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CALAVERAS Delivery Tag CUSTOMER COPY 2 <br /> HEIDELSERGCEMENTcroup Weighmaster Certificate <br /> Calaveras Materials Inc. PLAN I 134 MAN i Ll <br /> 7673 N. Ingram Avenue 11,345 LATHROP RD <br /> Fresno,CA 93711.5838 B00—bi&— <br /> Phone 559-277-7060 <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 /> WEIGHMASTER 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 /> CAUTION: PORTLAND CEMENT IS INJURIOUS TO EYES: CAUSES SKIN IRRITATION. READ WARNING ON REVERSE SIDE OF THIS FORM FOR <br /> DETAILED <br /> Santt WAM2 'VNo. Cu x)!.323 Sold To: HENN I NGS BROS. UR ILL I4. 4§ <br /> _fit-Oct-- .r <br /> DeI4rydrW JACKTONF RU STOCKTON KA Zone D"SOMAHIT, ANTHONY <br /> _714 <br /> SpeciIl d1s330/ICY' SLiJMPJPUMP/99N TOCA-26 LFT ON N JACk.TONE RU PMjsctNo&64/:3-,-1 <br /> Special Instructions Job Number <br /> Truck No. Load Size Mix.code — Slump %Air %Call. Project Name: <br /> Load Cumulative Ordered Unit of Product Product Unit Amount <br /> ' Quantity Quantity Quantity Measure Code Description Price <br /> 1. 00 ea CACARB CA. CARB/ENVIROt( I <br /> CALAVERAS MATERIALS INC.ASSUMES NO CERTIFICATE OF COMPLIANCE: WE CERTIFY that the <br /> RESPONSIBILITY FOR DAMAGE INCURRED IN ponland 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. CEMENTBRAND: Subtotal <br /> TYPE: II MILL LOCATION: Tax <br /> CHEMICAL ADMIX BRAND: TYPE: <br /> StInve Willson MANUFACTURER: <br /> By MINERALADMIX MANUFACTURER: <br /> CLASS: <br /> CONTROL <br /> 49635c%c Total <br /> NO. -4 DO NOT USE FOR TICKET NO. <br /> FORM M WC(Re¢WS)x2NW7 <br /> Maths OeSpn Qt/ R". red Batched %Vu%M e15ue Achal 'viat <br /> TEICHBO 24135 Ib 113 8S lb 12199 Ib -13am ICIZ%M 29 4 <br /> WATERf1 55.13 gs 2ma p 711.0 pl 1107% 721.0 a <br /> vIATER92 .13 % s a 91 .0 gl <br /> H©T"ATER .0 % x 13 91 a 91 <br /> CEMM me It 413413 ID 4865 It, 0.54% <br /> Trartlq hum 1300 e5 1 <br /> LA d issm it DeSpn WiC 13474 WtterlCerrwt 8472 T DeSlpn 275.0 Lt AcbA 249.9 at TOMM 25.1 0 <br /> Slump: lam In 8 Whlerin Truk: 130 y A.itmYdBev: DO yy !Load Trim Mater. -5.0 d i CyCrJolc MaruelleedoC<ued � <br />