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r�- KN I FE RIVER DATE: 22 <br /> REQUESTED DELIVERY 12:00 TIME: 12:00 AN FAOU RESOURCES COMPANY ELK GROVE ORDER NUMBER: 55005 <br /> Billing OFFICE (209) 933-6980 TICKET NUMBER: 1687258 <br /> vvww.kniferiver.com Dispatch: (800) 464-6572 / (209) 933-6999 CYDS DEL: 6.00 <br /> Safety First! P.O. BOX 66001, Stockton, CA 95206 LOAD#: 1 <br /> TRUCK ID DRIVER PLANT ID LEAVE PLANT ARRIVE JOB START POUR END POUR LEAVE JOB AT PLANT <br /> 550341808 MARCUS 06 <br /> CUSTOMER ACCT ID CUSTOMER P.O./PROJECT N0. PROJECT NAME LOT&BLOCK PREVIOUS TRUCK <br /> 378044 / <br /> SOLD TO: DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br /> VALLEY DRILLING VALLEY; 28600 N ELLIOT RD <br /> GALT <br /> ADDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br /> BEGINNING ENDING TOTAL <br /> Qty this Load Qty Ordered Qty Divd Product Code Product DescriptionA "' "` UOM Unit Price EXT Amount <br /> 6. 00 6. 00 6.00 504 10. 3 SK. SAND SLURRY yd 162.50 975.00 <br /> 6.00 55EFS EMERGENCY FREIGHT SURCHARGE CY 10. 00 60.00 <br /> WATER ADDLED/ESTIMATED SLUM STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 1,035.00 <br /> Full Load: GAL SLUMP Excess truck time will he assessed by dispatch at the current SALES TAX $85.39 <br /> 2/3 Load. GAL SLUMP rate per minute for orders exceeding five(5)minutes per ADDITIONAL TIME FEE TICKET TOTAL $1,120.39 <br /> 1/3 Load: GAL SLUMP cubic yard. GRAND TOTAL $1,120.39 <br /> DESIGN SLUMP, REQUESTED SLUMP ACKNOWLEDGEMENT OF RECEIPT,WATER ADDED,&TERMS AND CONDITIONS ON WEB SITE <br /> 4. 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.I(NIFERIVER.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. Deputy <br /> Truck Driver User Disp Ticket Num Ticket ID Time Date <br /> 550341808 483105 user 1687258 41647 11 : 15 6/23/22 <br /> Load Size Mix Code Returned Qty Mix Age Seq Load ID <br /> 6. 00 CYD-C 504 D 43514 <br /> Material Design Qty Required Batched %Var%Moisture Actual Wat <br /> TYPEII-V 968 Ib 5808 Ib 5790 lb -0.31% <br /> SAND 1935 Ib 12403 Ib 12440 Ib 0.30% 6.83%A 95 gl <br /> WATER 50.0 gl # 204.9 gl 205.0 gl 0.07% 205.0 gl <br /> Actual Num Batches: 1 <br /> Load 19938 Ib Design W/C: 0.430 Water/Cement: 0.432 A Design 300.0 gl Actual 300.4 gl To Add: 0.0 gl <br /> Slump: 8.00 in # Water in Truck: 0.0 gl Adjust Water: 0.0 gl /Load Trim Water: 0.0 gl / CYDE <br />