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7/11 MATERIALS,INC. WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity was weighed,measured, <br /> WEIGHMASTER or counted by a weighmaster,whose signature is on this certificate,who is a recognized <br /> P.O.BOX 4770 L <br /> authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of <br /> Division 5 of the California Business and Professions Code,administered by the Division <br /> MODESTO,CAh5352 of Measurement Staniards of the California Department of Food and Agriculture. <br /> (209)529-4050 CONTROL NO. 5 2 7 5®2 <br /> SOLD TO: SHIP TO: <br /> 12966 KETTLEMAN, LOD]: <br /> BETWEEN 88 & .JACK TONE. <br /> TIME MIX NO. LOAD SIZE CU YD/METERS ORDT SLUMP PLANT/TRANSACTION TRUCK# DRIVER <br /> DATE CONTACT NO OF LOADS ACCUM CU YD/METERS ZONE P.O.JOB# LICENSE# TICKET NUMBER <br /> QUANTITY CODE DESCRIPTION PRICE CU YD METER EXTENDED PRICE <br /> SHORT LOAD <br /> SUBTOTAL <br /> SALES TAX <br /> TOTAL <br /> PREVIOUS <br /> STANDBY <br /> 2714 Stagecoach Rd, <br /> WEIGHED AT: DEPUTY 1 ' <br /> REV COOBT ARIV PLNT LEFT JOB FIN POUR JOB NOT READY TRUCK BROKE DOWN Time Allowed JOB SITE CYLINDER TEST❑YES NO <br /> © 5 4 <br /> SLOW POUR OR PUMP ACCIDENT Water <br /> Added Gals to full load r YES <br /> TTime Due <br /> LEFT PLNT LEFT'PLNT ARIV JOB ST.POUR RUCK AHEAD ON JOB CITATION On Job <br /> O 2 g CONTRACTOR UNAVAIL [_]OTHER At Gals to 2/3 load ❑YES <br /> ADDED WATER Customer's <br /> FIN POUR TTL RD TRIP TTL @ JOB POUR TIMEJOB DELAY EXPLANATION Delay Time Request Gals to 1/3 load E]YES <br /> Five(5)minutes per yd/meter free unloading time allowed. AUTHORIZED BY' <br /> Additional unloading time charged at current hourly rate. <br /> 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 <br /> DELIVERIES INSIDE CURB LINES AND ON LOTS OR PROPERTY AT CUSTOMERS RISK ONLY AND ACCEPT NO RESPONSIBILITY WHATSOEVER FOR ANY DAMAGES RESULTING FROM SUCH DE- <br /> LIVERIES.CUSTOMER SHALL INDEMNIFY,HOLD HARMLESS&DEFEND 7/11 FOR,FROM&AGAINST ALL CLAIMS FOR DAMAGES OR PERSONAL INJURY.EXPENSE OF <br /> 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 <br /> 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 <br /> 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 <br /> LEAVING THE PLANT.ANY CHANGES OR CANCELLATIONS OF ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO OFFICE BEFORE LOADING STARTS.CUSTOMER IS RESPONSIBLE FOR PRO- <br /> VIDING A SUITABLE PLACE,ON CUSTOMER S PROPERTY,FOR DRIVERS TO WASH CHUTES AS NECESSARY.ANY CLEANUP COST OF CUSTOMER-PROVIDED WASHOUT SITE OR REMOVAL OF <br /> TRACKED-MUD FROM STREETS AND ROADS WILL BE BILLED TO CUSTOMER. <br /> RECEIVED BY: <br /> MMa�terial Description Desin Qtyy Required Batched % Var % Moisture Actual Wat <br /> SAND SAND ?936 lb 10130 Ib 10040 lb -0.89% 4.65% A 53 gl <br /> CEMENT CEMENT 968.0. 1b 4840.0 lb 4810.0 lb -0.6121% <br /> WATER WATER 50.00 g1 .00 gl .00 gl + <br /> WATER 2 WATER 2 100.00 X # 181.07 91 181.67 gl 0.33% 181.67 gl <br /> HOT HOT WATER BASED 0 .00 % # .00 gl .00 gl <br /> Actual Nus Batches: 1 Manual 13:00:00 <br /> Load Total: 16366 1b Design 0.431 Water/Cesent 0.408Design 250.0 Actual 235.1 gl To Add: 14.9 gl <br /> Slurp: 8.00 in # Water in Truck: 0.0 gl Adjust Water: 0.0 g1 Load gg1 Tris Water: -1.0 l/ C`r'D <br /> Actual W/C Ratio: 0.408 Actual Water: 235 gl Batched Cesent: 4810 lb Allowable Water: 111 lb <br />