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Lockeford Materials, Lockeford Materials 12505 E.Brandt Rd. lo. 6606 12505 E. Brandt Rd. No. 6 6 0 5 Lockeford,CA 95237 Lockeford, CA 95237 (209)727-5580 (209)727-5580 import ❑ Export Import ❑ Export DateJ22= — Z Tmme l b Trlc## �- Date,,/>-�- 6,-Z- Time Trk# Point of Origin Point of Origin ��- z �•' Point of Destination � (�i i Point of Destination Material Contractor's Name r�-•� / %>t�.� c i Contractor's Name J, #of Axles /#of yards,,::; ,r . ...-� #of Axles /#of yards Material (Please circle) clean Coni t�• Concrete w�Rebar • Material: (Please circle�Crean-me,• Concrete w/Rebar • Mixed load w/o Rebar • Mixed load with Rebar • Clean Asphalt Mixed load w/o Rebar • Nfixed load with Rebar • Clean Asphalt Other = - Other - Driver's Sigma= Driver's Signature �/ Underlying CarrierUnderlying Carrier ***Concrete must be less than 24"and rebar must be trimmed flush.All over- •**Conezete must be less than 24^and rebar must be trimmed flush.All over- sized concrete will be charged accordingly. ALL contaminated loads will be sized concrete will be charged accordingly. ALL contaminated loads will be refused(material with wood glass,pipe,etc.) All loads must be inspected and a refiised(material with wood,glass,pipe,etc) All loads must be inspected and a scale tag received. WE RESERVE THE RIGHT TO REFUSE ANY LOAF scale tag received- WE RESERVE THE RIGHT TO REFUSE ANY LOAD FORANYREASON. FOR ANY REASON. NO HAZARDOUS MATERIALS ACCEPTED NO HAZARDOUS NIATERIALS ACCEPTED 1 D. H. WINN Trucking, Inc. 19555 N.TULLY ROAD LOCKEFORD,CALIFORNIA 95237 (209)727-5531 Transportation Tax No. No.SR-ME-2&704014 CA#31332 DATE f c ` TIME J POINT C� OF ORIGIN: POINT OF j I DESTINATION: �l CONTRACTOR'S NAME: ^,j ADDRESS: NO.OF-TGNS OR YARDS. % `�/ MAT'L:,- TRUCK NO. PHONE. DRIVER'S SIGNATURE -TAGS MUST BE FILLED OUT COMPLETELY-