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"KN��� DATE: <br />IREQUESTED DELIVERY II 12:3736 ANWOURESOURCES COMPANY STOCKTON ORDER NUMB 5501 <br />Billing OFFICE (209) 933-6980 TICKET NUMBER: <br />www.kniferiver.com Dispatch: (800) 464-6572 / (209) 933-6999 CYDSDEL: 9.00 <br />Safety First! P.O. BOX 66001. Stockton. CA 95206 LOADM 1 <br />TRUCK ID <br />- <br />DRIVER <br />PLANT ID LEAVE PLANT <br />---- ----- <br />I ARRIVE JOB START POUR <br />END POUR <br />LEAVE JOB AT PLANT <br />550342057 <br />BILL LAY <br />STOCK Ii y <br />_ <br />CUSTOMER ACCT ID <br />CUSTOMER P.O. / PROJECT N0. <br />PROJECT NAME <br />LOT & BLOCK PREVIOUS TRUCK <br />378044 <br />/ <br />SOLD TO: <br />DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br />VALLEY DRILLING <br />VALLEY DRILLING; 11852 HARMONY G <br />LOCKEFORD <br />ADDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br />W/T PREPAID C/C <br />BEGINNING ENDING TOTAL <br />Qty this Load Qty Ordered Qty Dlvd Product Code Product Description UOM Unit Price EXT Amount <br />9.00 9.00 9.00 504 10.3 SK. SAND SLURRY yd 152.50 1,372.50 <br />WATER ADDED / ESTIMATED SLUMP <br />STANDBY AND UNLOADING TIME <br />OVERTIME MINUTESSUB <br />TOTAL 1,372.50 <br />Full Load: GAL SLUMP <br />Excess truck time will be assessed by dispatch at the current <br />rate per minute for orders exceeding five (5) minutes per <br />cubic yard. <br />ADDITIONAL TIME FEE <br />SALES TAX $106.37 <br />TICKET TOTAL $1,478.87 <br />GRAND TOTAL $1,478.87 <br />2/3 Load: GAL SLUMP <br />1/3 Load: GAL SLUMP <br />DESIGN SLUMP <br />REQUESTED SLUMP <br />ACKNOWLEDGEMENT OF RECEIPT, WATER ADDED, & TERMS AND CONDITIONS ON WEB SITE <br />0.00 <br />8.00 <br />Signature: Printed Name: <br />USE OF CONCRETE, AS PLACED: <br />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 pe ty of others as a result of such delivery. FOR ADDITIONAL RELEASE <br />INFORMATION: SEE WWW.KNIFERIVER.0 M/NCA FOR PROP 65 INFO WWW.P65WARNINGS.CA.GOV <br />TESTED BY <br />AIR/SLUMP/TEMP/CYL-S <br />Signature: Printed Name: <br />Knife River Weighmaster Certificate <br />THIS IS TO CERTIFY that the following scrib commodity was weighed, measured or counted by a weighmaster, <br />whose signature is on the certificat who i recognized authority of accuracy, as prescribed by Chapter 7 <br />(commencing with section 12700) of Division f the California Business and Professional Code, administered by <br />the Division of Measurement Standards of the alifornia Department of Food and Agriculture. <br />Deputy <br />Truck Driver User Disp Ticket Num Ticket ID Time Date <br />550342057 46614 user 1066836 96015 11:24 4/14/21 <br />Load Size Mix Code Returned Qty Mix Age Seq Load ID <br />9.00 CYDE 504 D 71 <br />Material Design Qty Required Batched % Var% Moisture Actual Wat <br />TYPEII-V 968.0 Ib 8712.0 Ib 8930.0 Ib + 2.50% <br />SAND 1936 Ib 18309 Ib 18360 Ib 0.28% 5.08% A 887 Ib <br />CITY 609 Ib 2718 Ib 2748 Ib 1.10% 2748 Ib <br />Num Batches: 1 <br />Trim <br />-25.00 gl <br />