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CALIVERAS Calaveras Materials Inc. Delivery Tay ' <br /> d.b.a. Western Stone Products r` <br /> a >.M': _•,Weighmast Certificate <br /> -:A. CBR Company 1022.Woodland Avenue• P.O.Box 3171 <br /> Modesto, CA 95353 <br /> 209 <br /> " (209)523-5615 • Fax . <br /> :-WEIGHED AT ( 1 521-1721 <br /> d <br /> 1022 Woodland Ave. 3371 N. Highway 59 711 S, Madison Lathrop.Rd.&w P, 1800 Paulsen Road 8181 W Bus Loco 205 <br /> 51 Modesto,CA 95351 52 Merced,CA 95340 53 Stockton.CA 95203 54 Manteca.CA 95336 55 Turinck CA 95380 56 Tracy CA 95376 a <br /> LOAD LEAVE PLANT ARRIVE JOB START PO- END POU LEAVE JOBARRIVE PLANT <br /> WATER ADDED ON JOB AT CUSTOMER <br /> CUSTOMER'S REQUEST GALLONS SIGNATURE X <br /> WEIGHMASTER CERTIFICATE:THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a weighmaster, whose <br /> signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter,7(commencing with Section 12700) of Division 5 of the <br />'I California Business and Professions Code, Administered by the Division of Measurement Standards of the California Department of Food and Agriculture <br /> CAUTION: <br /> CONCRETE IS CAUSTIC. AVOID CONTACT WITH SKIN. <br /> PLANT' TICKET NO. ORDER N0. CUSTOMER N0. SOLD TO: - <br /> DATE <br /> 4 W94164;�' LB 11000635 CLARK WigLL INC. <br /> OELi4'ERY ADDRESS 29—NOV-9 <br /> ZONE DRNER .a. PIO NUMBER <br /> LS45 HOLT Rd HIDLT ELEMENTARY fl1AVE C R E .' <br /> SPECIAL INSTRUCTIONS- - <br /> PROJECT.NO. _ <br /> F[+I3OL -4YOS 99K 71H SL U P P R <br /> 'SPECIAL INSTRUCTIONS:- } ' <br /> - JOB N0. - <br /> TRUCK N0. LOAD SIZE MIX CODE SLUMP %CACC. <br /> SPECIAL INSTRUCTIONS CONT - - <br /> 361 4. 1010 133 ' 7. 0@ <br /> Y <br /> LOAD CUMULATIVE 's <br /> -QUANTITY ..QUANTITY.-. ,'.'QUANTITY ',UNI .. `.PR000CT';. PRODUCT UNIT <br /> - MEASURE' :CODE' <br /> - - DESCRIP7lON PRICE - �,QIUIQUNT <br /> /y� __y, _. �/y fir. �+�y +� <br /> ' 1.y �, - _ Fii� VARD - :+FYf7l/�•+•1� � a'71� r7A.a- �+.�3 <br /> 1 1 1 E��ch 3101 ![ilrt3.lr*a� L.t�13e3Iel <br /> wESTERN STONE PRODUCTS r <br /> wEIGHMASTER. _ WESTERN STONE PRODUCTS ASSUMES NO SUB-TOTAL <br /> - RESPONSI311_7Y FOR DAMAGE INCURRED IN TAX <br /> ev DELIVERING MATERIALS INSIDE THE CURB LINE. <br /> UTY - i <br /> CUSTOMER TOTAL <br />