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KN I FE RIVER <br /> DATE: 12:30 <br /> KRPR - LODI 23 <br /> REQUESTED DELIVERY TIME: 12:30 <br /> AN MDU RESOURCES COMPANY ORDER NUMBER: 55024 <br /> Billing OFFICE (209) 933-6980 TICKET NUMBER: 1330835 <br /> vvww.kniferiver.com Dispatch: (800) 464-6572 / (209) 933-6999 CYDSDEL: 9.00 <br /> Safety First! P.O. BOX 66001, Stockton, CA 95206 LOAD#: 1 <br /> TRUCK ID DRIVER PLANT ID L VE PL T ARRIVE JOB START POUR END POUR LEAVE JOB AT PLANT <br /> 550341952 SAUL ILODI <br /> CUSTOMER ACCT ID CUSTOMER P.O./PROJECT N0. OJ CT NAME l T&BLOCK PREVIOUS TRUCK <br /> 378044 / <br /> SOLD TO: DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br /> VALLEY DRILLING VALLEY; 184 EAST HARNEY LANE <br /> LODI <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 192. 50 1, /32. 50 <br /> 1. 00 554015 FUEL SURCHARGE EA 40. 00 40.00 <br /> 9.00 55EFS CEMENT FREIGHT SURCHARGE CY 10.00 90.00 <br /> WATER ADDED/ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 1,862.50 <br /> Full Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX $144.34 <br /> 2/3 Load: GAL SLUMP rate per minute for orders exceeding five(5)minutes per ADDITIONAL TIME FEE TICKET TOTAL $2,006.84 <br /> 1/3 Load: GAL SLUMP cubic yard. GRAND TOTAL $2,006.84 <br /> DESIGN SLUMP REQUESTED SLUMP ACKNOWLEDGEMENT OF RECEIPT,WATER ADDED,&TERMS AND CONDITIONS ON WEB SITE <br /> 0.00 8.00 <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 /> 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 />