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WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by a weighmaster,whose signature is on this certificate,who is a recognized authority CONCRETE PRODUCTS INC. of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and 1900 Roosevelt Avenue, Escalon, CA 95320 Professions Code,administered by the Division of Measurement P & Standards of the California department of Food and Agriculture. 209-838-1448 WEI H A TER SIGNATURE INVOICE/TICKET NO. NOTICE: MY SIGNATURE BELOW INDICATES THAT I ACCEPT THE TERMS AND CONDITIONS OF THIS DELIVERY TICKET, WAITING TIME: 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 $ per hr.unloading charge. RESULTING FROM SUCH DELIVERIES.CUSTOMER SHALL INDEMNIFY, HOLD HARMLESS&DEFEND P&L CONCRETE LEAVE PLANT PRODUCTS,INC.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 ARRIVE JOB 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 COMMODITY AND BECOMES THE PROPERTY OF THE PURCHASER UPON LEAVING THE LEAVE JOB PLANT.ANY CHANGES OR CANCELLATIONS OF ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO OFFICE BEFORE LOADING STARTS.CUSTOMER IS RESPONSIBLE FOR PROVIDING A SUITABLE PLACE,ON CUSTOMER'S PROPERTY, FOR DRIVERS TO WASH CHUTES AS NECESSARY.ANY CLEANUP COST OF CUSTOMER-PROVIDED WASHOUT SITE ARRIVE PLANT OR REMOVAL OF TRACKED-MUD FROM STREETS AND ROADS WILL BE BILLED TO CUSTOMER. SEE TERMS AND CONDITIONS ON REVERSE SIDE.READ FRONT AND REVERSE CAREFIULLY WATER ADDED CYLINDERS TAKEN BY: CUSTOMER SIGNATURE ATCUSTOMER'SREQUEST GALLONS El YES El NO CUSTOMER ID P.O.NUMBER LOAD NUMBER JOB NUMBER TIME DATE TICKET SOLD TO DELIVER TO DRIVER iENNT.NL:IS) BROThiiEp,:; t ;?:i:i._t._?i'•I(_ MODE'.. O TERMS QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE Lii..I�.' (..t.. 1.. 1210 21. 00 _NV I r�Or*1F_N'rAL. FEE. /1_. 130 $20. 17 I0 !::l„ 0IZ) 16. 01:: C:MEtdT SHCIR.'rAGI". FEE /t,rJ $15. +vii : Y.i c:0. Oi'� TRUCK PLANT SLUMP DUE ATJOB USE OF CONCRETE WAITING TIME iii::45 ! :cA N D001 k'3 SUB TOTAL T,1 , 484. 127.112) SPECIAL INSTRUCTIONS TAX 13.5. 01A .. ._ TOTAL `G 1., 599. 01. 1., 77., 1 1748. (42 GRAND TOTAL INVOICE/TICKET NO. T,"IAC k �1 i'.i.\�C'r, Lk e 1'" D i is 'T'i l::L':E. 1, N t.t iFi j *S BOBBY F)HILIP 25596 1IZI.-21. 11. .f1.2i��t'I Loz:-.c:1 i Z e Mix 4::I;)r1e Ret+.tI'.,n ed QIly Mix Age SEq L.ea.(J ID ts, 00 Ci SAN L)0011,i 3 D Naterial besi@tv Required Batched Vac Moisture Actual Wat `+FIND 1101 285TG lb 24160 lb 24060 1 b -0.45% 6, = N t63 gl CEMENT 968.9 lb 7744.0 lb 7i65.0 l b 0.27 WATER 40.N 91 228,07 gl 228.N g 1 -0,1013% 228,00 g l Actual Nur Batches: 2 Lead Total: 33728 ib Design 8.345 Water/Cement 0,420 A Llesion ,:20.0g1 ktual '391.2 gl To Add: 0.0 gl Slump: 10.N in # Water in Truck: 0.0 gl Adjust Water: Z,.@ Q] / Loau Trim Water: 4.0 91/ yd Actual W/C Ratify: 0.420 Actual Water: 391 gi Batched Ceeenf: 7765 lb Allowable Waxer: 0 lb