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THIS isNOT aTIC <br /> CONTROL ® �!� - `-- - - - - (U <br /> �- NUMBER 4341 n <br /> S 01 gNERSIOE- ST - P <br /> 672020N T,Ga,_out ` c9 <br /> (n 02 RE0L NO VALLEY H25O Oq 215 Fronts OPEN 7 DAYS r ■ <br /> (D .� 03 flFDTA A-1.1 353 ALABAMA SL `' <br /> IA FONTANA-13792 SIOVEfl AVE - _ <br /> G ) <br /> (") Y6 PoMONA-2470 PoMONq BLVD. <br /> RUAET/SANJAIIN1016755TAIE SL `irt_ SLOtiD'Do.1310 swMPONW FORT IHVAN flO. �, <br /> 07 BEAUMONT-452 W.LUIS ESTRADA Rp. -AA AE <br /> E MARl ST <br /> 0a SUNOTY-2/OSOWATSONRO 3V'IOLET RD 0280TAYME -1�O MOSS A•h <br /> 09 ARROW7IEAD-29750 HWY 16 -116 RINCON CT 029 EL raorr- 03 lbltS BEACH.1602 W.NFA O ST - <br /> 01DSANTA FE SPRINGS-12311 GREENSIONE AVE 022 NO NOLLYW000--r13172 RAYMENS $7 03/H SPEHIA CORONA-1966t CAVE. 040 ARTESIA-13949E STAG LEY.400 W LOS ANGELES AVE <br /> 011 GABA20N-13990 APACHE TRAIL Y23 P4 041 MOJAVE-) VISTA 2275 HARONOOK ROAD -- <br /> #12SAN BERNARDIND-1955W 97N SI 024 RMLT�UNT-7277 E.ROSECRANSAVE 033 MIRAMAR.5692 EASTGATE DR 042 VICiAVE-14 ENWY SB I.RIAN UNS1AA40.3i51t GieBYiWAp <br /> 2601 N.ALDER AVE. 034 LUCERNE-36555 HWY 19 6952 N.DST 1547FM- LypLLN- i <br /> PLAN7 DATE 043 BAKER-56500 BAKER BLVD. 1550701NRD-COMING SOON <br /> t.'j <br /> CUSTOMER NO. SOLD i0: MAP PAGE TICKET NO. <br /> n 991 h,0 l_..1 NI Z (i_: <br /> TX CD DELIVERY ADDRESS B INSTRUOr10NS Y`v 4=-L 14 38 -, <br /> 128i-2 C(3RWIN DRIVE CUSTOMER PO lJOB OR LOT iK <br /> ^ UNION RI) NL1N f EGH 325`,81 y 4 <br /> yy 1�b I'herTe • t'_a25)580-2574 81iSLLtfjp LAST -f KS ;,� <br /> I. IT ORDER NO. METER READING' TIME TYPED <br /> "Ali 1IZI00. 111Q, TRUCK LIC NO. <br /> LOAD NO SLUMP TRUCK DRIVER , <br /> 1 4 • �ykt ?k41 8889 RAMOS, LcOIUf4F.D IVIISC. FLAT WORK <br /> DRUM JOL4 rS I1 1 0;oo <br /> To Joe I^, REVS. Job-site Cylinder Test: Yes <br /> . to , <br /> oN Joe I I� !Z% - �) Water added on job at CHECK <br /> TIME ON JOB MIN <br /> CUStorner'S request: STAND BY MIN. CHECK❑ - <br /> � START POUR �U � <br /> gals to Full Ld. RATE OF Xs PER MIN CASH <br /> FINISH POUR gals to 2/3 Ld. AAIpLJN7 BY <br /> ' gals to 1/3 Ld. <br /> S IM PLANTMGRSIG <br /> LEAVE JOB f 1 ADJ.Meter4 min.per yd.unloading time allowed. <br /> -} I I N Additional unloading time charged at current hourly truck rate. <br /> ARRIVE PLANT Add"Onal water added WN, its strength,Any rater added eAcieWing tie design wa+er is at n51NWSOwn risk. <br /> "E] <br /> Signature certltylnp under penalty of perjury that the inlDuaJion canlalned Ipihia written ttme,reeard Is true and correct. t� y <br /> EMPJ/ SKiNATURE /-!