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DATE: 05/17/24 <br /> r44KNIFE RIVER STOCKTON REQUESTE TIME: 10:30 <br /> ORDEIR NUMBER: 55022 <br /> Billing OFFICE (209) 933-6980 TICKET NUMBER: 1114364 <br /> www.kniferiver.com Dispatch: (800) 464-6572 / (209) 933-6999 CYDS DEL: 9.00 <br /> Sa ety 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 /> CUSTOMER ACCf ID CUSTOMER P.O./PROJECT NO. PROJECT NAME LOT&BLOCK PREVIOUS TRUCK <br /> 378504 / <br /> SOLD TO: DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br /> PURVIANCE DRILLERS INC 15988 E 8 Mile Rd, Linden, CA 95 <br /> PO BOX 64 <br /> LINDFN LINDEN <br /> ADDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br /> BEGINNING ENDING TOTAL <br /> Qty this Load Qty Ordered Qty Dlvd Product Code Product Description R UOM Unit Price EXT Amount <br /> 9. 00 9.00 9. 00 504 10.3 SK. SAND SLURRY yd <br /> 1.00 554015 FUEL SURCHARGE EA <br /> 9.00 55EFS CEMENT FREIGHT SURCHARGE CY <br /> WATER ADDED/ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL <br /> Full Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX <br /> 2/3 Load: GAL SLUMP rate per minute for orders exceeding five(5)minutes per ADDITIONAL TIME FEE TICKET TOTAL <br /> 1/3 Load: GAL SLUMP cubic yard. $2 . 5 0/min <br /> GRAND TOTAL <br /> DESIGN SLUMP REQUESTED SLUMP ACKNOWLEDGEMENT OF RECEIPT,WATER ADDED,&TERMS AND CONDITIONS ON WEB SITE <br /> 0.00 6.00 <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, adm' 'stered by <br /> the Division of Measurement Standards of the California Department of Food and Agricul <br /> Deputy <br />