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CALAVERAS Delivery Tag CUSTOMER COPY 2 <br /> HEIDELBERGCEMENTGroup Weighmaster Certificate <br /> Calaveras Materials Inc. <br /> 7673 N. Ingram Avenue VL_AN i :'1a+ MAN t LLA <br /> Fresno,CA 93711-5838 1945 LATHROP RD <br /> Phone 559-277-7060 800-67,6-3201 <br /> Toll Free 800-726-5615 <br /> Load Leave Plant Arrive Job Start Pour End Pour Leave Job Arrive Plant <br /> Water Added on Job at Customer <br /> Customer's Request Gallons Signature x <br /> WEIGH MASTER CERTIFICATE: THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by a weightmaster,whose <br /> signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the <br /> California Business and Professions Code,administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> INSTRUCTIONS.CAUTION: PORTLAND CEMENT IS INJURIOUS TO EYES: CAUSES SKIN IRRITATION. READ WARNING ON REVERSE SIDE OF THIS FORM FOR <br /> DETAILED <br /> Plant Ticket No. Order No. Customer No. Sold To: Date <br /> ". 7 <br /> 6"-2323 HENNING bi�itJ 1_' 5-.JUI-t. <br /> Delivery Address Zone Driver <br /> r <br /> ANTH N" <br /> Special Instructions Project No. <br /> 99 NORTH TO HWY 26 FAST T ON JACK TONE . 1 ON <br /> Special Instructions E. FAIRCHILD RD Job Number <br /> L H IOL8 <br /> Truck No. Load Size Mix Code Slump %Air %Call. Project Name: <br /> Load iCumulative Ordered Unit of Product Product Unit A1110Unt <br /> Quantity Quantity Quantity Measure Code Description Price <br /> e. 00 16. 00 16, W Vd 613005 1.0. 3 Sk SAND <br /> L + <br /> 0100 ea. CACARB M CARBIENVIRONM NI <br /> CALAVERAS MATERIALS INC.ASSUMES NO CERTIFICATE OF COMPLIANCE: WE CERTIFY that the <br /> RESPONSIBILITY FOR DAMAGE INCURRED IN portland cement,chemical and mineral admixtures contained in <br /> DELIVERING MATERIALS INSIDE THE CURB LINE. the material described below are brands stated and comply with <br /> specifications: <br /> CALAVERAS MATERIALS INC. CEMENT BRAND: Sub total <br /> TYPE: II MILL LOCATION: <br /> CHEMICAL ADMIX BRAND: TYPE: Tax <br /> MANUFACTURER: <br /> By S,tEtyI- W 1 1SaR- MINERALADMIX MANUFACTURER: <br /> CLASS: <br /> Total <br /> CONTO. 4 6 8 3 3 <br /> v DO NOT USE FOR TICKET NO. <br /> FORM#WC (Rev,5706)X289327 <br /> mal twig " Recored Batched %`!ar%tiolshtre Ache "at <br /> -1430 2409 ib 19655 ib 19WD lb -11.33% 204%E 47 0 <br /> rEW d5.0 01 .0 91 .0 hal <br /> TEFF 1(IM1% S 376.9 21 277.3 d 1.11% 377.3 V <br /> 'WATER a% * .0 1% .0 91 <br /> 4*1 we ib 7744 Ib 7759 Ib 1108% <br /> Nrrn Metch m i <br /> 1 36499 Ib 0eMgnWQ @474 WatedCernent 1.474 T Delo" 440.13 TA ACtLei 424.? 01 To Add 15.7 01 <br /> 11p: 8.00 In 3 ddater In Truck: 0D of Ad)ust Water. 0.0 yl I Load Ttlrn Water: -2D gi f CYC Note Manued feed occured <br />