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KN I FE RIVER <br />DRIVER PLANT ID <br />DATE: <br />21 <br />AN MMU RESOURCES <br />ELK GROVE <br />REQUESTED DELIVERY TIME: <br />11:30 <br />11:30 <br />COMPANY <br />Billing OFFICE (209) 933-6980 <br />ORDER NUMBER: <br />55035 <br />1678809 <br />uvww.kniferiver.com <br />TICKET NUMBER: <br />LOT & BLOCK PREVIOUS TRUCK <br />378044 <br />Dispatch: (800) 464-6572 / (209) <br />933-6999 CYDS DEL: <br />5.00 <br />Safetv First! <br />P.O. BOX 66001. Stockton. CA <br />952nF, Lnantt. <br />1 <br />TRUCK ID <br />DRIVER PLANT ID <br />LEAVE PLANT ARRIVE JOB <br />START POUR <br />END POUR <br />LEAVEJOB AT PLANT <br />5503417181 MAARTEN VANDERME 106 <br />10:53 6/24/21 <br />Load Size Mix Code Returned <br />Qty <br />Mix Age Seq <br />CUSTOMER ACCT ID <br />CUSTOMER P.O. / PROJECT NO. <br />PROJECT NAME <br />LOT & BLOCK PREVIOUS TRUCK <br />378044 <br />/ <br />Actual Wat <br />TYPEII-V 968 Ib 4840 Ib 4840 Ib <br />SOLD TO: <br />VALLEY DRILLING <br />DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br />VALLEY DRILLING; 24363 LEADSTONE <br />ACAMPO <br />MUUI I I VIVML L/CLIVCRT IINa I KUL I IUNY <br />C/S E WOODSON RD <br />Qty this Load Qty Ordered Qty Dlvd Product Code Product Description <br />5.005.00 5.00 504 10.3 SK. SAND SLURRY <br />DRUM REVOLUTIONS <br />UOM Unit Price <br />yd 157.50 <br />TOTAL <br />EXT Amount <br />?b7.50 <br />WATER ADDED / ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 937.50 <br />Full Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX $72.66 <br />2/3 Load: GAL SLUMP rate per minute for orders exceeding five (5) minutes per ADDITIONAL TIME FEE TICKET TOTAL $1,010.16 <br />1/3 Load: GAL SLUMP cubic yard. GRAND TOTAL <br />$1,010.16 <br />DESIGN SLUMP REQUESTED SLUMP ACKNOWLEDGEMENT OF RECEIPT, WATER ADDED, & TERMS AND CONDITIONS ON WEB SITE <br />4.00 8.00 <br />USE OF CONCRETE, AS PLACED: Signature: Printed Name: <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 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 <br />Disp Ticket <br />Num Ticket ID <br />Time Date <br />550341718 553309 user <br />1678809 <br />33441 <br />10:53 6/24/21 <br />Load Size Mix Code Returned <br />Qty <br />Mix Age Seq <br />Load ID <br />5.00 CYD-c 504 <br />D <br />35070 <br />Material Design Qty Required Batched <br />% Var% Moisture <br />Actual Wat <br />TYPEII-V 968 Ib 4840 Ib 4840 Ib <br />0.00% <br />SAND 1935 Ib 10178 Ib 10200 Ib <br />0.21% 5.20% A <br />60 gl <br />WATER 60.0 gl # 239.6 gl 239.0 gl <br />-0.25% <br />239.0 gl <br />Actual Num Batches: 1 <br />