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7/11 MATERIALS,INC. WEIGHMASTER CERTIFICATE <br /> WEIGHMASTER THIS IS TO CERTIFY that the following described commodity was weighed,measured, <br /> or counted by a weighmaster,whose signature is on this certificate,who is a recognized <br /> P.O.BOX 4770 authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of <br /> Division 5 of the California Business and Professions Code,administered by the Division <br /> MODESTO,CA 95352 WATERIALS,INC. of Measurement Standards of the California Department of Food and Agriculture. <br /> ` (209)529-4050 489455 <br /> � C <br /> CONTROL NO. #8 9 4 5 5 <br /> SOLD TO: SHIP TO: <br /> TIME MIX NO. LOAD SIZE CU YD/METERS ORD'D SLUMP PLANTITRANSACTION 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 /> SUBTOTAL <br /> SALES TAX <br /> TOTAL <br /> PREVIOUS <br /> STANDBY <br /> WEIGHEDAT: DEPUTY EM <br /> REV COUNT ARIV PLNT LEFT JOB FIN POUR Time Allowed ❑ <br /> ARIV OB JOB NOT READY TRUCK BROKE DOWN JOB SITE CYLINDER TEST[—]YES NO <br /> © 5 <br /> SLOW POUR OR PUMP ACCIDENT Water <br /> Added Gals tofull load YES <br /> TRUCK AHEAD ON JOB E]CITATION <br /> LEFT PLNT LEFT PLNT ARIV JOB ST.POUR Time Due On Job <br /> t p g CONTRACTOR UNAVAIL ❑OTHER At Gals to 2/3 load ❑YES <br /> 0 ADDED WATER Customer's <br /> FIN POUR TTL RD TRIP TTL @ JOB POUR TIME JOB DELAY EXPLANATION Delay Time Request Gals to 1/31oad 1FS <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 OFANY 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 ISA PERISHABLE COMMODITYAND 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 /> art Qty Rzqqu* d Batched x 'Jar % Moisture Actual Wat <br /> �lD 19361 11287 lb 11180 1b -0.95% G. M 76 g1 <br /> CEMENT 969.0 lb 5324.0 1b 5295.0 1b -0.64% <br /> WATER 50.N0 gg1 .@@ gl .0N gl <br /> WATER 2 100.N % # 156.44 gl 157.:2 gl 0.5'0% 157.22 g.l <br /> NOT IN % # .08 91 .00 g 1 <br /> Actual Nue Batches: i Manual 9:59:00 <br /> Load Total. 17782 lb Design @.431 Water/Cement 0.399 A Desi n 275.8 g1 Actual 233,1 gl To Add: 21.9 gl <br /> Slump: 7.8N in # Water in Truck: 20.0 ql Adjust Water: 0.0 1 r' Loa Trim Water: -1.8 l/ CYD <br /> Actual WIC Ratio: 0.399 Actual Water: 253 gl Batched Cemen 5290 1b Allowable Water: 168 1b <br />