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HEIDE , I-BERGUMENTG(Oup Weighmaster Certificate <br />C�-.Iavera!� Material. Inc. <br />M <br />7--)73 N. Ingram Avenue 14171,11111.11"I"IN, 111"Pill P` iff <br />Fresno, CA 93711-5838 <br />Phone 559-277-7060 <br />Toll Free 800-726-5615 <br />Load Arrive Job Start Pour <br />End PourArrive Plan <br />Leave Job <br />Water Added on Job at Customer <br />Customer's Request _' 4--. ) <br />KL--- Gallons Signature x <br />WBGV`IMASTER CERTIFICATE: THIS IST8-C <br />S19ure ;s Oil this certificate, who is a recognized 6TIFY that the following described commodity was weighed, measured. or counted by a weightmaster, whose <br />�1ed authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the <br />CaliforniaMia Bus�riess and Professions Code, administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br />Ilarit �Ticket Nr Na <br />q: --T(- do— G ustomer No. <br />Sold To:,i - <br />f- <br />Date, i' <br />Delt.very, Address <br />jr'—fix T <br />L41 c-,,' <br />Project No. <br />Special instructions <br />Job Number <br />TruckNo Load -S—,z,---T M,. —C.d,. "8f' <br />S IMP <br />o"a 'A u T17p 1�, % C Project Name: <br />III <br />i <br />Le'd' C ---I-tive Ordered Unit of <br />Ordered Unit of Product <br />Q � "tv Quantity Quantity <br />Quanlitv Quantity Quantity Measure Code <br />Me.""'. <br />Product <br />Unit <br />Arnount <br />II <br />Description <br />Price <br />Price <br />f <br />W <br />CALAVERAS:ASSUMES NO <br />RESPONSIBLit T' F DAMAGE INCURRED INCERTIFICATE OF COMPLIANCE: WE CERTIFY that the <br />DELIVERING MATERIALS INSIDE THE CURB LINE.J Portland cement, chemical and mineral admixtures contained in <br />the material described below are brands stated and comply with <br />CALAVERAS MATERIALS INC. specifications:CEMENTBRAND: <br />TICYE <br />TYPE: 11 MILL LOCATION: --- Sub total <br />CHEMICAL ADMIX BRAND: <br />By MANUFACTURER: TYPE:-- Tax <br />MINERAL ADMIX MiA—NUFACTURER.. <br />— <br />GONTROL,j <br />-40 1 CLASS:7 <br />t�o. Total <br />DO NOT USE FOR TICKET NO. F <br />i� FDR we <br />U <br />