HomeMy WebLinkAboutCemex 1st Pourzzcamax
Plant:
Begin,: Loading:
,To Job:.
` Arrive Job:
Start Unload:
3 10
Customer Code:
Customer Name:
^ t 1::e2495
DPI f Z I MME- RITlAP'41
Project Code:
Project Name:
Ticket Date:
Addresfs:
yD—elivery
f yry q
ER
Delivery Instructions:
Noy C) SOVAh
Nr r,,i 14-- I Lloe DOtCr
Dispatcher:
Ticket Number:
Due On Job:
Slump:
ruck Number:
Driver Number:
Driver Name:
End Use:
_}1�1�7�'5151-4 1,)1:,r.'29
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t-!^itH.L
iJrE�_f�!��F?�:
BL_Etk1r3,.
C
LOAD
QUANTITY
CUMULATIVE
QUANTITY
ORDERED
QUANTITY
MATERIAL CODE
PRODUCTION DESCRIPTION
UOM
UNIT PRICE
AMOUNT
y
r::ail,�}#..}C3 l"tCr0
1"'1l F -1 /,- r 7
1 , 5 1...I.
t�
C '?� rr v ':
.I L rf` 0 8.: 15' 4"' 1..1i:'_l_.. SUR1. 1"1.ril'?S6F
Cash Check # / Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Without Standby Charges:
Check
Charge _
Comments:
D11
WATERADDED:GAL YARDS IN DRUM:
WHEN ADDED.
OCT 1Q ED SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
e �/�V ' �`r /w I SIGNATURE
• ❑LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important
control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handlin`g��JJhformation, and to the material safety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED (SIGNATURE: °
within one business day after the receipt of materials.
68UNIVERSAL PRE",') TRKt , �r INVOICE �..ui l;:. 9`•:I�i'I " i
This Delivery Ticket incorporates herein by reference .Buyer's previously executers Credit Application, if any, Seller's Standard
Terms and. Conditions, Seller's Quotat if any, and Seller's Order Confirmation I uding limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agr(,,, —mt"). Seller will provide the Standard Teia�,,, and Conditions upon request. Buyer agrees
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
AGGREGATE., / CEMENT / CONCRETE PRODUCTS / FLY ASH
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and. other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and
other siliceous materials. These products, .including fly ash, may contain more than 0.02.5% crystalline silica.
]Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling,
crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled.
If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
dust above recommended limits (see MSDS), wear suitable NI:OSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust .is inhaled, move to fresh
air. If wet cement contacts Skin, rinse thoroughly with water. Get proper medical attention if irritation persists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/.12 For more information please visit www.cemextrsa.eom.
Este ticket de entrega incluye Como referenc.ia al comprador (ya previamente ejecutada en su aplicaci6n de er6dito); cualquier
t6rmino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y
garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveera Jos t6rminos esfandares y condiciones detal-
lados en caso de as% ser requeridos. Con este documento, el comprador acepta Jos mismos ya antes mencionados y que las cantidades
y materiales fueron entregados como so expresa en el mismo. Acepta pagar el monto de acuerdo al contaato; al menos que se identi-
fique con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, roca volcdnica, arena, Brava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanileria, pozzolan (tipo 1P), azr:rlejo de
azotea y estuco. Los productos de conereto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, roca volednica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025% de silicio cristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y ojos, y
reacciones al6rgi.cas en la pie]. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel y/o en
la zona .respiratoria. Polvo del manejo en el triturarniento, pulido, corte y/o perforaci6n puede contener materiales
silicon, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse
en temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad: La burned ad puede causar la liberaci6n del amoniaco. La inhalaci6n del arnoniaco puede causar toner, irritaci6n o
quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en la salad depende on
]a duraci6n y el nivel de la exposici6n.
Segurid.ad.: Evite of contacto con ojos y contacto prolongado con la piel. Use guantes; protecci6n en los ojos y ropa
Primeros adecuada Para protecci6n.. Uvese ].as manor con jab6n suave y agua despu6s del manejo de materiales. Evite in.halar
auxilios• polvos. Si se expone a polvos mas de los limites recomendados, use protecci6n respirators.
