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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 p Standards of the California department of Food and Agriculture. 209-838-1 448 WEIGHMASTER 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 I __ 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 COAIDITIONS ON REVERSE SIDE READ FRONT AND REVERSE CAREFIULLY - / - J WATER ADDED - CYLINDERS TAKEN � �/ !j BY. CUSTOMER SIGNATURE AT CUSTOMER'S REQUEST GALLONS ❑YES [I NO CUSTOMER ID P.O.NUMBER LOAD NUMBER JOB NUMBER TIME DATE TICKET SOLD TO DELIVER TO DRIVER TERMS QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE ;J(=1Ni:J�r'+�1 i k�.. 1 kl, ,:; ;�f�CF; '�if•3rdU :aLlr'F�(h'r EH I NV I R0NMENTAL FEE TRUCK PLANT SLUMP DUE AT JOB USE OF CONCRETE .. t' AhJ1)I?14%�1.fll.? WAITING TIME SUB TOTAL SPECIAL INSTRUCTIONSj -RLICI,, TAX TOTAL GRAND TOTAL 33176- INVOICE/TICKET x;176INVOICE/TICKET NO. Tt•lacI Dr-i Ver- IJSer T)isp "Ficket Nr-tm 1'icket Ill Time Bate 56 J. D PHILIP _3176, 12:38 8/26/21 L.oad Size Mix Code Retur reed Gity Mix (1ge Seq Load ID 8. 50 yd SAND001 rL 3 D 35415 Material Design Qtyy Required Batched % Var % Moisture Actual Wat SAND 1101 2850 lb 25579 lb 25690 lb 0.04% 6.00% M 174 gl CEMENT 968.0 ib 8228.0 1b 8225.0 1b -0.04" WATER 40.N g1 233.82 gl 234.00 g1 0<08% 234.00 91 Actual Nus Batches: 2 Load Total: 35868 lb Design 0.345 Water/Ceoent 0.414 A Design 340.0 gl Actual 408.3 gl To Add: 6.0 gl Sluep: 10.00 in 0 Water in Truck: 0.6 g11Adjust Water: 0.0 1 / Load Trio (dater: 3.0 1/ yd Actual W/C Ratio: 0.414 Actual Water: 4@8 gl Batched Ceoen�: BM lb Allowable Wa er: 0 lb