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DELIVERY TICKET <br /> IFW&NW (209)838.1448 WEIGHMASTER CERTIFICATE <br /> C O N C R E T E PRODUCTS THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted <br /> PLANT: 1900 Roosevelt Road Escalon CA 95320 by aweighmaster,whose signature ison this certficate,who isa recognized authority ofaccuracy, <br /> e r as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California <br /> Business and Professions Code,administered by the Division of Measurement Standards of the <br /> California Department of Food and Agriculture. <br /> OWNER/AGENT/CONSIGNEE <br /> MASDRI00 <br /> MASELLIS DRILLING INC *991 MANELA <br /> 119 ALBERS ROAD 891 MANILA RD <br /> MODESTO CA 95357 LATHROP CA 95330 <br /> X-MANTHEY RD <br /> PREV, TRUCK ORDER# 50633 <br /> ON JOB TIME MIX I.D.# CUBIC YARDS YRDS ORDERED PL 7 <br /> 2:30 W10E0E2S 6.50 6.50 <br /> DATE LOAD TIME LOAD YRDS DELIVERED <br /> 09/30/25 1:25 PM 1 6.50 PO# PLANT 7 <br /> BATCH SLUMP TICKET NUMBER TRK#/DRIVER WEIGH MASTER: P&L CONCRETE PRODUCTS <br /> 67181 6.00 7009472 211 DEPUTY PH I L I P VAUGHN <br /> LUPPINO,ANTO <br /> This agreemant requires compliance with the H2O ADD GALLONS TIME YDS IN TRK <br /> requirements of the Public Labor Code and YES NO 1st <br /> falls under AB219 <br /> 2nd <br /> My signature acknowledges that I agree to the property damage release and all 3rd <br /> terms and conditions of this entire delivery as I stated on the reverse side. Additional: <br /> PRINT NAME: SIGNATURE: <br /> X X <br /> DEPARTED PLANTARRIVED JOBSTART UNLOADING ADDITIONAL CHARGES UNLOADTIME SUB:. <br /> PUMP WASH ❑ $ TAX:. <br /> TICKET:. <br /> RETURNED TO PLANT LEFT JOB FINISH UNLOADING COLOR ADD ❑ $ TIME ALLOWED PREV:. <br /> OTHER ❑ $ O 3 5 CARTAGE <br /> TOTAL ROUND TRIP TOTAL AT JOB UNLOADING TIME DRIVER SIGNATURE: STANDBY TIME ADDITIONAL CHARGE <br /> X GRAND TOTAL <br /> CODE DESCRIPTION UNIT PRICE EXTENDED PRICE <br /> 6.50 W10E0E2S 10.3 SACK SAND SLURRY <br /> 1.00 ENVIRO ENVIRONMENTAL FEE PER LOAD <br /> Gallons Plasticizer 7009472 <br /> Material Design Qty Required Batched %Var %Moisture Actual Wat <br /> SAND 1903 lb 13240 lb 131901b -0.38% 7.04%A 104 gl <br /> CEMENT 968.0lb 6292.0lb 6270.Olb -0.35% <br /> WATER 72.00 gl 214.15 gl 214.00gl -0.07% 214.00 gl <br /> Actual Num Batches: 1 <br /> Load 21246lb Desian W/C: 0.621 Water/Cement: 0.623 T Desian 468.0gl Actual 318.0gl To Add: 150.0g1 <br /> Slumo: 6.00 in # Water in Truck: 0.0 gl Adiust Water: 0.0 al/Load Trim Water: -20.0 al/ CY <br /> Actual W/C Ratio:0.423 Actual Water: 318 al Batched Cement: 6270lb Allowable Water: 1.238lb <br />