Primeros auxil.ios: En caso de contacto en los ojos, inmediatamente fluva agua on la parte afectada por 15 mirttrtos.
Si se inhala polvo, exp6ngase a afire fresco. Si el cemento fresco tiene contacto con sus ojos, lavclos a Tondo con
agua. Acuda a atenci6n m6dica inmediatamente si la in•itaci6n continua.
CEMEX, Memorial ;Hermann Tower
929 Gessner. Suite 000
V7 combinado Houston, Texas 77024
02/12 Para mas informaci6n visita www.cemexusa.corn.
Financial Project No.:
F.D.O.T. Plant No.:
Concrete Supplier:
N/A
Serial No.:
N/A Date:
CEMEX
Address: 6100 Midway Road
Ft. Pierce, FL 34981
33296125
August 12, 2014
Delivered To: Day & Zimmermen
Address: 5601 Ocean Blvd
FPL Nuclear Plant
Truck No.
Class
Mix No.
Cubic Yards (M3) This Load
64589
5000
1572119
10
Time Loaded
Arrived
Discharged
Cubic Yards (M3) Total
5:38
10
Allowable site Water Addition
Jobsite Slump
Jobsite w/c Ratio
24
DAREX
Cement CEMEX TYPE II
5810
WR GRACE
N/A
Brand
Amount
Source
Amount
WR GRACE
Coarse Agl87-090 1.1%
17040
WRDA60
703
Pit # % Moist.
Amount
Source
Amount
WR Grace
Fine Agg. 87-090 4.1%
13320
ADVA 120
351
Pit # % Moist.
Amount
Source
Amount
Propex
Batch Wa r (Gals)
211
300 Fiber
15
Amount
Source
Amount
Issuance of this ticket constitutes certification that the concrete batched was produced and
information recorded in compliance with Department specification requir (3 7-5).
Sign re of PlAfltSatcher
Water added at Jobsite Gal./Liters
Issuance of this ticket constitutes certification that the maximum specified water cementitious
ratio was not exceeded and the batch was delivered and placed us
ance with Dep mentspecification requirements (347-5)
Signature of Contractors
Plant: '
Begin Loading: J
=To Job: "
'rive -Job:
Siarf Unload:
Finish Unload:
Leave Job:
Retum Plant:
Customer Code: CustomeF Name: Customer Job Number. Order /Date:
� DAY % 7. 3:4�16 l +it I�',6 P°�r�' I C 4 4 >►3 / 1 / 14
Project Gode: Projecf•Name a", Project P.O:'Numberr = r Number.
_
Ticket Date: Delivery Address: Map Page: Map/Row/Column:
ei ejy lnstnicfions _ D's atcher.
1 UCINEC
Ticket Number:
c
. .
q„r g OfuJob:, Slump::_r a „"14,j 1 4ar%i _'N!P r,�E I �, f �f( /tuber: ryer V13,
a End Us r
4. I` t, R f�l�2f�X 5 t�I..DI�IL G�'.
'LOAD
QUANTITY
CUMULATIVE
QUANTITY
ORDERED
QUANTITY
MATERIAL CODE
PRODUCTION DESCRIPTION
UOM
UNIT PRICE
AMOUNT
10.00
20h,4'„�1)
47. 00
RE13,/Fi/Ir' B/6�"t 1. `a LB F YDZ
I. 4r4�
1.E- r�'618,.� �iF
aUl�>�1-IFi�C
I. t,l4,i
}
1, E027-44 ENV I FrONMENT 4L. ' CHARGE
I
Cash
Check # / Auth Code:
Signature of Driver Receiving Cash:
Cash Received:
Total COD Order Amount to Collect'
Without Standby Charges:
Check
Charge
f"
Comments:
WATER ADDED:
GAL YARDS IN DRUM:
4d
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
SIGNATURE
❑ LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job, concrete strength
Company assumes no responsibility for damages inside curb or property line.Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important
control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety h ling information, and to the mate i� �tydatasheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTH E S N TURE:within one business day after the receipt of materials. {p 0 p^p,�"�
68UNIVERSAL I'-} RE V TRK —. 10064589 t4:}tt:..idit•58
INVOICE
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and Conditions, Seller's Quotati �f any, and Seller's Order Confirmation ( iding limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agre,,—rit"). Seller will provide the Standard ,ref..., and Conditions upon request. Buyer agrees
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and. aggregate products including limestone, dolomite, granite, volcanic .rock, sand, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling,
crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled.
