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CMIaaterials Inc. Delivery Tag <br /> Fh�?wAvenue Weighmaster Certificate <br /> ` ;?fa 93711-3204 <br /> ' 59-2777060 CUSTOMER COPY 1 <br /> y .. Fax 559-,277--7134 <br /> Meaeca Rea Mix Plant <br /> :54 7945E Lathrop Tracy Ready Mix Plant Thome Ave.Ready Mix Plant 2 Thome Ave.Ready Mix Plant 1 River Ready Mix Plant 3 <br /> prop Road #56 ai el W.it th <br /> tth Street #60410 N.Thome Avenue Selma Ready Mix Plant 4 <br /> Lathrop,CA 95330 Tracy,CA 95376 Fresno,CA 93706 Fre N.Thome Avenue #62 Pine al Nees Avenue #63 1475 Whitson <br /> Fresno,CA 93706 Pinedale,CA 93650 Selma,CA 93662 <br /> Load Leave Plant Arrive Job <br /> Start Pour End Pour Leave Job Arrive Plant <br /> �6 )2- 0 <br /> Water Added on Job at Customer <br /> Customers Request 70 Gallons Signature x <br /> ;VEIGHMASTERon t CERTIFICATE: THIS re og CERTIFY that the following described commodity was weighed,measured,or counted by a weightmaster,whose <br /> alifo re is si this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the <br /> alifomia Business and Professions Code,administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> IW-1 It, ETES: CAUSES SKIN IRRITATION. READ WARNING ON REVERSE SIDE OF THIS FORM FOR <br /> DETAILED INSTRUCTIONS. <br /> Nant 11fCKetNo. Order No. Customer No. Sold To: <br /> Date <br /> f ,-L... r r-_�.t...,. .... _ <br /> )@livery Address Zone Driver . r f P./O.Number c}_5 <br /> HOT PLANT' FRENCH CPvl "' I U1,4131 r:;f;, .. G^ 1 -4' <br /> ipecial Instructions Project No. <br /> ani ,n7 r� z' 4 TRUCV, <br /> 3pttdal Instructions <br /> Job Number <br /> ii No. Load Size Mix Code Slump %Air %Call. Special Instructions <br /> 3''69 r+• 5Q7t 61:10170 4'ii r <br /> Ord�`red Lfnd of �JftGCl Xr aK %nom iPfQC�jti r1L# t�hit� i t l `• s s <br /> ent ��Uantl xsA i f181131�('y? �pte8Si7r@ � ' �Od� ti�l� a nL #u 8��1did- ti <br /> � <br /> v + <br /> f�i::� �..A Lam.. 'f-I�-j('•: Sr + <br /> L �)':;I';�� <br /> > <br /> r <br /> 4 � ^ <br /> t <br /> L1 <br /> is <br /> t r y <br /> � Y <br /> r <br /> CALAVERAS MATERIALS INC.ASSUMES NO CERTIFlCATE OF COMPLIANCE: WE CERTIFY that the <br /> RESPONSIBILITY FOR DAMAGE INCURRED IN <br /> DELIVERING MATERIALS INSIDE THE CURB LINE. Portland cement,chemical and mineral admixtures contained in <br /> the material described below are brands stated and comply with <br /> CALAVERAS MATERIALS INC. specifications: <br /> CEMENT BRAND: Sub total <br /> TYPE: II MILL LOCATION: <br /> CHEMICAL ADMIX BRAND: TYPE: Tax <br /> MANUFACTURER: <br /> MINERALADMIX MANUFACTURER: "' <br /> CLASS: '4= <br /> Total <br /> it <br />