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1 WEIGHMASTER CERTIFICATE <br /> 'THIS IS TO CERTIFY that the following described commodity was weighed,measured,or <br /> counted by a weighmaster,whose signature is on this certificate,who Is a recognized authority <br /> of accuracy,as prescribed by Chapter 7(Commencing with Section 12700)of Divisions ofthe 46760 <br /> California Business and Professions Code, etlministere! by the Division of Measurement <br /> Standards of the California Department of Food and Agriculture. <br /> tt PEARSONS CONCRETE <br /> CAUTION 10284 UNDERWOOD RD., ACAMPO, CA 95220 <br /> 4v TELEPHONE (209) 334-9234 <br /> Freshly mixed cement, mortar, IV <br /> concrete or grout may cause skin ORDER NO. DATE ' 19— <br /> injury. <br /> 19_injury. Avoid contact with skin where CUSTOMER NAME <br /> possible and wash exposed skin ADDRESS <br /> areas promptly with water. If any JOB LOCATION LOAD NO <br /> cement mixtures get into eyes, rinse DRIVER e Sh" MG K NO. CU. YDG. <br /> immediately and repeatedly with <br /> water and get prompt medical CONCRETE MIX START TIME <br /> attention. CEMENT ARRIVE JOB <br /> ADMIX 1 <br /> KEEP OUT OF REACH OF CHILDREN. A-1 LEAVE JOB <br /> A-2 END TIME <br /> ADMIX 2 <br /> A-3 TOTAL <br /> A-4 FREE <br /> Dear Customer: <br /> WATER NET <br /> THIS LOAD SACK WEIGHED AT <br /> NOTICE: WE MAKE DELIVERIES INSIDE THE CURB LINE GUARANTEED CUBIC CON- MIX 901 SIMMERHORN <br /> AT CUSTOMER'S RISK ONLY, AND ACCEPT NO TO YIELD YARDS CRETE NO. GALT,CA. <br /> RESPONSIBILITY WHATSOEVER FOR DAMAGES ev PEARSONS CONCRETE—wE1GHMAsrER <br /> RESULTING FROM SUCH DELIVERIES. QUANTITY UNITS DESCRIPTION UNIT PRICE AMOUNT <br /> The driver Of this truck,in requesting the additional signature below,is of the opinion CU YDS CONCRETE <br /> that the size and weight of the truck may possibly cause damages to the premises - <br /> and/or adjacent property if the driver places the material in this load where you desire <br /> it. It is our wish to help you in every way that we can,but in order to do this,the driver <br /> is requesting that you or your representative sign below indicating you have released Q <br /> the driver and PEARSONS CONCRETE from all responsibility for any damage that <br /> may occur to the premises and/or adjacent property,buildings,sidewalks,driveways, <br /> curbs, etc. by the delivery of this material. Further, as additional consideration, you A, <br /> agree to help the driver remove mud from the wheels of the driver's vehicle sothat <br /> the driver will not litter the public street, and you agree to indemnify and hold <br /> harmless the driver of this truck and PEARSONS CONCRETE for any and all liabilities MIN. STAND BY TIME <br /> and damages to the premises and/or adjacent property which may be claimed by HOURS RENTAL <br /> anyone to have arisen out of delivery of this order. - <br /> 5MINUTES PER YARD FREE I CHARGE C.O.D. <br /> Signature: UNLOADING TIME ALLOWED TOTAL <br /> TERMS: Not 30 Days. One and one-half 11th%) percent charged on past due accounts.Any Material legal fees <br /> incurred in collection of above will be added In this charge. <br /> G.B.P.-REV 3/90 Received By: X <br />