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KN 1 FE RIVERDATE: <br />Driver <br />REQUESTED DELIVERY TIME: <br />03/11/22 <br />12:30 <br />AT PLANT j <br />KRPR - LODI <br />user 1327441 18221 <br />12:24 3/11/22 <br />AN MDU RESOURCES COMPANY <br />CUSTOMER ACCT ID <br />ORDER NUMBER: <br />55032 <br />/ <br />Billing OFFICE (209) 933-6980 <br />TICKET NUMBER: <br />1327441 <br />www.kniferiver.com <br />Dispatch: (800) 464-6572 / (209) <br />933-6999 CYDSDEL: <br />9.00 <br />Safety First! <br />P.O. BOX 66001, S�QcktkrN NA <br />912Qq% - LOAD#: <br />1 <br />TRUCK ID DRIVER PLANT 10 L A P NTRRI <br />Driver <br />J ST T 0 <br />END POUR LEAVE JOB <br />AT PLANT j <br />5503414341 MIA AGUTAR LODI <br />user 1327441 18221 <br />12:24 3/11/22 <br />Load Size <br />CUSTOMER ACCT ID <br />CUSTOMER P.O. / PROJECT NO, PROJECT NAME LOT & BLOCK PREVIOUSTRUCK <br />378044 <br />/ <br />SOLD TO: <br />DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br />VALLEY DRILLING <br />VALLEY; 5647 EAST JAHANT RD <br />0.24% <br />GALT <br />ADDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br />PREPAID CC <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 157.50 1,417.50 <br />9.00 55EFS EMERGENCY FREIGHT SURCHARGE CY 10.00 90.00 <br />WATER ADDED / ESTIMATED SLUMP <br />STANDBY AND UNLOADING TIME <br />OVERTIME MINUTES <br />SUB TOTAL 1,507.50 <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 $116.83 <br />TICKET TOTAL $1,624.33 <br />GRAND TOTAL $1,624.33 <br />2/3 Load: GAL SLUMP <br />1/3 Load: GAL SLUMP <br />DESIGN SLUMP <br />REQUESTED SLUMP <br />ACKNgW DGEMENT OF RECSIPT, WATER ADDED, & TERMS AND CONDITIONS <br />ON WEB SITE <br />0.00 <br />8.00 <br />Signature: Printed Name: <br />USE OF CONCRETE, AS PLACED: <br />RELEASE: ontractoror 0 ners agree to indemnify and save harmless Knife River Corporation from liability imposed as a <br />result of any damage c sed to the property of others as a result of such delivery. FOR ADDITIONAL RELEASE <br />INFO R ATION: SEE W.1 'ERIVER.COM/NCA FOR PROP 65 INFO W .P65WARNINGS.CA.GOV <br />TESTED BY AIR/SLUMP/TEMP/CYL'S <br />Signa 'e""/ Pri d 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 hapter 7 <br />(commencing with section 12700) of Division 5 of the California Business and Professional Code, inistered by <br />the Division of Measurement Standards of the California Department of Food and Agricultur7>_ <br />Deputy <br />Truck <br />Driver <br />User Disp Ticket Num Ticket ID <br />Time Date <br />550341434 <br />48501 <br />user 1327441 18221 <br />12:24 3/11/22 <br />Load Size <br />Mix Code <br />Returned Qty Mix Age Seq <br />Load ID <br />9.00 CYDS <br />504 <br />D <br />19787 <br />Material <br />Design Qty Required <br />Batched <br />% Var% Moisture Actual Wat <br />SAND <br />1936 Ib 18313 Ib <br />18300 Ib <br />-0.07% <br />5.10% A 889 Ib <br />TYPEII-V <br />968.0 Ib 8712.0 Ib <br />8720.0 Ib <br />0.09% <br />WATER <br />350 Ib 2261 Ib <br />2266 Ib <br />0.24% <br />2266 Ib <br />Actual <br />Num Batches: <br />3 <br />Load <br />29286 Ib Design W/C: 0.362 <br />Water/Cement: <br />0.362 A <br />Design 3150.0 Ib <br />Slump: <br />8.00 in # Water in Truck: <br />0.0 gal <br />Adjust Water: <br />0.0 gal / Load Trim Water: <br />Manual 12:24:33 <br />Actual 3154.8 Ib To Add: 0.0 Ib <br />0.0 gal / CYDE <br />