If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh
air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists.
CEMEA, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www.cemexusa.corn.
Este ticket de entrega incluye como referenc.ia at comprador (ya previamente ejecutada en su aplicacion de credito); cualquier
termino estindar, condiciones del vendedor, propuestas del vendedor y Orden de -confirmation del vendedor (con limitaciones y
garantfas), como acuerdo total del ticket de entrega ("Con.trato"). El vendedor proveera los terminos estandares y conditions detal-
lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que [as cantidades
y materiales fueron entregados comp se expresa en el mismo. Acepta pagar el monto de acuerdo at contacto; at menos que se identi-
fique con una nota at frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rota volcanica., arena, gravy y otros
materiales si.l.icios. Los productos de cemento incluyen Cemento de typo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, roea volcanica, arena, Brava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la dual puede
contener mas de 0.025% de silicio crystalino.
Pel'igros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritacion en los Ojos, quemaduras en piel y ojos, y
reactions alergicas en la piel. Concreto seco y polvo de agregados, pueden causar irritacion en .los ojos, piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, carte y/o perforation puede contener materiales
silicos, los cual.es pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse
en temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad' La humedad puede causar la liberation del amoniaco. La inhalation del. amoniaco puede causar toser, irritacion o
quemaduras en la nariz, garganta y pulmones.Acudir inmediatamente at medico. El riesgo en la salud depende en
la duration y el nivel de la exposition.
Seguridad: Evite el contacto con Ojos y contacto pro.longado con la piel. Use guantes, proteccion en los Ojos y ropa
Primeros adecuada para proteccion. Lavese las manos con jabon suave y agua despues del manejo de materiales. Evite inhalar
auxilios' polvos. Si se expone a polvos mas de los limites recomendados, use proteccion respiratoria.
Primeros auxilios: En caso de contacto en los Ojos, inmediatamente fluya agua en la parte afectada por 15 minutos.
Si se inhala polvo, expongase a aire fresco. Si el cemento fresco tiene contacto con sus Ojos, lavelos a fondo con
agua. Acuda a atencion medica inmediatamente si la irritacion continua.
CEMEX., Memorial Hermann "Power
929 Gessner, Suite 1900.
V7 combinado Houston, Texas 77024
02/12 Para mas information vi:sita www.cemexusa.com.
O
Financial Project No.: N/A
F.D.O.T. Plant No.:
Concrete Supplier:
N/A
CEMEX
Address: 6100 Midway Road
Ft. Pierce, FL 34981
Serial No.:
Date:
33296163
August 12, 2014
Delivered To: Day & Zimmermen
Address: 5601 Ocean Blvd
FPL Nuclear Plant
Truck No.
Class
Mix No.
Cubic Yards (M3) This Load
64924
5000
1572119
10
Time Loaded
Arrived
Discharged
Cubic Yards (M3) Total
6:12
20
Allowable Jobsite Water Addition
Slump
w/c Ratio
26
lJobsite
lJobsite
DAREX
Cement CEMEX TYPE II
5800
WR GRACE
N/A
Brand
Amount
Source
Amount
WR GRACE
Coarse Ag! 87-090 1.1%
17040
WRDA60
704
Pit # % Moist.
Amount
Source
Amount
WR Grace
Fine Agg. 87-090 4.1%
13320
ADVA 120
353
Pit # % Moist.
