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CAL A VERA5 Delivery Tag CUSTOMER COPY 2 <br /> HEI DELBE RGtEMENT croup Weighmaster Certificate <br /> Calaveras Materials Inc. PLAN t j4 1`i�iav t L.Li-* <br /> 7673 N. Ingram Avenue 1945 LATHROP RD <br /> Frbsno,CA 93711-5838 g00-6-M—�20.1. <br /> Phone 559-277-7060 <br /> Toll Free 800-726-5615 <br /> Load Leaye 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 /> DETAILEDCAUTION: PORTLAND CEMENT IS INJURIOUS TO EYES: CAUSES SKIN IRRITATION. READ WARNING ON REVERSE SIDE OF THIS FORM FOR <br /> INSTRUCTIONS. <br /> Plant Ticket No. Order No. Customer No. Sold To: Date <br /> 45 664-323 HENNIkGS BROS. DR I LL IN Aua-1 l <br /> Delivery Address Zone Driver <br /> i 61:i i JNbbz.NL— Rb STOCKTON . 0l[1AH1 T ANTHONY <br /> P <br /> Specla Ih5tructi 0" SLUMP/I-205 WEST NORTlfM TRACY ALVD RT W. HOWAR�3 RD Project No. <br /> Special InstructionsrJiNF= RD Job Number <br /> Truck No. Load Size Mix Code Slump %Air %Call. Project Name: <br /> Load Cumulative Ordered Unit of Product Product Unit <br /> Amount <br /> Quantity Quantity Quantity Measure Code Description Price <br /> 0. 00 ea CACARS CA.CARS/ENVIRONM! .NT <br /> dl i ty il�011 QUAD L t1131 <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: Tax <br /> CHEMICAL ADMIX BRAND: TYPE: <br /> By Steve W i 11 slcr1 MANUFACTURER: <br /> MINERAL ADMIX MANUFACTURER: <br /> CLASS: <br /> CONTROL 497013 <br /> Total <br /> 40! NO. DO NOT USE FOR TICKET NO. <br /> •• -%.. FORM#WC(Rev.5/06)X289327 <br /> arld Designcrr Re-Wred S c etom %Vnr%Motssre Aduni out <br /> :HaD 2409 Ib 7459 Ib 24M lb -2.4096 ZI x!6 E e gi <br /> lna QrtrM ima s o .11=131% <br /> I(OA I ER u ii+ s .0 Qi A sT <br /> qPl .766 IU JSi6 AV A1R1 !V [.[i7o <br /> !d .hien satclInew 1 <br /> i aBQO Ib Design WC. 51474 WaMOCemert 11.464 T Design 5E.0 p Acted 5,9 gi ToAdl 71.1 gI <br /> TV. 10A0 In Y Water In Truk 79.0 gi Agtat VVZW. t10 .,gi i Lead Trim Watt r -20,0 91 1 CY r NOW MEmm l Jfte d <br /> f , ` ,� <br /> iii lL i <br />