX MANUFgCTURER <br /> RDL 469586 <br /> ® DO NOT USE FOR TICKET NO. —`—'--- <br /> Total <br /> vall <br /> :AIt3 ib <br /> W3 ffi '.27S3 Ib 13�1:itat <br /> imn y5 Y "bun%hA3isl�w <br /> -VATER it Sie9t :.56x5 E <br /> d ai6:ti q Il 1`h a{ vd <br /> t 9"It * n aias 01 ,4-1 s3 06 <br /> 8712 Is U :Q1 a1e.s <br /> it) -0-4s% ti <br /> 4� <br /> 3II31�'2 i0 <br /> r i4lffi in <br /> S <br /> 00.3 -Aicnt t1476 T <br /> A�imwa� I0 t of aas.a <br /> a Lead Tri'n: reje, Acturq <br /> -1 n 497.S ._ <br />