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1 FE RIVER <br />DRIVER <br />DATE: <br />REQUESTED DELIVERY TIME: <br />02/23/22 <br />13:09 <br />"KN <br />AN MDU RESOURCES COMPANY <br />STOCKTON <br />ORDER NUMBER: <br />55008 <br />STOCK. <br />Billing OFFICE (209) 933-6980 <br />TICKET NUMBER: <br />1081511 <br />www.kniferiver.com <br />Dispatch: (800) 464-6572 / (209) <br />933-6999 CYDSDEL: <br />18.00 <br />Safetv First! <br />P.O. BOX 66001, Stockton, CA <br />95206 LOAD#: <br />2 <br />TRUCK ID <br />DRIVER <br />PLANT ID <br />I LEAVE PLANT <br />ARRIVE JOB FSTART POUR END POUR LEAVE JOB <br />AT PLANT <br />5503415391 <br />RICARDO PATINO <br />STOCK. <br />13:43 2/23/22 <br />Dad <br />Size Mix Code <br />CUSTOMER ACCT ID <br />CUSTOMER P.O. / PROJECT NO. <br />Mix Age Seq <br />PROJECT NAME <br />LOT & BLOCK PREVIOUS TRUCK <br />378044 <br />D <br />1550341432 <br />TOLD TO: <br />VALLEY DRILLING <br />Design City Required <br />DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? OCheck <br />VALLEY DRILLING; 3146 NEWTON ROA <br />STOCKTON <br />4DDITIONAL DELIVERY INSTRUCTIONS: <br />NTRANCE 20FT SOUTH OF BOBCAT CENTRAL, PREPAID C/C <br />DRUM REVOLUTIONS <br />BEGINNING I ENDING I TOTAL <br />aty this Ladd Qty Ordered Qty Dlvd Product Code Product Description UOM Unit Price EXT Amount <br />9.00 18.00 18.00 504 10.3 SK. SAND SLURRY yd 157.50 1,417.5( <br />9.00 55EFS EMERGENCY FREIGHT SURCHARGE CY 10.00 90.00 <br />WATER ADDED / ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 1,507.50 <br />u!' Load' GAL.SLIJMP Excess truck time will be assessed by dispatch at the current SALES TAX $i16.8a <br />?/3 Load: GAL SLUMP rate per minute for orders exceeding five (5) minutes per ADDITIONAL TIME FEE TICKET TOTAL $1,624.33 <br />L/3 Load: GAL SLUMP cubic yard. GRAND TOTAL $3,248.66 <br />DESIGN SLUMP REQUESTED SLUMP ACKNOWLEDGEMENT OF RECEIPT, WATER ADDED, & TERMS AND CONDITIONS ON WEB SITE <br />0.00 6.00 <br />Signature: Printed Name: <br />USE OF 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 />'ESTED BY AIR/SLUMP/TEMP/CYL-S <br />Signature: _ Printed Name: <br />Cnife River Weighmaster Certificate <br />'HIS IS TO CERTIFY that the following described commodity was weighed, measured or counted by a weighmaster, <br />✓hose 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 />:he Division of Measurement Standards of tiie California Department of Food and Agriculture. <br />Deputy <br />ruck <br />Driver User <br />Disp Ticket <br />Num Ticket ID <br />Time Date <br />50341539 <br />580343 user <br />1081511 <br />110125 <br />13:43 2/23/22 <br />Dad <br />Size Mix Code <br />Returned <br />Qty <br />Mix Age Seq <br />Load ID <br />.00 <br />CYD: 504 <br />D <br />54 <br />terial <br />Design City Required <br />Batched <br />% Var% Moisture <br />Actual Wat Tot.Wat <br />Trim <br />PEII-V <br />968.0 Ib 8712.0 Ib <br />8790.0 Ib <br />0.90% <br />ND <br />1936 Ib 18328 Ib <br />18400 Ib <br />0.39% 5.19% A <br />908 Ib 1217 <br />rY <br />609 Ib 2698 Ib <br />2694 Ib <br />-0.16% <br />2694 Ib 2694 -25.00 <br />gl <br />tual <br />Num Batches: <br />1 <br />)d <br />29884 Ib Design WIC: 0.629 <br />Water/Cement: <br />0.624 T Design <br />5480.3 Ib Actual <br />3601.8 Ib To Add: 1878.4 Ib <br />imp: <br />8.00 in # Water in Truck: <br />0.0 gl Adjust Water: 0.0 gl /Load <br />Trim Water: -25.0 gl / <br />CYDS <br />