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t <br /> 7/11 MATERIALS,INC. WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity was weighed,measured, <br /> WEIGHMASTER or counted by a weighmasler,whose signature is on this certificate,who is a recognized <br /> P.O.BOX 4770 authority of accuracy,as prescribe4by Chapter 7(commencing with Section 12700)of <br /> Division 5 of the California Business and Professions Code,administered by the Division <br /> MODESTO,CA 95352of Measurement Standards of the California Department of Food and Agriculture. <br /> ' <br /> (209)529-4050 4CONTROL NO. 501024 <br /> SOLD TO: SHIP TO: <br /> _'7' 5 r::FiSI" v i.c� -op [ L,(A 7 <br /> TIME MIX NO. LOAD SIZE CU YD/METERS ORDT SLUMP PLANT/TRANSACTION TRUCK# DRIVER <br /> DATE CONTACT NO OF LOADS ACCUM CU YD/METERS ZONE P.O.JOB# LICENSE# TICKET NUMBER <br /> QUANTITY CODE DESCRIPTION PRICE CU YD METER EXTENDED PRICE <br /> I, <br /> SUBTOTAL <br /> SALES TAX <br /> TOTAL <br /> PREVIOUS <br /> STANDBY <br /> WEIGHED AT: DEPUTY ,;F. . 1 <br /> RARR'OOB ARIV PLNT LEF"I'JOB FIN POUR JOB NOT READY TRUCK BROKE DOWN Time Allowed JOB SITE CYLINDER TEST[—]YES <br /> NO <br /> SLOW POUR OR PUMP ACCIDENT Water <br /> Added Gals to full load ❑YES <br /> TRUCK AHEAD ON JOB �CITATION <br /> LEFT PLNT LEFT PLNT ARIV JOB ST.POUR Time Due On Job <br /> Q 2 g CONTRACTOR UNAVAIL OTHER At Gals to 2/3 load YES <br /> ADDED WATER Customer's <br /> FIN POUR TTL RD TRIP TTL @ JOB POUR TIME JOB DELAY EXPLANATION Delay Time Request Gals to 1/3 load []YES <br /> Five(5)minutes per yd/meter free unloading time allowed. AUTHORIZED BY: <br /> Additional unloading time charged at current hourly rate. <br /> NOTICE:MY SIGNATURE BELOW INDICATES THAT I ACCEPT THE TERMS AND CONDITIONS OF THIS DELIVERY TAG INCLUDING THE TERMS AND CONDITIONS ON THE REVERSE WE MAKE <br /> DELIVERIES INSIDE CURB LINES AND ON LOTS OR PROPERTY AT CUSTOMER S RISK ONLY AND ACCEPT NO RESPONSIBILITY WHATSOEVER FOR ANY DAMAGES RESULTING FROM SUCH DE- <br /> LIVERIES.CUSTOMER SHALL INDEMNIFY,HOLD HARMLESS&DEFEND 7/11 FOR,FROM&AGAINST ALL CLAIMS FOR DAMAGES OR PERSONAL INJURY.EXPENSE OF <br /> REMOVING MIRED TRUCK PAYABLE BY CUSTOMER.WE ARE NOT RESPONSIBLE FOR THE STRENGTH,SLUMP,OR QUALITY OF ANY CONCRETE TO WHICH WATER OR ANY OTHER MATERIAL HAS <br /> BEEN ADDED AT THE BUYER S REQUEST.WE DO NOT GUARANTEE THE COLOR OF THE CONCRETE.WE HAVE NO CONTROL OVER THE PLACING,FINISHING OR CURING OF CONCRETE AND <br /> DO NOT GUARANTEE THE FINISHED WORK IN WHICH IT IS USED,INCLUDING CRACKING.CONCRETE IS A PERISHABLE COMMODITY AND BECOMES THE PROPERTY OF THE PURCHASER UPON <br /> LEAVING THE PLANT.ANY CHANGES OR CANCELLATIONS OF ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO OFFICE BEFORE LOADING STARTS.CUSTOMER IS RESPONSIBLE FOR PRO- <br /> VIDING A SUITABLE PLACE,ON CUSTOMER S PROPERTY,FOR DRIVERS TO WASH CHUTES AS NECESSARY.ANY CLEANUP COST OF CUSTOMER-PROVIDED WASHOUT SITE OR REMOVAL OF <br /> TRACKED-MUD FROM STREETS AND ROADS WILL BE BILLED TO CUSTOMER. <br /> RECEIVED BY: <br /> MH I '.:.H utblbN u I Y � ._ J _ �BH I GHED _ Y YH ,� <br /> SAND 1936 1b W 8170 1 b 8180 0. 3.a 5. 5111 -I*1 <br /> C:ENENT 9G. 0+�I�h; :��;7 SLI 1.b ,?.,f3`,1!.0 j . 5 <br /> WATER 51271. 00 q). ISS. 00 g). 0% <br /> WATER 2 101Ze• 00 % #132. 96 gl 1.34. 2'1 ell„ 94,!. 13A.. e 1 91. <br /> HOT 0. 00 g 1 # 0. 17,0 g 1. 0. 00 0. 00% <br /> KION---S I MUL.ATE.O NUN BATCHES: 1. <br /> LOAD TOTAL: 13150 lb DESIGN W/C: 0.431 WATER/CEMENT: 0,291T DESIGN WATER: 200.0 gl ACTUAL WATER: 134.2 gl TO RDD: 65.8 gl <br /> SLUMP): 7.00 n# ADJUST WATER: 0.0 gl /load TRIM WATER: -1,0 gl ;yd <br />