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WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity <br /> was weighed,measured,or counted by a weighmaster,whose <br /> signature is on this certificate,who is a recognized authority CONCRETE PRODUCTS, INC. <br /> of accuracy,as prescribed by Chapter 7(commencing with <br /> Section 12700)of Division 5 of the California Business and 1900 Roosevelt Avenue, ESCalon, CA 95320 <br /> Professions Code,administered by the Division of Measurement P & <br /> Standards of the California department of Food and Agriculture. 209-838-1448 <br /> I HMA TER SIGNATURE INVOICE/TICKET NO. <br /> NOTICE: MY SIGNATURE BELOW INDICATES THAT I ACCEPT THE TERMS AND CONDITIONS OF THIS DELIVERY TICKET, WAITING TIME: <br /> INCLUDING THE TERMS AND CONDITIONS ON THE REVERSE.WE MAKE DELIVERIES INSIDE CURB LINES AND ON <br /> LOTS OR PROPERTY AT CUSTOMER'S RISK ONLY AND ACCEPT NO RESPONSIBILITY WHATSOEVER FOR ANY DAMAGES $ per hr.unloading charge. <br /> RESULTING FROM SUCH DELIVERIES.CUSTOMER SHALL INDEMNIFY,HOLD HARMLESS&DEFEND P&L CONCRETE LEAVE PLANT <br /> PRODUCTS,INC.FOR,FROM&AGAINST ALL CLAIMS FOR DAMAGES OR PERSONAL INJURY.EXPENSE OF REMOVING <br /> MIRED TRUCK PAYABLE BY CUSTOMER.WE ARE NOT RESPONSIBLE FOR THE STRENGTH,SLUMP,OR QUALITY OF r —Z <br /> ANY CONCRETE TO WHICH WATER OR ANY OTHER MATERIAL HAS BEEN ADDED AT THE BUYER'S REQUEST.WE DO ARRIVE JOB <br /> NOT GUARANTEE THE COLOR OF THE CONCRETE.WE HAVE NO CONTROL OVER THE PLACING, FINISHING OR <br /> CURING OF CONCRETE AND DO NOT GUARANTEE THE FINISHED WORK IN WHICH IT IS USED,INCLUDING CRACKING. k <br /> CONCRETE IS A PERISHABLE COMMODITY AND BECOMES THE PROPERTY OF THE PURCHASER UPON LEAVING THE LEAVE JOB <br /> PLANT.ANY CHANGES OR CANCELLATIONS OF ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO OFFICE BEFORE <br /> LOADING STARTS.CUSTOMER IS RESPONSIBLE FOR PROVIDING A SUITABLE PLACE,ON CUSTOMER'S PROPERTY, <br /> FOR DRIVERS TO WASH CHUTES AS NECESSARY ANY CLEANUP COST OF CUSTOMER-PROVIDED WASHOUT SITE ARRIVE PLANT <br /> OR REMOVAL OF TRACKED-MUD FROM STREETS AND ROADS WILL BE BILLED TO CUSTOMER. <br /> SEE TERMS AND CONDITIONS ON REVERSE SIDE.READ FRONT AND REVERSE CAREFIULLY <br /> WATER ADDED <br /> CYLINDERS TAKEN <br /> BY: CUSTOMER SIGNATURE ATCUSTOMER'SREQUEST GALLONS 1:1 YES 12 NO <br /> CUSTOMER ID P.O.NUMBER LOAD NUMBER JOB NUMBER TIME DATE, TICKET <br /> SOLD TO DELIVER TO DRIVER <br /> TERMS <br /> QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED <br /> THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE <br /> if li..:CJl.i Li :.I,l.. ._. 111..1 _i li'' D _...-L1RR�Y <br /> F NV I ROIVMENTAL._ FEE <br /> TRUCK PLANT SLUMPDUE AT JOB USE OF CONCRETE WAITING TIME <br /> SUB TOTAL <br /> SPECIAL INSTRUCTIONS TAX <br /> 1 TRUCK _Too liki MARIPOSA TOTAL <br /> ABOUT 1. 5 M I LES WEST OF JACKTONE: GRAND TOTAL <br /> PURPLE HOUSE <br /> INVOICE/TICKET NO. <br /> Tr`kACk Dr- iVer- UF,er^ Diyp 1 Lc:keG ill-ins 'I i':keU til i iIII e Chatty <br /> 60 JESUS JUNIOR ;;,::,477 12: 10 9/7/c <br /> I...oad Size Mix Code Rel<I-trued at Mix Age Sec_i Load TT' <br /> f.-,. 00 yd SANDOO1.03 D 3573:.' <br /> Material Design Bty Reyaired Batched % Var 't: Moisture Actual Wat <br /> SAND 1101 2850 lb 18126 lb 18016 lb -0.64% 6.00% M 122 gl <br /> CEMENT 968,0 lb 5808.0 lb 5805.0 1b -0.05% <br /> WATER 40.00 gl 123.05 gl 123.E gl -6.04% 123.00 gl <br /> Actual Nun Batches: 1 <br /> Load Total: 24841 lb Des'ggn 0.34g Wa er,`WCent 0.352 A Desi n 2 6.0 q1 tual 245.2 gl To Add: 0.0 g <br /> Slump: 6.N in * Water in 1fPuck: 0 0g Adjust Water: 0.0 gg1 Loag Tri® Patzr: 0.0 1/ yd <br /> Actual W/C Ratio: 0.352 Actual Water: 2% gl Batched Ceeent: 5805 lb Allowable Wa�er: 0 ib <br />