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CONTROL THIS IS NOT A TICKET NO. .1-BERTSON'S Q NUMBER 4 4 V 9 O 7 ifs, Phone 800/834-7557 San Diego 800/870-1220 #1 RIVERSIDE-612020th ST #13 IRWINDALE-13631 LIVE OAK LANE www'.rrmca.com yrtr #2 MORENO VALLEY-14250 Old 215 Frontage Road #14 PASADENA-1420 N.LINCOLN AVE. OPEN 7 DAYS 1 0 #3 REDLANDS-8353 ALABAMA ST. #15 VERNON-LOS ANGELES-3365 E.26TH ST #4 FONTANA-13792 SLAVER AVE. #16 ANAHEIM-2011 COMMERCIAL ST #25 GARDENA-301 W.ROSECRANS AVE. #35 BIG BEAR LAKE.42025 GARSTIN DR. #44 FT IRWIN-58825 FORT IRWIN RD. #5 POMONA-2470 POMONA BLVD. #17 SANTA ANA-310 N.TOWNSEND ST. #26 THOUSAND PALMS-72460 VARNER RD. #36 ESCONDIDO-1310 SIMPSON WAY #45 BARSTOW-2700 E.MAIN ST. #6 HEMET/SAN JACINTO-1675 STATE ST, #18 LAKE FOREST-25931 TOWN CENTRE DR. #27 MURRIETA-26190 ADAMS AVE. #37 INDIO-88110 FARGO CANYON RD. #46 CAL-CITY-7900 MOSS AVE. #7 BEAUMONT-452 W.LUIS ESTRADA RD. #19 ADELANTO-12203 VIOLET RD. #28 OTAY MESA-7961 AIRWAY RD. #38 RIDGECREST-2157 INYOKERN RD. #47 PORT OF LONG BEACH,1602 W.PIER D ST. #8 SUN CITY-27050 WATSON RD. #20 SAN CLEMENTE-116 RINCON CT #29 EL CAJON-215 CYPRESS LN. #39 PALMDALE.37790 75TH ST.EAST #49 SIMI VALLEY-400 W.LOS ANGELES AVE. #9 ARROWHEAD-29750 HWY 18 #21 IRVINE-16081 CONSTRUCTION CIR.WEST #30 CORONA-1540 SHERBORN ST #40 ARTESIA-13949 E.STAGE ROAD #52 CHULA VISTA-2275 HARDROCK ROAD #10 SAMA FE SPRINGS-12311 GREENSTONE AVE. #22 NO.HOLLYWOOD-13132 RAYMER ST. #31 HESPERIA-9661 C AVE. #41 MOJAVE-140 E.HWY 58 #53 SAN JUAN CAPISTRANO-31511 GIBBY ROAD #11 CABAZON-13990 APACHE TRAIL #23 PARAMOUNT-7277 E.ROSECRANS AVE. #33 MIRAMAR-5692 EASTGATE DR. #42 VICTORVILLE-16952 N.D ST #54 TEMESCAL VALLEY-25050 MAITRI ROAD #12 SAN BERNARDINO-1955 W.9TH ST #24 RIALTO-2601 N.ALDER AVE. #34 LUCERNE-36555 HWY 18 #43 BAKER-56500 BAKER BLVD. #55 OXNARD-COMING SOON .. PLANT DATE CUSTOMER NO: SOLD TO: MAP PAGE TICKET NO. _/ R C L.1. 1 I`ll- 6-11.11`1 t t{ Iii a TX CD DELIVERY ADDRESSORANGE NSTRUCTIONS CUSTOMER P.O./JOB OR LOT# CITY OF ESCALON MANTEC_A I r:l:__r ORDER NO. METER READING TIME TYPED TRUCK LIC NO. 782 1.t(titZ►. fZ►0 <I, LOAD NO. SLUMP TRUCK DRIVER y� 01/1 2055 0 R ? , f U IL..L_gY Al.J9 l...l:N DRUM x1113 T r- �' (. 1. `I I7 TO JOB REVS: Job-site Cylinder fieSt: Yes TIME ON JOB MIN. CHECK# ON JOB Water added on job at STAND BY MIN. CHECK❑ Customers request: AMOUNT By START POUR gals to FUII Ld. RATE OF X$ PER MIN. CASH ❑ AMOUNT BY FINISH POUR gals to 2/3 Ld. $ PLANT MGR SIG gals t0 1/3 Ld. OVERTIME CHARGE LEAVE JOB 4 min.per yd.unloading time allowed. ADJ.Meter ti r 1 T I,•I Additional unloading time charged at current hourly truck rate. ARRIVE PLANT Additional water added to this concrete will reduce its strength.Any water added exceeding the design water is at customer's own risk. Signature certifying under penalty of perjury that the information contained in this written time record Is true and correct. EMPJ# SIGNATURE TERMS AND CONDITIONS OF SALE Customer agrees that the described