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Address: 21014 Comstock Rd, Linden Permit: WP0041428 <br />"KNIFE RIVER <br />ANIADU RESOURCES COMPANY STOCKTON <br />REQUESTED DELIVERY TIME: 11:45 <br />ORDER NUMBER: 55011 <br />DATE: 06/17/21 <br />Billing OFFICE (209) 933-5980 www.kniteriver.corn TICKET NUMBER: 1069874 <br />Dispatch: 1800) 464-6572 / (2091 933-6999 CODS DEL: 18.00 <br />., . <br />Sletylirst! P.C. Box E6301, E Coit or: 95206 <br />PLANTID LEAVE PLANT AREVE108 1---l'ART POUR <br />50341540 JMIER CAMACHO STOC.. <br />WADE 2 <br />TRUCK ID DRIVER <br />\— <br />CUSTOMER ACCr ID \ CUSTOMER P.O. / PROJECT 0 41ECT NAT <br />.55. <br />SOLD TO: <br />PURVIANCE DRILLERS INC <br />PO BOX 64 <br />LINDEN <br />ADDITIONAL DELIVERY INSTRUCTIONS: <br />C/S N FINE <br />BEGINNING ENDING I TOTAL <br /> <br />UOM Unit Price EAT Amount <br /> <br />Qty this Load Qty Ordered Qty Olvd Product Code Product Description <br />P .00 IC,. 3 216. 00!50 SLURRY <br />TER ADDED! ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL <br />oact GAL SLUMP <br />SALES Ttur <br /> Excess truck time will be assessed by dispatch at the current <br />Mud GAL SLUMP rate per minute for orders exceeding five (5) minutes per ADDITIONALTIME FEE TICKET TOTAL <br />3 Loud GAL SLUMP cubic yard. I I GRAND TOTAL <br />DESIGN SLUMP REQUESTED SLUMP <br />ACKNOWLEDGEMENT OF RECEIPT, WATER ADDED, &TERMS AND CONDITIONS ON WEB SITE <br />END POVRTII-ATrE103 AT PLANT ! <br />37 8504 / COMSTOCK COMSTOCK RD. <br />ADDRESS VERIFIED? 11 Check DELIVERY ADDRESS/LOCATION: <br />21014 COMSTOCK RD. <br />LINDEN <br />DRUM REVOLUTIONS <br />LOT & BLOCK <br />.55034181z <br />PREVIOUS TRUCK <br />stitnatu(e. Princod Nam, <br />RELEASE: Contractor or Ownerk agree to indemnify and auye harmless Knife River Corporation from liability imposed ass <br />result of any damage caused to the property of others as a result of sod, delivery. FOR ADDITIONAL RELEASE <br />INFORMATION: SEE WWW.KNIFERWER.COM/NCA FOR PROP 65 INFO WWW.P6SWARNINGS.CA.GOV <br />0.00 <br /> <br />6 . 00 <br />USE OF CONCRETE, AS PLACED: <br />TESTED BY AIR/SLUMPATEMP/CYL:5 <br />SI nature <br />Prin ed Nam <br />Knife River <br />Weighmaster Certificate <br />THIS IS TO CERTIFY that the following <br />described commodi ty was weighed, measured or counted by a ue intana a ter , <br />whose signature is on the certificate, who Is <br />a recognized authority of accuracy, as prescribed by Chapter 1 <br />(commencing with section 12700) of Division 5 of the <br />California Business and Professional Code, administered by <br />Deputy the Division of Measurement Standards of the Cal i fornia Department of Food and Agriculture. <br />Naseem Ahmed, Registered Environmental Health Specialist