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KN I FE RIVER <br /> DATE: 2:30 22 <br /> REQUESTED DELIVERY 1 <br /> TIME: 12:30 <br /> AN MOU RESOURCES COMPANY STOCKTON ORDER NUMBER: 55014 <br /> Billing OFFICE (209) 933-6980 TICKET NUMBER: 1085670 <br /> www.kniferiver.com Dispatch: (800) 464-6572 / (209) 933-6999 <br /> p CYDS DEL: 9.00 <br /> Safety First! P.O. BOX 66001, Stockton, CA 95206 LOAD#: 1 <br /> TRUCK ID DRIVER PLANT ID LEAVE PLANT ARRIVE 10B START POUR END POUR LEAVE JOB I AT PLANT <br /> 5503414311 TOM PEASE STOCK <br /> CUSTOMER ACCT ID CUSTOMER P.O./PROJECT NO. PROJECT NAME LOT&BLOCK PREVIOUS TRUCK <br /> 378044 / <br /> TOLD TO: DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? 0 Check <br /> VALLEY DRILLING VALLEY; 1764 METIER RD <br /> LODI <br /> NDDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br /> PREPAID CC <br /> BEGINNING ENDING TOTAL <br /> aty this Load Qty Ordered Qty Divd Product Code Product Description UOM Unit Price EXT Amount <br /> 9. 00 9. 00 9. 00 504 10. 3 SK. SAND SLURRY yd 162 . 50 1, 462.5( <br /> 9. 00 55EFS EMERGENCY FREIGHT SURCHARGE CY 10.00 90.00 <br /> WATER ADDED/ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 1,552.50 <br /> ull Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX $128.08 <br /> 2/3 Load: GAL SLUMP rate per minute for orders exceeding five(5)minutes per ADDITIONAL TIME FEE TICKET TOTAL $1,680.58 <br /> L/3 Load: GAL SLUMP cubic yard. GRAND TOTAL $1,680.58 <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 /> -ESTED BY AIR/SLUMP/TEMP/CYL'S <br /> Signature: Printed Name: <br /> (rife River Weighmaster Certificate <br /> 'HIS IS TO CERTIFY that the following described commodity was weighed, measured or counted by a weighmaster, <br /> chose 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 /> :he Division of Measurement Standards of the California Department of Food and Agriculture. <br /> Deputy <br /> ruck Driver User Disp Ticket Num Ticket ID Time Date <br /> 50341431 612732 user 1085670 114045 11 : 44 5/12/22 <br /> Dad Size Mix Code Returned Qty Mix Age Seq Load ID <br /> . 00 CYDE 504 W 83 <br /> terial Design Qty Required Batched %Var%Moisture Actual Wat Tot.Wat Trim <br /> PEII-V 968.0 Ib 8712.0 Ib 8635.0 Ib -0.88% <br /> .ND 1936 Ib 18341 Ib 18360 Ib 0.11% 5.26%A 917 Ib 1226 <br /> FY 609 Ib 2686 Ib 2660 Ib -0.97% 2660 Ib 2660 -25.00 gl <br /> tual Num Batches: 1 <br /> id 29655 Ib Design W/C: 0.629 Water/Cement: 0.635 T Design 5480.3 Ib Actual 3577.5 Ib To Add: 1902.8 Ib <br /> imp: 8.00 in # Water in Truck: 0.0 gl Adjust Water: 0.0 gl /Load Trim Water: -25.0 gl / CYDE <br />