Amount
Source
Amount
Propex
[Batch Water (Gals)
209
300 Fiber
15
Amount
Source
Amount
Issuance of this ticket constitutes certification that the concrete batched waT-(347-.
and
information recorded in compliance with Department specification requiremSignature her
Water added at Jobsite Gal./Liters
Issuance of this ticket constitutes certification that the maximum specified water cementitious
ratio was not exceeded and the batch was delivered and placed in compliance with Department
specification requirements (347-5), A
Sig'fature of Contrfeitfrs
1)
Plant:
Begin Loading:
To JO,6-:
Arrive Job: a
Start Unload:':
Finish Unload:
Leave Job:
Return Plant:
n2 / 1. 0` 21
Customer Code: '° Customer Name: Customer'Job Number: Order Code / Date:
3122495 DAY ZTiylME€;MAC'.N 'NP - 1074 08/12 14
e _
! Prolact Code: �; Projeot Name: _ e mlect P.O. Number: Order P.O. Number: '
4
Ticket Date: Delivery Address: Map Page: Map/Row/Column:
08/12/1.4 56(I1 N OCEAN) DR r""CC-- I•^°L
Delivery Instructions: _ Dispatched
(Y T
%d .
- v i Ticket Number:
°
,
p .. 94
11
Due On Job:
Slump:
Truck Number:
Driver Number:
Driver Name:
End Use:
7 o w 1.
6. 0 A
f.}(DG5.l,.: 4. �. 1:�{.:7iryf.
3 I`/I
s1
�^iO i RUDOLPH
BI_DNG S SLAB
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
1.vno c t50. ,. 4 7. OQ 15'72 1 : 500:x . REB/H/F'B/67 1. 5 LB F= YD
11.00
Cash Check # / Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Check Without Standby Charges:
Charge
Comments
WATER ADDED: GAL YARDS IN DRUM:
WHEN ADDED. '
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
SIGNATURE
L1 LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important
control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety andling information, and to t e5ijaterial safety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemedwaived unless made to us in writing AUT�h(( IZ D SIGNATURE:
within one business day after the receipt materials. O �
68UNIVERSAL {-rREV "l"RKm 10064924
INVOICE
LOAD NUM: 3
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any. Seller's Standard
Terms and. Conditions, Seller's Quotati, f any, and. Seller's Order Confirmation (i ding limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agre�..._it"). Seller will provide the Standard Teri..., -nd Conditions upon request. Buyer agrees
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH
Aggregateproducts are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and
other siliceous materials. These products, .including fly ash, may contain more than 0.025% crystalline silica.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling,
crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled.
If ingested, keep warn, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh
air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists.
CEMEX. Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/1.2 For more information please visit www.cemexusa.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en su aplicaci6n de credito); cualquier
termino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmacion del vendedor (con limitaciones y
garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveera Jos terminos estandares y condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que las cantidades
y materiales fueron entregados como se expresa en el mismo. Acepta pagar el monto de acuerdo al contaato: al menos que se identi-
fique con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, coca volcanica, arena, Brava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, roca volednica, arena, Brava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025% de silicio cristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritacion en los ojos, quemaduras en piel y ojos, y
reacciones alergicas en la piel. Concreto seco y polvo de agregados, pueden causar irritacion en los ojos, piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, corte y/o perforacion puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse
en temperatura calida, reposar y tomar grandes cantidades de aqua. Las cenizas volantes pueden contener amoniaco.
Seguridad: I.a humedad puede causar la liberacibn del amoniaco. La inhalacion del amoniaco puede causar toser, irritacion o
quemaduras en la nariz, garganta y pulmones. Acud.ir inmediatamente al medico. El .riesgo en la salud depende en
]a duraci.6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto pro.longado con la piel. Use guantes, proteccion en los ojos y ropa
Primeros adecuada para proteccion. LAvese Las manos con jabon suave y agua despucs del manejo de materiales. Evite inhalar
auxilios• polvos. Si se expone a polvos mas de los limiter recomendados, use proteccion respiratoria.
Primeros auxi.lios: En caso de contacto en los ojos, inmediatamente fluya aqua en la parte afectada por 15 minUtos.
Si se inhala polvo, expongase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a Tondo con
agua. Acuda a atencion medica inmediatamente si la irritacion continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para mas informacion visita www.cemexusa.com.
Financial Project No.: N/A
F.D.O.T. Plant No.: N/A
Concrete Supplier: CEMEX
Address: 6100 Midway Road
Ft. Pierce, FL 34981
Serial No.:
33296232
Date:
August 12, 2014
Delivered To:
Day & Zimmermen
Address:
5601 Ocean Blvd
FPL Nuclear Plant
Truck No.
