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E <br />Q- <br />v <br />w <br />U) <br />ty <br />:' <br />CU <br />m <br />O <br />3 <br />CD <br />7 <br />W <br />CD <br />D) <br />Cn <br />CD <br />ei <br />N <br />En <br />(n <br />CD <br />N <br />O <br />+, <br />N <br />KNIFE <br />b <br />I: <br />ANN R I �Ei\ <br />DU RESOUPCES COMPANY <br />�V"w k.niferiver.com i <br />_ <br />06/15 <br />/21 <br />DATE: <br />Safety FllSt% 10:35J'LICKI_S 55041REQUESTEORDER NUMBER: <br />_ ? <br />f.. 5tifJ3giF;,,t DRIVER` 7� IIt_LJ�' 2c n- TICKET NUMBER: <br />1069744'_ <br />CUSTOMER ACC7ID ti,TL I. ``. ti r PLANT fD LEAVEo J DD.•t r -a3 599'i CYDS DEL. 10.00 <br />n L' ; <br />1 J CUSTOMER P /PRO JECT J 1.0 jC �`._ �m aAk1J08 i , �_ _ LOAD ll: Z <br />_ NO STARTPOUR EpID PQUR LE�13AJISOLD TO: - LOr_t TL Fr alI—"EMQQ , .r`_LO OCK <br />RMAN'S WATER SYSTEMS INC <br />All 2120'+`Ir VrRy AGDRE <br />STO[KTONSS/LO '--- D U ri 1 1 <br />• TON RD E I <br />- I 980 E•LOUISE AVE ADDRESS VERIFIED? <br />TADDITIONAL DELIVERY INSTRUCTIONS: <br />OLD GLASS PLANT LATHROP <br />LITTLE ELK BOX CODE 80064 —---i`�_------ <br />DRUM REVOLUTIONS <br />his Load _ .BEG nNING f <br />Qty Ordered -"- <br />Qty Olvd Produ-._.-_-..--.--P ods <br />t t <br />ct Code <br />C Dl'J <br />Umt Piicg. <br />WATER ADDED /ESTIMATED SLUM, ---. ___ <br />I Full Load: STANDBY ANO UNLOADING TIME OVERTIME MINUTES <br />sAl SLUMPI SUB TOTA <br />Z/3 Load Excel' t uck time w�Il be assessed by a'sPatch at the current) <br />SLUhSP gate per minute for orders exceedingfive (5) m nutes II SALESTAX.. <br />1{3 Load: GAL S� iJMP cubic —Y, <br />ard, Per ADD1T'ION AL TIME FEE ` VICKET IOTAL <br />DESIGN SLUMP REQUESTED SLUMP ACKNOVdLEDEiFM'NT OF RECEIPT, WATER AD� --- RANO TOTAL <br />D . 00 L—_ _DED, Px TERMS AND CONDITIONS ON WER ,c7 <br />USEB. —.— -- _. <br />USE OF CONCRETE, AS PLACED: IS;pnature:_ _ __ __ _ Printed tdae�e. <br />RELEASF.YONractor or Owners agree to 'mde:nnif y and save fia� unless gnife River Corporation from 1ia611itY Impo<cd as a - <br />Y --- -----_ <br />esult ofarty damaf;e causedto the property of others as. result of such delivery. FOfi A6DITIONn,11-NASE <br />�1� <br />N'rORMATION: SEE WWW.KNIFERIVER.COM/NCA FOR PROP 551NrO WWW.P6SVJAR NINGS.CA.,iOV <br />iED BY AIR/SLUMP/TEMP/CYL'S <br />Wife River - _�- — <br />Weighmaster Certificate <br />:S 4 TO CER TIrY Lhat the roll wir.r_.des :ben con.od ty --S +'e{? r ascxed ;r ,._rJ <br />,se signa^ure is _ the certificate, who :s : recog Izr.d authorir o. c_ulacy, as ttf, 'y a -,hapteer, <br />"' crz�u.,1 b/ �nanter 7 <br />uriencing with -ccrioi 12700! cf .'vision 5 of the c!ifcrn.to Bun .::ess and Professional. Code, administered <br />D:visier of .,easuremer.t Stanr.�a.ds of the _Elifo..ia Dspartment of Food and Agriculture, wl <br />Deputy, <br />k Driver User D`.sp 'Picket �Jum Ticket 1D Time Da <br />821 622709 <br />user <br />10'09744 <br />y8832 <br />13.22 6/15/ <br />_ _ r. _ Mix Code <br />Returned <br />Qt" <br />Mix Aqe Sc^q <br />Load 10 <br />, _ S 504 <br />D <br />49 <br />DPS,9! OtY Required <br />Balched <br />^o V'ar 4J Goislure <br />Wat TolWat <br />T-im <br />5os_C Ib +,9'50 Ib <br />t99001b <br />2 79'9 <br />t 53fi Ib 4081 Ib <br />A050 Ib <br />1 <br />-,.04`/0 54% <br />20y lb 2.5 <br />Sns 'y 959 Ib <br />952 ib <br />0 -:" <br />952 Ib 952 <br />3 G0 <br />C) <br />X 0) 00 <br />E3 0�O <br />ED_m <br />N <br />0�r <br />nC. <br />N U <br />CD <br />D <br />ED <br />O <br />n <br />N <br />CO <br />CJl <br />N <br />W <br />O <br />R. <br />