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7/11 MATERIALS,INC. WEIGHMASTER CERTIFICATE WEIGHVASTERr!]iIIIIr THIS IS TO CERTIFY that the followinVescribed commodity was weighed,measured, or counted by a weighmaster,whote slg'nature is on this certificate,who is a recognized s P.O.BOX 4770 authority of accuracy,as prescribed ty Chapter 7(commencing with Section 12700)of i I Division 5 of the California Business and Professions Code,administered by the Division MODESTO,CA 95352of Measurement Standards of the California Department of Food and Agriculture. MATERIALS,INF (209)529-4050 CONTROL NO. 501022 SOLD TO: SHIP TO: C;PINEPA +R SONS DRILLING 1.3715 EAST VICTOR ROAD LODI 14,'-364 CLUES—nn ur TH T S JOB IS EAST OF' JACK TONE RD ORDER o 1 El TIME MIX NO. LOAD SIZE CU YD/METERS ORDT SLUMP PLANT/TRANSACTION TRUCK# DRIVER Id.I Rt_6ERTGIBOA DATE CONTACT NO OF LOADS ACCUM CU YD/METERS ZONE P.O.JOB# LICENSE# TICKET NUMBER -r 5'1,-7;R f? QUANTITY CODE DESCRIPTION PRICE CU YD METER EXTENDED PRICE 121, I: C.[ J VI. SUBTOTAL SALES TAX TOTAL PREVIOUS STANDBY EESM WEIGHEDAT: f :hF.'-''' C', j r)f-F f-) r'--I...I ti..I.nrKT0j,,I DEPUTY 'y ATT 1_II."ifr4..lt,,l-•Y" REV C UNI' ARIV PLNT LEFT JOB FIN POUR Time Allowed ARIV OB E] JOB NOT READY TRUCK BROKE DOWN JOB SITE CYLINDGR'f GST❑YES NO SLOW POUR OR PUMP �ACCIDENT Water Added Gals to full load [:]YES TRUCK AHEAD ON JOB �CITATION LEFT PLNT LEFT PLNT ARIV JOB ST.POUR Time Due On Job p g CONTRACTOR UNAVAIL OTHER At Gals to 2/3 load YES ADDED WATER Customer's FIN POUR TTL RD TRIP TTL @ JOB POUR TIME Dela Time Request Gals to 1/3 load YES JOB DELAY EXPLANATION y Five(5)minutes per yd/meter free unloading time allowed. AUTHORIZED BY: Additional unloading time charged at current hourly rate. 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 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- LIVERIES.CUSTOMER SHALL INDEMNIFY,HOLD HARMLESS&DEFEND 7/11 FOR,FROM&AGAINST ALL CLAIMS FOR DAMAGES OR PERSONAL INJURY.EXPENSE OF 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 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 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 LEAVING THE PLANT.ANY CHANGES OR CANCELLATIONS OF ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO OFFICE BEFORE LOADING STARTS.CUSTOMER IS RESPONSIBLE FOR PRO- VIDING A SUITABLE PLACE,ON CUSTOOME� PROPERTY,FOR DRIVERS TO WASH CHUTES AS NECESSARY.ANY CLEANUP COST OF CUSTOM ER-PROVIDED WASHOUT SITE OR REMOVAL OF TRACKED-MUD FROM STREETS AND,OA�WILL BE BILLED TO CUSTOMER. RECEIVED BY: H I L .L71 I i' _ ! ) {— 1 Y H ._ Y 'It.. .. _- %M217,._.. C._..PE.�._.__'`__.5... SANL _ ._.� l.936, 1 b E.i 27 1.b6030 . 77% ..._.._1,5.5124 "I.:-. C_EIYIENI 968, 0 1.b 2`.304. 0 1. b i-'900. 0r{' . 14% WATER 50. 00 g I. Ch: 00 g 1. 0: Oa � 0. 00 WATER c 10 0. 0,0 ;; #b �)r-=). 7;_ g I. 100. 18 O. 46% 100. 1 E' g 1. HOT 0. 00 g 1 :y, 0. 00 g 1 0. 0k 0. 00% NON-:a I f4tjLATED NUM BATCHES: 1 LOAD TOTAL: 9816 1b DESIGN WIC: 9.1.431 WATER/CEMENT: 0.288T DESIGN WATER: 150.0 gl ACTUAL WATER: 10fI.L q1 TO ADD: 49.9 gl SLUMP: 7.041 4 ADJUST WATER: 0.0 gl And TRIM WATER: -1,:8 gl iyd