Class
Mix No.
Cubic Yards (M3) This Load
25347
5000
1572119
10
Time Loaded
Arrived
Discharged
Cubic Yards (M3) Total
6:33
30
Allowable Jobsite Water Addition
JJobsite Slump
w/c Ratio
24
lJobsite
DAREX
Cement CEMEX TYPE II
5810
WR GRACE
N/A
Brand
Amount
Source
Amount
WR GRACE
Coarse Ag187-090 1.1%
17040
WRDA60
704
Pit # % Moist.
Amount
Source
Amount
WR Grace
Fine Agg. 87-090 4.1%
13320
ADVA 120
353
Pit # % Moist.
Amount
Source
Amount
Propex
Batch Water (Gals)
F
211
300 Fiber
15
Amount
Source
Amount
Issuance of this ticket constitutes certification that the concrete batched was produced and
information recorded in compliance with Department specification requirements (347-5).
Signature of
Water added at Jobsite Gal./Liters
Issuance of this ticket constitutes certification that the maximum specified water cementitious
ratio was not exceeded and the batch was delivered and placed i compliance w'� it Department
specification requirements (347-5) jJ'1�UuW`J\
Signature of Contractors
W
`AIV Ccmcx
Plant:
Begin Loading:
To Job;
Arrive"Job:" `"
Start'Unload
Finish,Unload:
Leave Job:
Return Plant:
ystoyner C�o�de:
�,�c-.i ��. ,
stomer N
LrrY� e: ���il�iL:iP/f4�t�iN
r�
NPs
Customer Job Number:
Order Code / Date: 3
1t>7 ti Cad,./ 12/14
Pro►ect Code:°
Project Name:
_
° Rrotect,P.O. Number:
TVPe.;Number:
�cke Date:
14
pe'very ddress'
Map Page: Map/Row/Column:
}r'�± jf el(tvge,�ry I Irpcbons
• °
= "� , �
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Ticket Number _..
• .
'� v:l79
32 1s.:1
-0uepn Job:
{
Slump: — ..
ruckj�lumbert,
Dfi er,�lurr�ber:
rpriver•-Name• EMS
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LOAD
QUANTITY
CUMULATIVE
QUANTITY
I ORDERED
QUANTITY
MATERIAL CODE
PRODUCTION DESCRIPTION
UOM
UNIT PRICE'
AMOUNT
IJO .40„6 )
48. ()0 157'2 1 :1.
5000
REG'H/FB/67 1. 5LB i YD3 ;
.;33
".1=ilE1_4lRi
ifRC
IZ,02°7413
ENVIRC1NMENTAL.. CHARGE
Li Cash
Check # / Auth Code:
Signature of Driver Receiving' Cash:
. -
Cash Received:.
Total COD Order Amount to Collect
Check
Without Standby Charges:
Charge
Comments:
WATER ADDED:
GAL YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
SIGNATURE
❑ LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: ,Product may cause skin and/or eye irritation. CAUTION`. Material
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important
control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handli g 'nformation, and tothematerial �fety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZ D IGN 'TU E:
within one business day after the receipt of materials. O
68UNIVERSAL
INVOICE
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and Conditions, Seller's Quotat if any, and Seller's Order Confirmation i uding limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agrc-.._.;nt"). ,Seller will provide the Standard Tei..-, and Conditions upon request. Buyer agrees
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic .rock, sand, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.02.5% crystalline silica.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause imitation to eyes, skin, and/or respiratory tract.. Dust from handling,
crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled.
If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
dust above .recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh
air. It wet cement contacts skin., rinse thoroughly with water. Get proper medical attention if irritation persists.
CEMEX, Memorial Hermann Tower
929 Lessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www.cemexusa.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada on su aplicaci6n do credito); cual.quier
termino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y
garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveera Jos t6rminos estdndares y condiciones detal-
lados en caso de asi ser requeridos. Con este documento, el comp.rador acepta los mismos ya antes menc.ionados y que las cantidades
y materiales fueron entregados como se expresa en of mismo. Acepta pagar el monto de acuerdo al contrato: al mends que se identi-
fique con una rota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTFS
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, coca volcanica, arena, gravo otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanileria, pozzolan (tipo IP), az'1 jo de
azotea y estuco. Laos productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, di.,. mita,
granito, coca volcanica, arena, Brava, y otros materiales silicios. Estos productos incluyen. cenizas volantes (fly ash) la cua. puede
contener mas de 0.025% de silicio crista.lino.
