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7/11 MATERIALS,INC. WEIGHMASTER CERTIFICATE WEIGHMASTER THIS IS TO CERTIFY that the following described commodity was weighed,measured, or counted by a weighmasteq whose signature is on this certificate,who is a recognized P.O.BOX 4770 authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code,administered by the Division MODESTO,CA 95352 WATERIALS,INC. of Measurement Standards of the California Department of Food and Agriculture. (209)529-4050 CONTROL NO. 525463 SOLD TO: SHIP TO: _1. 1914 BRAN,'f RD LOCKFI:IRD ['I nF i Ir,l TIME MIX N0. LOAD SIZE CU YD/METERS ORDT SLUMP PLANT/TRANSACTION TRUCK# DRIVER DATE CONTACT NO OF LOADS ACCUM CU YD/METERS ZONE P 0.JOB# LICENSE# TICKET NUMBER QUANTITY CODE DESCRIPTION PRICE CU YD METER EXTENDED PRICE F I�f417 EfdV:[RUP9NidfAL I=LE: SUBTOTAL SALES TAX TOTAL PREVIOUS NA`i T FILJh1PFIRCY�' STANDBY I WEIGHED AT: DEPUTY t REVCOUNTARIV PLNT LEFT JOB FIN POUR ❑ JOB NOT READY TRUCK BROKE DOWN Time Allowed JOB SITE CYLINDER TEST[:]YES ❑NO ® 5 SLOW POUR OR PUMP ACCIDENT Water 1:1Added Gals to full load DYES TRUCK AHEAD ON JOB CITATION LEFT PLNT LEFT PLNT ARIV JOB ST.POUR Time Due On Job 1) p g CONTRACTOR UNAVAIL OTHER At Gals to 2/3 load YES ❑ ADDED WATER Customer's FIN POUR TTL RD TRIP TTL C&JOB POUR TIME Dela Time Request Gals to 1/3 load ONES JOB DELAY EXPLANATION y Five(5)minutes per yd/meter free unloading time allowed. AUTHORIZED BY: Additional unloading time charged at current hourly rale. NOTICE:MY SIGNATURE BELOW INDICATES THAT I ACCEPT THE TERMS AND CONDITIONS OF THIS DELIVERY TAG INCLUDING THE TERMS AND CONDITIONS ON THE REVERSE WE MAKE DELIVERIES INSIDE CURB LINES AND ON LOTS OR PROPERTY AT CUSTOMER S RISK ONLY AND ACCEPT NO RESPONSIBILITY WHATSOEVER FOR ANY DAMAGES RESULTING FROM SUCH DE- LIVERIES.CUSTOMER SHALL INDEMNIFY,HOLD HARMLESS&DEFEND 7/11 FOR,FROM&AGAINST ALL CLAIMS FOR DAMAGES OR PERSONAL INJURY.EXPENSE of REMOVING MIRED TRUCK PAYABLE BY CUSTOMER.WE ARE NOT RESPONSIBLE FOR THE STRENGTH,SLUMP,OR QUALITY OF ANY CONCRETE TO WHICH WATER OR ANY OTHER MATERIAL HAS BEEN ADDED AT THE BUYER S REQUEST.WE DO NOT GUARANTEE THE COLOR OF THE CONCRETE.WE HAVE NO CONTROL OVER THE PLACING,FINISHING OR CURING OF CONCRETE AND DO NOT GUARANTEE THE FINISHED WORK IN WHICH IT IS USED,INCLUDING CRACKING.CONCRETE IS A PERISHABLE COMMODITYAND BECOMES THE PROPERTY OF THE PURCHASER UPON LEAVING THE PLANT.ANY CHANGES OR CANCELLATIONS OF ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO OFFICE BEFORE LOADING STARTS.CUSTOMER IS RESPONSIBLE FOR PRO- VIDING A SUITABLE PLACE,ON CUSTOMERS PROPERTY,FOR DRIVERS TO WASH CHUTES AS NECESSARY.ANY LEANUP COST OF CUSTOMER-PROVIDED WASHOUT SITE OR REMOVAL OF TRACKED-MUD FROM STREETS AND ROADS WILL BE BILLED TO CUSTOMER. i yy55 RECEIVED BY: .- 5Alr'G � 4Q101 4 lb 10180 lb 0.16r 5.00% M gl CEMENT 968.0 lb 4840.0 1b 4820.0 lb -0.41% WATER 50.00 g 1 .00 gl .00 g! WATER 2 100.00 % # 174.50 gl 174.48 gl -0.01% 174.48 gl HOT .00 % # .00 gl .00 gl Actual Num Batches: I Manual i2:08:42 Load Total: 16456 1b Design 0.431 Water/Cement 0.403 A Design 250,0y1 Actual 232.6 gl To Add: 117.4 gl Slump: 7.50 in # Water in Truck: 0.0 gl Adjust Water: 0.0 1 / Load Trim Water: -1.0 l/ CYD Actual W/C Ratio: 0.403 Actual Water: 233 gl Batched Cement: 4820 lb Allowable Water: 136 1b