`//_ <br /> Customer a reel Ilia(the described material has be eho5 n solely by Cusibmer without Robenscin'S direction,or review of an Tans or gg where <br /> AND CONDn10NS OF SALE 19 <br /> Customer further a'.reel Incl it Snell be solely responsible for the delivery location,and disetargerplacement of material on the any <br /> site,Including henon-sitendrtenon oPRobertSon's the en e Material tothe to <br /> ignatteed <br /> location.Customer s review and approval the described maleral shall be evidenced by Customers signature and/or placement of the described material on the lob site.Inconsideration of the above,CLutonter <br /> releases and agrees to defend,indemnity,and hold Robertson's and ds employees and agents harmless boon any and all losses,damages,liabilities,costs and claims asserted 13y Customer or arty third <br /> arissng from(i)material being inappropnate,incompaDble.Improper or mconsistent with plans and specifications,or with the 9rountl soils or conditions on the Wnd where the material�s uulized,and(u)the <br /> movement o ot>ertson's vehicles upon or about the delivery localial Solety to the extent Customer lads to Omely pay for the described materials,in the even)Robertson's retains the services of an attorney. <br /> Customer agrees to pay such reasonable attorney's teas incurred by Robertson s in fudflerartce of such collectAxl a ods. Robertson's and Customer is arm <br /> attorney's fees arlsrtg from any otfw conta'd / <br /> Customer agrees to pay a Gone rice ditterenhal of f Y:%per month on any amounts owed to Robertsons for more than thirty(30)days.Color Dleclalrlrer Due to yregulartties ancl/onnconsisterlcy of nateriats <br /> Robedson's is not responsible Por the results of arty concrete where the coloring agent hes been added al the request of the customer,either at our plant or on the job site. <br /> LID QTY CUM OTY ORD QTY PROD CODE MIX AND COMMODITY UOM UNIT PR AMT <br /> ID. 00 10. 00 10. 00 RC966N11 10, 3 SK SLUR NO ASH YD3 113. 00 1130. 00 <br /> 1. 00 1. 00 1. 00 2111 ENV I RON01ENTAL FEE RL 35.00 35.00 <br /> 1. 00 1. 00 1. 00 2.11,; ENERGY SURCHARGE PL. 35. 001 35.00 <br /> 1 <br /> I <br /> 1FF Tedit <br /> ', Gdl�'GRfGIAS 1 <br /> All <br /> THIS IS TO CERTIFY that the following described commodity was weighed. TAX <br /> measured,or counted by a wetghmaster,whose signature is on this certificate, <br /> who is a recognized authority of accuracy,as prescribed by Chapter 7 <br /> (commencing with Section 12700)of Division 5 of the California Business arkPREVIOUS 99• Qtlt (D <br /> Professions Code,administered by the Division of Measurement Standards of the n <br /> �i California Department of Food and Agriculture. BALANCE p <br /> ROBERTSON'S SUB Q <br /> WEIGHMASTER <br /> TOTAL p <br /> (�D <br /> BY DEPUTY STAND BY 1 DEPUTYCHARGE <br /> UOM CONVERSION CY.YAROS3 I=POUNDS GL-GALLONS.FO=OUNCES CU•METERS3 KG-KILOGRAM L-LITERS ML-MILL M55,1 i_r,—,,1;,I-I O <br /> CONCRETE DELIVERY TICKET TOTAL o <br /> AGREED TO AND RECEIVED BY CUSTOMER PO BOX 3600 CORONA,CA 92878-3600 <br />