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- _ I WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity was weighed,measured,or <br /> counted bya weighmaster,whose signature is on this certificate,who is a recognized authority 46761 <br /> of accuracy,as prescribed by Chapter l(commencing with Section 12]00)of Division 5 of the <br /> California Business and Professions Code, administered by the Division of Measurement <br /> Standards of the California Department of Food and Agriculture. <br /> = 1, PEARSONS CONCRETE <br /> CAUTION 10284 UNDERWOOD RD., ACAMPO, CA 95220 <br /> ' <br /> Freshly mixed cement, mortar, _V , TELEPHONE (209) 334-9234 <br /> concrete or grout may cause skin ORDER NO. DATE 7_ � 19 <br /> injury. Avoid contact with skin where CUSTOMER NAME <br /> possible and wash exposed skin ADDRESS l/O <br /> areas promptly with water. If any JOB LOCATION LOAD NO. <br /> cement mixtures get into eyes, rinse <br /> immediately and repeatedly with DRIVER 't- TRUCK NO. CU. VDG. <br /> water and get prompt medical CONCRETE MIX START TIME <br /> attention. .Z�y CEMENT ARRIVE JOB <br /> KEEP OUT OF REACH OF CHILDREN. A-1 ADMIX 1 LEAVE JOB <br /> A-2 END TIME <br /> ADMIX 2 <br /> A-3 TOTAL <br /> A4 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 /> PEARSONS.CONCR I WEIGHMASTER <br /> RESPONSIBILITY WHATSOEVER FOR DAMAGES BY <br /> RESULTING FROM SUCH DELIVERIES. GUANTITY 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. h is our wish to help you in every way that we can,but in order to do this,the driver //L- �.�� � - <br /> is requesting that you or your representative sign below indicating you have released <br /> the driver and PEARSONS CONCRETE from all responsibilty 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 <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 - <br /> anyone to have arisen out of delivery of this order. - - HOURS RENTAL <br /> 5 MINUTES PER YARD FREE CHARGE C.O.D. <br /> Signature: UNLOADING TIME ALLOWED TOTAL 2 �] <br /> TERMS: Net 30 Days. One and one-half I1lh%I percerR charged an pest due accused.Any reasonable legal face <br /> incurred in collection of abwe will be added to this charge. <br /> G.BP.—REV.3/W Received By: X <br />