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• ATING TO THE SKIN AND EYES WEIGHMASTER CERTIFICATE CONTROL NUMBER ains Portland Cement,Wear Rubber Books and Gloves. "IS IS TO CERTIFY that theJollowing described commodity was rr.�d,measured, //� _t OLONGED CONTACT MAY CAUSE BURNS. counted by a weighmaster,whose signature is on this certificate,who is a recognizetl 2 5 " 1 � 7 1 aid Contact With Eyes and Prolonged Conatl With Skin. authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Case of Cannot Wlih Skin or Eyes,Flush Thoroughly With Division 5 of the Calttomia Business antl Professions Code,administered by the Division Water.if Irritation Peones,Get Medical Attention. of Measurement Stands, of the California Department of Food and Agriculture TICKET NUMBER NOTICE:Cement,fine and coarse aggregate contains chemicals • kha—k`mn atePf C,flOIraf9F9ffJ)W..dfgmbIK p}(g�gl • or other rept Ir8 ha Ttlatrhmpany shall have no liability for and hereby evcludea warranties or merchantability and NOPE:fitness for any purpose, and all other warranties agrees or Implied, with respect to reactive KEEP OUT OF gEACN OF CHILDREN. aggregate,and popping(POP-Outa),checking,discoloring of surtace cracking of concrete. LOADING I LEAVE PLANT I ARRIVE JOB START UNL FINISH UNL LEAVE JOB ARRIVE PLANT OVERTIME WATER ADDED DRIVER:I have verified the specific slump for this job to be: ver that this load will meet the slum sec on ihe'ob]L Please initial REASON FOR DELAY TIME IMPORTANT ACCE PTANQE OF AA ER MS ICOND f10NS&WAIVERS PRINTED ON FRONT B&4CK OF TH3 ORM ES ❑ JOBSITE DELAY ❑ 75%OF LOAD ALL INVOICES SHALL BE PAID IN FULL ON OR BEFORE THE LAST DAY OF THE MONTH FOLLOWING THE DATE OF DELIVERY.CUSTOMER AGREES TO PAY A SERVICE CHARGE 1 1/2%PER MONTH ON ALL INVOICES WHICH ARE PAST ❑ PLACEMENT ❑ 50%OF LOAD DUE. IN ADDITION, CUSTOMER AGREES TO PAY ALL COSTS AND EXPENSES FOR COLLECTION OF ANY AMOUNTS DUE HfiEUNDER,.INCLUOlNG.AGTUALATTp EY'S S INCURRED. ❑ EARLYARRIVAL ❑ 25%OF LOAD ❑ EQUIPMENT FAILURE ❑ WAS WATER ADDED lit i l-iEhl 11.), I.A-i ''/1:1t:cti AFTER BEING ON JOB ❑ 100%OF LOAD FOR 30 MIN OR MORE TIME: SOLO TO P.O.# CUSTOMER# 0.0. DATE SPECT'kllhl F'XGLCIRA"fI01+I IIV!:. (ai }3!''Fhltlfi l :L'1f117ij1 [ ") 3:?p .l._0y CASH CHECK DELIVEADDRESS DFEMAP PAGE ZONE TINE DUFF L MOhJl'E: CAN INL_AI+I'f SIY.PJ :,.;_,{ CROSS STREETS - PROJECT# ORDS # P # FTl EF RT & WI'[hJOR �_47 aET MIX SACKLOAD SIZE LOAD# USE PLANT TfiUCKA IV R 0 '-�. .`.iVf 'v f3FPdERflI. 3c�' :3c?�3 tTCP;iiARD kiP:'117.F _. .. WEIGHMASTER - - f , LOAD QUANTITY CUMULATIVE OTY. ORDERED QTY. PRODUCT CODE PRODUCT DESCRIPTION UNIT PRICE AMOUNT :%. BVI CY .'h. 407 sf1. .'n,'I A"0 5�K 9 MR ; (. 1in0L6 00 . Iainic'_f; k: l-,IV i:Klahll'4 :i�11" I''I: F MIX INGREDIENT WEIGHTS �t MIN.LOAD CHG. TAX rl J SUB TOTAL OVERTIME TOTAL D U E WATER ADDED AT PLANT o MOISTURE F.M. TA. SLUMP Potomac checks may subject maker,in addition to the amount . C.5. 00 r .-f i 14 ^'f 5 G. 0i", a lU/i owing,treble the amount owing,up to a minimum of$1500,00 (Civil Code Sect,1719). A returned check charge of$20.00 will RECEIVED BY The tame and cordific s an FOR Naeate aids of the Dehasy ticket and arry atlxhmpt6 Clereb am a park d Cie ag&'vrenl belwaen be charged Plus an additional$35.00 for any mechanics lien, Cnrgary aM Cusbnsr.PtLeptarczdtlis artier oaffiMes agreement to all tams aM ooreAtias sFrnmmtls fazeard h3dc `1.. 1: 1 L V K READ FRONT AND REVERSE SIDES CAREFULLY. MINUrts OF UNmADwc TIME The aboveS is over- Of¢eighteen PERYAI�OFDCNLREIEfREE C£GVAGE IFee 90, Igh ( )years and has aiMorBy to execute thre Agreement on behalf of Customer. ADDRION&UW(Vk[NGT.F RGED ATdalfamr aoumY modaMn