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CALAVERAS TRANSIT MIX <br />SAN ANDREAS, CA 95249 <br />(209) 754-4291 <br />WEIGHED / MEASURED AT: <br />#1 270 George Reed Dr. <br />San Andreas, CA <br />#2 1470 Linebaugh Road <br />Arnold, CA <br />State Contractor's License No. 21137 A <br />A DIVISION OF GEORGE REED, INC. <br />DATE: hi .1. _) / .i r 1.0: 02AM <br />TUOLUMNE TRANSIT MIX <br />SONORA, CA 95370 <br />(209) 984-5370 <br />WEIGHED /MEASURED AT: <br />#3 6000 O'Byrnes Ferry Road <br />Jamestown, CA <br />GEORGE REED, INC. <br />WEIGHMASTER <br />P.O. BOX 4760 <br />MODESTO, CA 95352 <br />(209)523-0734 <br />SOLDTO: fRISKI WELL. DRILL-11,41- <br />P, <br />RT.LL-11,41P, <br />PROJECT: <br />DELIVERY INSTRUCTIONS: ,I I..,-rnMFR F' I CIV ` <br />LV PLNT I ARIV JOB ST. POUR <br />FIN POUR LV JOB ARIV PLNT <br />TRUCK I LOAD # <br />DRIVER CUMULATIVE TOTAL <br />SCHEDULED ON JOB ICU YD ORDERED <br />JOB ADDED WATER * HARD HATS. SAFETY GLASSES AND VESTS REQUIRED ON JOB SITE '- <br />SLUMP FULL 203 1/3 P.O. # ZONE LOT BLOCK <br />QUANTITY U/M MIX I NO I DESCRIPTION UNCE AMOUNT <br />-1300 + 10.30 SACK WEL.L.. <br />(?.: AV I ENV I R -FEE <br />RTI I MTI AT)TrQ0Qf(:H <br />DEPUTY <br />PLANT NO. <br />WEIGHMASTER CERTIFICATE <br />THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a <br />weiginmaster, whose signature is on this certificate, who is a recognized authority of accuracy, as prescribed by <br />Chapter 7 (commencing with Section 12700) of Division 5 of the California Business and Professions Code, <br />administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br />WARNING <br />Ready mixed concrete or cement may be harmful to the skin, eyes or mucus membranes. Avoid direct contact <br />where possible and wash exposed areas promptly with water. If Irritation persists, seek prompt medical attention. <br />NOTICE: we make deliveries inside the curb line at customer's risk only, and accept no responsibility whatsoever for damages resulting from <br />such deliveries. The driver of this truck, in requesting the additional signature below. is of the opinion that the size and weight of the truck may possibly <br />cause tlamages to the premises and/or adjacent property if the tlriver places fhe material In this load where you desire it. It Is our wish to help you in every <br />way we can, Dui in ortler 10d this, the driver is requesting that you or your representative sign below indicating you have released the diner and this <br />company from all responsibility for any tlamage that may occur to the premises and/or adjacent property, buildings. sitlewalks, tldveways, curbs, etc. by <br />the delivery of this material. Further, as atltlitional consitlaration, you agree to help the driver remove mutl from the wheels of the dnvefs vehicle so that <br />the tlrivI will not litter the public street antl you agree to indemndy and hold harmless the driver of this truck antl this company for any and all liabilities <br />antl damages to the premises and/or adjacent property which may be claimed by anyone to have arisen out of delivery of this order. <br />'Not responsible for concrete temper, -s <br />'Nol responsible }or pumpability. Check with your pumping company <br />'Not responsible for colored concrete it water is added on site <br />.Noresponsible Ior concrete slumps over 5'. Unless specified on mix design. <br />Sionature: <br />SUBTOTAL <br />SALES TAX <br />STAND BY <br />TOTAL <br />ACCUMULATED <br />TOTAL <br />RECEIVED BY CONTROL NO. 00042715 <br />,TRUCK USER LOGIN DISP TICKET NUM TICKET NUM TICKET ID' TIME DATE <br />tMMr-- OrLH 1bV-24-'Z619E <br />46M TMr- TUT�i c�T7 <br />'LOAD SIZE MI CS <br />S_EDQ_ LC_ ID <br />" <br />1. 3.50 yd <br />;MATERIAL SOURCE DESIGN QTY ABS FREE <br />18 <br />MST ADJ.T RE9U1RED BATCHED <br />VAR %MOISTURE %ABSP %TOTMST ACTUAL WAT ABS.WAT <br />In-- SPR 7f W07F -747. <br />S- &W7-77ir-TT6 -i T- T5- <br />- 55-8 SAS" i� � �T Fig I- <br />CEMENT TYPE II %8.0 lb <br />968.0 3388.0 lb 37355.0 lb <br />-33.0 <br />LAIR AIR 10.1 oz <br />10.1 35.4 oz 35.0 oz <br />-0.4 <br />WATER WATER 50.0 gl <br />27.1 94.7 gl 94.0 gl <br />-0.7 94.00 g1 00 <br />GRYWATER r 0.0 gl <br /># 0: gl 0.0 gl <br />0.0 <br />]TEMPERED TEMPERED W 0.0 gl <br /># 0.1 gl 0.0 gl <br />0.0 <br />.RMTIMENT PLASTIMENT 0.0 oz <br /># 0.0 oz 0.0 oz <br />0,0 <br />'NON -SIMULATED NUM BATCHES: 1 <br />LOAD TOTAL: 118& lb DESIGN WATER: 175.0 <br />g1 ACTUAL WATER: 125.0 qI TO ADD: <br />50.0 gl <br />SLUM: 5.00 "# ADJUST WATER: 0.0 y1/load <br />TRIM WATER: -15.0 1 /yd <br />1LOAD �:TIME- <br />. C3M�'LFTED LOAD <br />TCG SCALE P : 1 �� : 0 1. Li <br />:4�1:47 _ fARE_._:_.___.._._..__..__.....___..._.._... <br />E : E-_0 1 b CEM SCALE <br />B : 1. ' ; : L; 1. b (- : 1D 1 :-, <br />