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KN I FE RIVERDATE: 21 <br /> REQUESTED DELIVERY 11:53 <br /> TIME: 11:53 <br /> AN NDU RESOURCES COMPANY STOCKTON ORDER NUMBER: 55020 <br /> Billing OFFICE (209) 933-6980 TICKET NUMBER: 1071220 <br /> www.kniferiver.com Dispatch: (800) 464-6572 / (209) 933-6999 CYDSDEL: 18.00 <br /> Safety First! P.O. BOX 66001, Stockton, CA 95206 LOAD#: 2 <br /> TRUCK ID I DRIVER PLANT ID I LEAVE PLANT ARRIVE JOB START POUR END POUR LEAVE JOB AT PLANT <br /> 55034160-9F— SCOTT C STOCK <br /> CUSTOMER ACCT ID CUSTOMER P.O./PROJECT NO. PROJECT NAME LOT&BLOCK PREVIOUS TRUCK <br /> 378504 /GAWNERD GAWNE RD 1550342055 <br /> SOLD TO: DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? OCheck <br /> PURVIANCE DRILLERS INC 19812 GAWNE RD <br /> PO BOX 64 <br /> LINDEN STOCKTON <br /> ADDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br /> EAST OFF OF MARIPOSA <br /> BEGINNING ENDING TOTAL <br /> Qty this Load Qty Ordered Qty Divd Product Code Product Description UOM Unit Price EXT Amount <br /> 9. 00 18 . 00 18. 00 504 10.3 SK. SAND SLURRY yd <br /> 9.00 55EFS EMERGENCY FREIGHT SURCHARGE CY <br /> WATER A DED/ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL <br /> Full Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX <br /> 2/3 Load: GAL SLUMP rate per minute for orders exceeding five(5)minutes per ADDITIONAL TIME FEE TICKET TOTAL <br /> 1/3 Load: GAL SLUMP cubic yard. GRAND TOTAL <br /> DESIGN UMP REQUESTED SLUMP ACKNOWLEDGEMENT OF RECEIPT,WATER ADDED,&TERMS AND CONDITIONS ON WEB SITE <br /> 0.00 6.00 <br /> Signature: Printed Name: <br /> USE 4 CONCRETE,AS PLACED: RELEASE:Contractor or Owners agree to indemnify and save harmless Knife River 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 /> INFORMATION:SEE WWW.KNIFERIVER.COM/NCA FOR PROP 65 INFO WWW.P65WARNINGS.CA.GOV <br /> TESTED BY AIR/SLUMP/TEMP/CYL'S <br /> Signature: Printed Name: <br /> Knife River Weighmaster Certificate <br /> THIS IS TO CERTIFY that the following described commodity was weighed, measured or counted by a weighmaster, <br /> whose signature is on the certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 <br /> (commencing with section 12700) of Division 5 of the California Business and Professional Code, administered by <br /> the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> Deputy <br /> Truck Driver User Disp Ticket Num Ticket ID Time Date <br /> 550341609 592378 user 1071220 100250 11 : 45 7/15/21 <br /> Load Size Mix Code Returned Qty Mix Age Seq Load ID <br /> 9 . 00 CYDS 504 D 59 <br /> Material Design Qty Required Batched %Var%Moisture Actual Wat Tot.Wat Trim <br /> TYPEII-V 968.0 Ib 8712.0 Ib 8860.0 Ib 1.70% <br /> SAND 1936 Ib 18337 Ib 18320 Ib -0.09% 5.24%A 912 Ib 1220 <br /> CITY 609 Ib 2690 Ib 2692 Ib 0.09% 2692 Ib 2692 -25.00 gl <br /> Actual Num Batches: 1 <br /> Load 29872 Ib Design W/C: 0.629 Water/Cement: 0.619 T Design 5480.3 Ib Actual 3604.2 Ib To Add: 1876.1 Ib <br /> Slump: 6.00 in # Water in Truck: 0.0 gl Adjust Water: 0.0 gl /Load Trim Water: -25.0 gl / CYDE <br />