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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 HMA 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 a 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 i 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. C J 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 ATCUST AT CUSTOMER'S REQUEST GALLONS Ll YES ❑NO CUSTOMER ID P.O.NUMBER LOAD NUMBER JOB NUMBER TIME DATE TICKET SOLD TO DELIVER TO DRIVER 'PIHSLL.L i 1?1i L1._I NG INC Ri:' i 1.9 ALBERS RD MODESTO F-/,f-n__ON CA r?"_1 1 TERMS rA QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE TRUCK PLANT SLUMP DUE AT JOB USE OF CONCRETE WAITING TIME f.. 1 t . 010 :0 Q F :f4Nl OQI SUB TOTAL SPECIAL INSTRUCTIONS TAX I HENRY RD 3i'4 MILE NORTH OF TOTAL C:AR f ER RD WEST SIDE BIG POND ROAD ON NORTH SIDE OF POND GRAND TOTAL INVOICE/TICKET NO. TI-lacl, Driver User' DiBp Ticket; Ni-km Ticket. tri Time Dcatr 46, JUNIOR PHILIP 1281.7 12:2 1 Load Size Mix Code ReGur,ned aty Mix Age Seq Load ID 1. 00 yd SAND00103 D 3504L Material Design 9ty Reqquired Batched % V"ar % Moisture Actual Wat SAND 1101 28% 1b 21147 lb 20950 lb -0.93% 6.00'x: N 142 gl CEMENT 968.0 1b 6 776.0 lb 6785.0 lb 0.13% WATER 40.08 gl 157.56 gl 158.00 gl 0.28% 158.00 gl Actual Num Batches: 1 Load Total: 291654 lb Design 0.345 Water/Cement 0.369 R Desi n 280.0 1 'Actual W.1 gl To Add: @.@ gl Slurp• 6.00 in # Water in Truck: 0.01 Adjust dater: 0.0 pl / � Trim er: 2.0 11 '/d Hctuaf W/C Ratio: 0.369 Actual Water: gl Batched Cemen lb towable Wafer: 0 lb