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4KNIFE <br /> RIVE DATE: 10/18/2 <br /> 2 <br /> STOCKTON REQUESTED DELIVERY TIME: 11:301:30 <br /> AN MDU RESOURCES COMPANY ORDER NUMBER: 55021 <br /> Billing OFFICE (209) 933-6980 TICKET NUMBER: 1093806 <br /> www.kniferiver.com Dispatch: (800) 464-6572 / (209) 933-6999 CYDSDEL: 6.00 <br /> Safety First! P.O. BOX 66001, Stockton, CA 95206 LOAD#: 1 <br /> TRUCK ID DRIVER PLANT ID I LEAVE PLANT ARRIVE JOB START POUR END POUR LEAVE JOB AT PLANT <br /> 5503414321 DANIEL CAZARES STOCK <br /> CUSTOMER ACCT ID CUSTOMER P.O./PROJECT N0, PROJECT NAME LOT&BLOCK PREVIOUS TRUCK <br /> 378044 / <br /> ;OLD TO: DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br /> VALLEY DRILLING VALLEY DRILLING; 3782 EAST EMERS <br /> ACAMPO <br /> 4DDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br /> 'REPAID C/C <br /> BEGINNING I ENDING TOTAL <br /> aty this Load Qty Ordered Qty Dlvd Product Code Product Description UOM Unit Price EXT Amount <br /> 6. 00 6. 00 6.00 504 10. 3 SK. SAND SLURRY yd 187 . 50 1, 125.0( <br /> 1.00 554015 FUEL SURCHARGE EA 40. 00 40.00 <br /> 6.00 55EFS EMERGENCY FREIGHT SURCHARGE CY 10. 00 60.00 <br /> WATER ADDED/ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 1,225.00 <br /> -ull Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current. SALES TAX $94.94 <br /> ?/3 Load: GAL SLUMP rate per minute for orders exceeding five(5)minutes per ADDITIONAL TIME FEE TICKET TOTAL $1,319.94 <br /> 1/3 Load: GAL SLUMP cubic yard. <br /> GRAND TOTAL $1,319.94 <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 /> (nife 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 /> 50341432 641618 user 1093806 121824 10 : 51 10/18/22 <br /> Dad Size Mix Code Returned Qty Mix Age Seq Load ID <br /> . 00 CYDE 504 D 49 <br /> terial Design Qty Required Batched %Var%Moisture Actual Wat Tot.Wat Trim <br /> PEII-V 968.0 Ib 5808.0 Ib 5785.0 Ib -0.40% <br /> ND 1936 Ib 12131 Ib 12080 Ib -0.42% 4.43%A 512 Ib 717 <br /> rY 609 Ib 1887 Ib 1868 Ib -1.02% 1868 Ib 1868 -25.00 gl <br /> tual Num Batches: 1 <br /> id 19733 Ib Design W/C: 0.629 Water/Cement: 0.632 T Design 3653.5 Ib Actual 2380.4 Ib To Add: 1273.1 Ib <br /> imp: 7.00 in # Water in Truck: 0.0 gl Adjust Water: 0.0 gl /Load Trim Water: -25.0 gl / CYDE Note:Manual feed occured <br />