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16684 S Tide Rd, Ripon WP2501387 <br /> 01/29/2026 <br /> PHOTO#2 <br /> CA 95320 <br /> PLANT:1900 Roosevelt Road,Escalon, "m.neh 9 was s .b> rds cI:hl <br /> „n..aJmlohler•d by tha DIYISIOn d'.!.e i- :^nl Stanch . <br /> r^:ppnr..dtwn. <br /> ON "ONSIGNEE <br /> RMDRI00 f <br /> R&M DRILLING *16684 S. TIQt_ <br /> MIKE MCGEE 166134 S. TIDE RD. <br /> VALLEY SPRINGS CA 95252 RIPON, CA <br /> X - FRENCH CAMP RD* C - <br /> F I LE* <br /> PREV. TRUCK ORDER# 61013 wa - <br /> 1 ON JOB TIME MIX I_D.M CUBIC YARDS YRDS ORDERED I PL 7 <br /> 146 V,110E0E2S 700 700 <br /> DAZE LOAD TIME LOAD —YRDS DELFVERED. PQIt PLANT 7 •� <br /> 01/29/26 111 PM 1 700 <br /> EiATOM SLUMP TICKET NUMBER rTRK a r oR11/ER WEIGHMASTER:P8L CONCRETE PRODUCTS �J •J <br /> — 206 PHILIP VAUGHN <br /> i 69193 i 9.OD I 7011466 JLUPPINO,ANTOii DEPUTY <br /> TIME YD3 IN TRK <br /> This agreement requires compliance vath the H2O ADD GALLONS <br /> requirements of the Public Labor Code and YES NO 1st ' <br /> ` falls underAB219 2nd <br /> My signature acknowledges that I agree to the property damage release and all 3rd <br /> terms and Conditions of this entire delivery as I stated on the reverse sltle. Additional: <br /> PRINT NAME: SIGNATURE: ? . <br /> x x <br /> SUB:. $1,49226 <br /> DFPAAtEitPNT; ARRIVED JOB START GADING ADDRit1ItALCHAR , TAX:. $115.65 <br /> / PUMP WASH [2 $ TICKET:. $1,607.90 <br /> J b TIMEALLOWED,PREV% <br /> I �ETURNEDTO PW LEFf JOB FINISH UNLOADING COLOR ADD :I $5 �� — <br /> `OTHER u $ (J CARTAGE <br /> TOTAL ROUND TRIP TOTAL AT J08 UNLOAD�MG TIME DRIVER SIGNATURE: STANDBY TIME ADNDCHARGE_$1,607.90 <br /> OT <br /> x-----—- <br /> UNR PRICE EXTENDED PRIC <br /> TC CODE DESCRIPTION $206 75 $1,447.25I <br /> 1.0 W10EOE2S 10.3 SACK SAND SLURRY $45 00 $45.00. <br /> 7.00 ENVIRONMENTAL FEE PER LOAD <br /> 1.00 ENVIRO <br /> Matenal Gallons Plasticizer _._---- <br /> SANO �— %Var °k Moisture Actual Wat <br /> CEMENT Matenal Desgn Oty Required Batched <br /> 14028 Ib 13930lb -0 70% 5 31%A 64 gl <br /> WATER SAND 1903 tb 67650tb .016% <br /> CEMENT 968.0 Ib 6776 0 Ib 0 2650091 <br /> Actual WATER <br /> 72,00 gl 265 24 gl 2650091 <br /> Load Actual 349291 To Add 154891 <br /> stumo: Actual C Batches 1 Dwain 504Ogl <br /> 22906 lb Desrgn WIC 0 62t WaterrCernent 0 622 T <br /> Actual W/C Load Adwst Water 00 oil Load Tam Water 122 6 mr Cy <br /> SJOmD 9 00 m Water m Truck 0 99r 6765 lb <br /> AJgwaa�e Water 1 2851b <br /> Actual WIC Ratio 0 A31 <br /> Actual Water 34901 Balctted Cement <br /> Receipt from cement truck 10.3 sack sand slurry used. <br /> Rena' LeRoy, Registered Environmental Health Specialist Page 2 of 3 <br />