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TRUCK ID <br />Driver User <br />DRIVER PLANT ID I <br />LEAVE PLANT <br />I FE RIVER <br />START POUR END POUR LEAVE JOB <br />02:00 <br />"DATE:KN <br />AN NOU <br />STOCKTN O <br />REQUESTED DELIVERY TIME: <br />12:00 <br />RESOURCES COMPANY <br />Mix Age Seq <br />ORDER NUMBER: <br />55021 <br />CUSTOMER P.O. / PROJECT NO. <br />Billing OFFICE (209) 933-6980 <br />TICKET NUMBER: <br />1081148 <br />vdww.kniferiver.com <br />terial <br />/ <br />Batched <br />% Var% Moisture <br />Dispatch: (800) 464-6572 / (209) <br />933-6999 CYDSDEL: <br />2.00 <br />Safetv First! <br />P.O. BOX 66001. Stockton. CA <br />9526 LOAD H, <br />1 <br />TRUCK ID <br />Driver User <br />DRIVER PLANT ID I <br />LEAVE PLANT <br />ARRIVE JOB <br />START POUR END POUR LEAVE JOB <br />AT PLANT <br />5503414311 <br />109772 <br />TOM PEASE ISTOCKI <br />Dad <br />Size Mix Code <br />Returned Qty <br />Mix Age Seq <br />CUSTOMER ACCT ID <br />.00 <br />CUSTOMER P.O. / PROJECT NO. <br />PROJECT NAME <br />LOT & BLOCK <br />PREVIOUS TRUCK <br />378044 <br />terial <br />/ <br />Batched <br />% Var% Moisture <br />Actual Wat Tot.Wat <br />TOLD TO: <br />VALLEY DRILLING <br />PEII-V <br />968.0 Ib 1936.0 Ib <br />DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br />VALLEY DRILLING; 4569 HARVEST RD <br />ACAMPO <br />AUUI IIUNAL UtLIVtKY INbI KULI IUNS: <br />:/S 99 FRONTAGE RD, PREPAID C/C <br />DRUM REVOLUTIONS <br />Zty this Load Qty Ordered Qty Divd Product Code Product Description UOM Unit Price <br />2.00 2.00 2.00 504 10.3 SK. SAND SLURRY yd 157.50 <br />2.00 55EFS EMERGENCY FREIGHT SURCHARGE CY 10.00 <br />TOTAL <br />EXT Amount <br />315.00 <br />20.00 <br />WATER ADDED / ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 510.00 <br />-ull Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX $39.53 <br />2/3 Load: GAL SLUMP rate per minute for orders exceeding five (5) minutes per ADDITIONAL TIME FEE TICKET TOTAL $549.53 <br />L/3 Load: GAL SLUMP cubic yard. GRAND TOTAL $549.53 <br />DESIGN SLUMP REQUESTED SLUMP ACKNOWLEDGEMENT OF RECEIPT, WATER ADDED, & TERMS AND CONDITIONS ON WEB SITE <br />0.00 7.00 <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 />Cnife 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 <br />Driver User <br />Disp Ticket <br />Num Ticket ID <br />Time Date <br />50341431 <br />612732 user <br />1081148 <br />109772 <br />11:25 2/15/22 <br />Dad <br />Size Mix Code <br />Returned Qty <br />Mix Age Seq <br />Load ID <br />.00 <br />CYDE 504 <br />D <br />66 <br />terial <br />Design Qty Required <br />Batched <br />% Var% Moisture <br />Actual Wat Tot.Wat <br />Trim <br />PEII-V <br />968.0 Ib 1936.0 Ib <br />1930.0 Ib <br />-0.31% <br />ND <br />1936 Ib 4070 Ib <br />4120 Ib <br />1.22% 5.12% A <br />201 Ib 270 <br />IY <br />609 Ib 936 Ib <br />934 Ib <br />-0.22% <br />934 Ib 934 <br />-5.00 gl <br />tual <br />Num Batches: <br />1 <br />9d <br />6984 Ib Design W/C: 0.629 <br />Water/Cement: <br />0.631 T Design <br />1217.8 Ib Actual <br />1134.8 Ib To Add: 83.1 Ib <br />Imp : <br />7.00 in # Water in Truck: <br />0.0 gl <br />Adjust Water: 0 0 gl / Load <br />Trim Water: -5.0 gl <br />/ CYDE <br />