material has been chosen solely by Customer without Robertson's direction,or review of any plans or specifications relating to the prol'ect(s)where the material is to be used. Customer further agrees that it shall be solely responsible for the delivery location,and discharge/placement of material on the lob site,Including the on-site direction of Robertson's vehicles to the designated location.Customer s review and approval the described material shall be evidenced by Customer's signature and/or placement of the described material on the job site.In consideration of the above,Customer $ y releases and agrees to defend,indemnify and hold Robertson's and its employees and agents harmless from any and all losses,damages,liabilities,costs and claims asserted by Customer or any third party, arising from(i)material being inappropriate,incompatible,improper or inconsistent with plans and specifications,or with the ground soils or conditions on the land where the material is utilized,and(ii)the movement of Robertson's vehicles upon or about the delivery location.Solely to the extent Customer fails to timely pa for the described materials,in the event Robertson's retains the services of an attorney, Customer agrees to pay such reasonable attorney's fees incurred by Robertson's In furtherance of such collection efforts. Robertson's and Customer disclaim attorney's fees arising from any other context. Customer agrees to pay a timo price differential of 1%z%per month on any amounts owed to Robertson's for more than thirty(30)days.Color Disclaimer Due to irregularities and/or inconsistency of materials Robertson's is not responsible for the results of any concrete where the coloring agent has been added at the request of the customer,either at our plant or on the job site. LD QTY CUM QTY ORD QTY PROD CODE MIX AND COMMODITY UOM UNIT PR AMT kiL) i. I[7k"I . 1 •J _ .... .... 1 _ _Jr:. Ii1�l 3f�•r,= 1. 011) 1. 00 1'. 00 1. 1 1 ENV 1 RONMENTAI.. FEE_ 1='1._. :_,5. 00 35. L?I171 1 . 00 1. 00 1 . 00 2:I. 1.', ENERGY SURCHARGE HARGE r'rL_ F.,. 00 35. 00 H20 A1...1__OWE 1._ 172. 00 WEIGHMASTER CERTIFICATE H220 BATLHFI.) 1..36. If7�7f-�1_. THIS IS TO CERTIFY that the following described commodity was weighed, TAX measured,or counted by a weighmaster,whose signature is on this certificate, Mrs I GTLIRE: Fig- I. f7tC�fal.. who is a recognized authority of accuracy,as prescribed by Chapter 7 54'x. 1 (commencing with Section 12700)of Division 5 of the California Business and PREVIOUS M A k. ADD H,:4'.1 13. 0 G A L_ Professions Code,administered by the Division of Measurement Standards of the BALANCE CEMENT _,100. O L B California Department of Food and Agriculture. ROBERTSON'S SUB W 1;A1,14D 6560. IZIL-R WEIGHMASTER WATER REDUCE '= ,. I�- TOTAL f_ F'L...n . STAND BY BY DEPUTY CHARGE UOM CONVERSION CY=YARDS3 #=POUNDS GL=GALLONS FO=OUNCES CU=METERS3 KG=KILOGRAM L=LITERS ML=MILLILITERS CONCRETE DELIVERY TICKET TOTAL PO BOX 3600 CORONA,CA 92878-3600 AGREED TO AND RECEIVED BY CUSTOMER