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WEIGHMASTER CERTIFICATE <br /> 4 THIS IS TO CERTIFY that the following described commodity was weighed,measured,orl�; <br /> counted by a weighmaster,whose signature is on this certificate,who Is a recognized authority <br /> of accuracy,as prescribed by Chapter 7(commencing with Section 1271X1)of Division 5 of the �• <br /> California Business and Professions Code,administered by the Division of Measurement <br /> Standards of the California Department of Food and Agriculture. <br /> PEARSONS CONCRETE <br /> CAUTION' 10284,UNDERWOOD RD., ACAMPO, CA 95220 <br /> -3 TELEPHONE (209) 334-9234 <br /> Freshly -Mixed cement,.- mortar, ; <br /> Concrete or grout may cause skin ORDER NO. # DATE <br /> injury. Avoid contact with skin where CUSTOMER NAME <br /> possible and wash exposed skin ADDRESS _ ,f ' <br /> areas promptly with water. If any JOB LOCA'-ION ¢ 5111 4.13 LOAD NO. <br /> cement mixtures get into eyes, rinse !.,DRIVER �� TRUCK NO. Cu. YDG. x <br /> immediately and repeatedly with ; <br /> water and get, prompt medical C�NCRETEMIX START TIME <br /> attention. CEMENT ARRIVE JOB <br /> KEEP, OUTS.OF REACH OF CHILDREN. A-, � 1 LEAVE Jab <br /> A-2 END TIME <br /> ADMIX 2 <br /> A-3 TOTAL <br /> \� <br /> A-4 � FREE <br /> Dear Customer: `. <br /> WAT_EA NET <br /> ` THIS LOAD 1 -"*ACK WEIGHED AT t` <br /> NOTICE' WE MAKE DELIVERIES INSIDE THE CURB LINE cuARANTEED ,' ' Cuelc ON- MIX 9bT SIMMERHORN' <br /> AT C(JSTOMER'S RISK ONLY AND ACCEPT NO To YIELD ,�. YARos r� 'CRETE. NO. „J GALT,CA. <br /> PES C NCRETE—WEIGHMASTER <br /> RESPONSIBILITY WHATSOEVER FOR DAMAGES' x' <br /> sY <br /> RI~SULTING FROM SUCH DELIVERIES. <br /> QUANTITY - UNITS DESCRIPTION UNIT PRICE AMOUNT <br /> ` _ <br /> The driver of this truck,In requesting the additional signature below,is of the opinion r CU YDS CONCRETE <br /> that tht"size and weight of the'#ruck may possibly cause damages to the premises v <br /> and/or'adjacent property if the driver places the material in this load where you desire <br /> it.It is our wish to help you in-every way that we can,but in order to do this,the driver < <br /> is requesting that you or your representative sign below indicating you have released <br /> the driver and PEARSONS.CONCRETE from all responsibilty for any damage that <br /> may occur to the premises and/or adjacent property,buildings,sidewalks,driveways, _ <br /> curbs, etc. by the delivery of this material. Further,as additional consideration, you `i_ <br /> agree to help the driver remove mud from the wheels of the driver's vehicle so that <br /> the driver will not litter the public street, and you agree to indemnify and hold <br /> harmless the driver of this truck and PEARSONS CONCRETE for any and all liabilities MIN. STAND BY TIME <br /> and damages to the premises and/or adjacent property which may be claimed by =' <br /> anyone to have arisen out of delivery of this order. HOURS RENTAL _ ; <br /> 4 5 MINUTES PER YARD FREE CHARGE C.O.D. <br /> Signature: UNLOADING TIME ALLOWED DOTAL <br /> �,� <br /> TERMS: Net 30 Days. One and ane-haH(1%%)percent Charged oo p1119 a accouters.Any reasonable legal lees <br /> incurred in collection of above will be added to this charge. <br /> GgP,—REV.3/90 Received ey: -— •— <br />