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1 _ _. �. ar-�-"•+F"c"__'„�'�--�--.-.-..�.=yr-ter��-;�:.-._ .'ar:-r�...--..,__--- _ <br /> WEIGHMASTER CER*ICAT! <br /> THIS 18 TO CERTIFY Mel Onfoffo In dee fe d comnw da,wee weighed.Rse—d,or _ <br /> counted by a wWWhm W.wIl OW.Iun is on Mb ovtlecaee,who Ie&I woogm,_d"Needy <br /> of—-y,n preecdbed b,Ch pter 7(comm .g w1M aecibn 147001 of Dlvtevn 5 of ole - {`+ e► <br /> CAW—I.Bll i—,end Prpelm.Code.edm1,1*Wed by t111 Dlo i-of h.11AWwdIMt :j Y <br /> Standard.of a,e Cel I%ffAo Department or Food end Agr"hun <br /> A_A�V* <br /> PEARSONS CONCRETE <br /> CAUTION 10284 UNDERWOOD RD., AcAMPO, CA 95220 <br /> TELEPHONE (2039) 334-9234 <br /> Freshly mixed cement, mortar, •� — <br /> concrete or grout may cause skin ORDER NO J DATE <br /> injury. Avoid contact with skin where CUSTOMER NAMEy L ' <br /> possible and wash exposed skin ADDRESS - <br /> areas promptly with hater. It any AOR LOCATION _ LOAD NO <br /> cement mixtures get Into eyes, rinse DRIVER TRUCK NO. j 1 cu voc <br /> immediately and repeatediy 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-11 LEAVE JOB <br /> A-Z END TIME <br /> ADMIX] <br /> A-3 TOTAL <br /> A-4 FREE _ <br /> Dear Customer. <br /> WATER NET <br /> THIS LOAD - aACK p arnso AT <br /> NOTICE: WE MAKE DELIVERIES 0ISIDE THE CURB LINE RUARAk MED jlx cunt - 7 "" vex i I'�' '�/ eve a1MMEfNIo <br /> AT CUSTOMER'&'RISK OILY, AND ACCEPT NO To YIELD �'- ,AARs cRErE No. GALT,CJS <br /> PEARSO C30NCRETE-WEIGHMASTER <br /> RESPONSIBILITY`'WHATSOEVER FOR DAMAGES <br /> RESULTING FOOM SUCH DELIVERIES. ouANTITY UNIT? ESCRIFTION L"T MICE AMOUNT <br /> The driver of this truck,in requesting additional signature tnwow,is of the opinion CU YOS CCHCRETE <br /> that tiro size and weight of the truck ay posslbl use dam gee to Ula premises <br /> and/or adjacent property it the driver p aces the m terie!in this load where you desire <br /> it.k is our wish to help you in every wdy that we can,but In order to do this,the driver <br /> is requesting that you or your represegtative sipr, -low indicating you have released V <br /> the driver and PEARSONS CONCRETE tronl all/responslbllty for any damage that <br /> may occur to the premises erld/or adjac#at property,bulldinga,sidewalks,driveways, <br /> curbs,etc,by the delivery of this mr.{arlel.Fur sr,as additional consideration•you tie <br /> 039 agree to help the driver remove spud From the heels of the driver's vehicle so that <br /> 1 the driver will not litter the public eat End you agree to Indemnity and hold — - <br /> Y I A&rmleas the driver of thl:truck and S CONCRETE for any and all liabilities HUM. STAND SY TIMEd damages the prsmisea andldrA property which may be claimed by HURRENTAL <br /> nyone to have arisen out of delivery of this order. <br /> 5 MIe1UTES PEA YARD FREE CKAROE C.O.D. <br /> UNLOADING TIME ALLOWED TOTAL <br /> Signature Ave wmmta her Wit."leas/M <br /> " TEMaE: 1111 Ia 0".DDesad 1aXrasY(L%%]vnl peer riEf�•� <br /> ' -'-- _ hwrM N�/aeeeceee tk etww.eta M tlfyee M MX dal. <br /> c.aP.-REV a/w Received BY: X <br />