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WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity was weighed,measured,or <br /> 'may counted by a weighmaster,whose signature is on this certificate.who Is a recognized authority <br /> �+�l of accuracy.as prescribed by Chapter 7(commencing with Section 12700)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 /> V , �' '� { _y .• : r ; 10284 UNDERWOOD RD., ACAMPO, CA 95220 <br /> TELEPHONE (209) 334-9234 <br /> Freshly mixed cement, mortar, <br /> t concrete or grout may cause skin ORDER NO. DATE ,200 <br /> injury. Avoid contact with skin where CUSTOMER <br /> possible and wash exposed skin <br /> areas promptly with water. If any <br /> cement mixtures get into eyes, rinse DRIVER TRUCK LOAD CU YDG <br /> immediately and repeatedly with <br /> water and get prompt medical CONCRETE MIX START TIME <br /> attention. CEMENT ARRIVE JOB <br /> ADMIX 1 <br /> KEEP OUT OF REACH OF CHILDREN. A-1 LEAVEJOB <br /> A-2 END TIME <br /> ADMIX 2 <br /> A-3 TOTAL <br /> A-4 FREE <br /> Dear Customer: <br /> WATER INET <br /> THIS LOAD SACK WEIGHED AT <br /> GUARANTEED CUBIC CON- MIX 901 SIMMERHORN <br /> �' �• i TO YIELD YARDS CRETE NO. GALT,CA. <br /> PEARSONS READY MIX CONCRETE INC.—WEIGHMASTER <br /> ii i?;''siC,, t':'tit" ".` `.r.;• BY <br /> gSLNf;' (' QUANTITY UNITS DESCRIPTION UNITPRICE AMOUNT <br /> The driver of this truck,in requesting the additional signature below,is of the opinion CU YDS CONCRETE <br /> that the size and weight of the truck may possibly cause damages to the premises <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 <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 /> UNLOADING TIYARD <br /> E ALLOWED CHARGE C.O.D. TOTAL <br /> Signature: ERRORS IN PRICE EXTENSION AND ADDITION SUBJECT TO CORRECTIONS <br /> TERMS: Net 30 Days.One and one-half(11/2x)percent per month will be charged on past due accounts. <br /> c Any reasonable legal fees Incurred In collection of above will be added to this charge, <br /> 4 <br /> Received By: X <br /> GERMANY BROTHERS PRINTING - REV.9/01 t <br />