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<br />WATER ADDEO / ESTIMATIO SLUMP STANDBY AND UNLOADING TIME . . . <br />Full Load. GAL SLUMP Excess truck time will be assessed by dispatch at the omen <br />2/3 Load GAL SLUMP rate per minute for orders exceeding five (s) minutes per <br />1/3 Load GAL SLUMP cubic yard. <br /> <br />OVERTIME MINUTES <br /> <br />SUB TOTAL <br />SALES TAO <br />TICKET TOTAL <br />GRAND TOTAL <br />ADDMONAL TIME FEE <br /> <br />ADDITIONAL DELIVERY INSTRUCTIONS: <br />N FINE <br />— - <br /> <br />069 1915 Load Eby Ordered Lay 1)Nd Product Code <br />'1. O. 23.00 9.00 <br />Product Description <br />10 . 3 3K. 3A1,10. 01. <br />..-4KNIFE RIVER DATE: 06/17/21 <br />AN KW RESOuRCES COMPANY STOCKTON REQUESTED DELIVERY TIME: 11:00 <br />ORDER NUMBER: 55015 <br />Billing OFFICE 1209) 933-6980 TICKET NUMBER: 1069868 <br />vAvw kniteriver COOT Dispatch: (8001 464-6572 / 1209) 933-6999 CODS DEL: 9.00 <br />Safety First! 9.0. 000 6.06 0.1, Stodkton, CA 92206 100° C: 1 <br />LEAVEJOB AT PLANT• <br />LOT & 81006 <br /> PREVIOUS TRUCK <br />378504 /COMSTOC? COMSTOCK RD. <br />1 TRUCK:Er DRIVER j PLANT ID <br />530341012 ANTONID GASCIAISTOCKTI&...S-0 <br />CUSTOMER ACCT ID CUSTOMER P.O.! PROTECT NO. PROJECT NAM <br />LEAVE PLANT 197.„0,8 START POUR END POUR <br />SOLD TO: <br />PURVIANCE DRILLERS INC <br />PO BOX 64 <br />LINDEN <br />DELIVERY ADDRESS/LOCATION: <br />21014 COMSTOCK RD. <br />LINDEN <br />ADDRESS vERITIED7 Li Check <br />,DESIGN 51.0MP REQUESTED SLUMP <br />0.00 6.00 <br /> <br />ACIIT4OWL0060MENTOP RECEIPT, WATER ADDED, & TERMS AND CONDITIONS ON WEB SITE <br /> <br />U5E0F CONCRETE, AS PLACED: Slenkture• Pnnted name <br />1 <br /> RELEASE: Contractor or Owners agree to Indemnify and save harmless Knife Myer Corporation from liability Imposed as a <br />result of any damage caused to the property of others as a result of such delivery. FOR ADDITIONAL RELEASE <br />WFORMATION: SEE WWVV.KNIFERIVER.COM NCA FOR PROP 65 INFO WWW.PESWARNINGS.CA.GOV <br />Siunature• Printed Name. <br />Truck Driver User Disp Ticket Num Ticket ID Time Date <br />550341812 46534 user 1069868 98951 10:34 6/17/21 <br />Load Size Mix Code Returned Qty Mix Age Seq Load I <br />9.00 CYDS 504 D 66 <br />Malarial Design Oa Required Batched %Var% Moisture Actual Wat TaLWat Tarn TYPERN 088.010 8712.0 th 8860 0 lb 1.70% SAND 1936 lb 18335 lb 18400 lb 0.36% 6.22% A 613 lb 1222 CITY 609 lb 2693 th 76174 10 0.03% 21194 lb 2694 48.00 pl <br />Bum Betimes I <br />TESTED ay AW,SWAAP/TEMP/OTS <br />1t <br />Knife River Weighmaster Certifa.c.ate <br />THIS IS TO CERTIFY that the f olio,. ng described commodity was Adighed, measured or counted by a we i ghmaster , <br />whose signature is on the certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 <br />(commencing with section 127001 of Division 5 Of the California Business and Professional Code, administered by <br />he Division of Measurement Standards of the California Department of Food and AgrlCulture. <br />Deputy <br />DRUM REVOLUTIONS <br />6)015695 660:110 TOTAL <br />UOM Unit Price OCT Amount <br />Address: 21014 Comstock Rd, Linden Permit: WP0041428 <br />Naseem Ahmed, Registered Environmental Health Specialist