Peligros: Mezela de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y ojos, y
reacciones alergi.cas en la pie]. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel y/o en
la zona respiratoria. Po.lvo del manejo en el trituramie.nto, pulido, torte y/o perforaci6n puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cancer si son .inhalados. En caso de ser ingeridos, mantenerse
en temperatura edlida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad: La hurnedad puede causar la .l.iberaci6n del. amoniaco. La inhalaci6n del amoniaco puede causar toner, irritaci6n o
quemaduras on ]a nariz, garganta y pulmoncs. Acud.ir inmediatamente al medico. El riesgo en la sapid depende en
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto pro.longado con la piel. Use guantes, protecci6n en los ojos y ropa
Primeros adecuada para protecci6n. Lavese .l.as manos con jab6n suave y agua despues del manejo de materiales. Evite inhalar
auxilios• polvos. Si se ex -pone a polvos mas de los limites recomendados, use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la paste afectada por 15 minutos.
Si se inhala polvo, exp6ngase a a.ire fresco. Si el cemento fresco time contacto con sus ojos, lavelos a fondo con
agua. Acuda a atenci6n m6dica inmediatamente si la inritaci6n continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para mds informati6n visita www.cemexusa.com.
Financial Project No.: N/A Serial No.:
F.D.O.T. Plant No.:
Concrete Supplier:
N/A
CEMEX
Address: 6100 Midway Road
Ft. Pierce, FL 34981
33296379
Date: August 12, 2014
Delivered To: Day & Zimmermen
Address: 5601 Ocean Blvd
FPL Nuclear Plant
Truck No.
Class
'Mix No.
Cubic Yards (M3) This Load
25332
5000
1572119
10
Time Loaded
Arrived
Discharged
Cubic Yards (M3) Total
7:16
40
Allowable Jobsite Water Addition
JJobsite Slump
Jobsite w/c Ratio
25
DAREX
Cement CEMEX TYPE II
5850
WR GRACE
N/A
Brand
Amount
Source
Amount
WR GRACE
Coarse Ag! 87-090
1.1%
17040
WRDA60
704
Pit #
% Moist.
Amount
Source
Amount
WR Grace
Fine Agg. 87-090
4.1%
13360
ADVA 120
353
Pit #
% Moist.
Amount
Source
Amount
Propex
Batch Water (Gals)
210
300 Fiber
15
Amount
Source
Amount
Issuance of this ticket constitutes certification that the concrete batched was produce
information recorded in compliance with Department specification requj;enw,,nts (34-7'-5).
Batcher
Water added at Jobsite Gal./Liters
Issuance of this ticket constitutes certification that the maximum specified water cementitious
ratio was not exceeded and the batch was delivered and placed in compliance with Department
specification requirements (347-5) ho
SigTfature of Contractors
F
CEMEX 616841950
Plant: Begin Loading. To job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant:
92/1092
Customer Code: Customer Name: Customer Job Number., Order Code Date:
3122495 DOY & ZIMMERMAINI"4 NPS 1074 CJ8112114
�Project Code: " Project Name; ieC�0.6. NuWbWr.. -Order P.O.
Ppi
-,qTEVE
Ticket Date: Delivery Address: Map Page: Map/Row/Column:
08/12/14 5601 N OCEAN D R FPL_
,fpelivery Instructions:, Dispatcher:,
Ticket Number:
�33296504
Due On Job:
Slump:
Truck Number:
Driver Number:
Driver Name:
End Use:
3.- 39
6.50 1
C�'JoG46213 1109205
TONY
ANTONUCCI
BLDNIG.- SL.,AB
LOAD
CUMULATIVE
QUANTITY
ORDERED
QUANTITY
MATERIAL CODE
PRODUCTION DESCRIPTION
UOM
UNIT PRICE
AMOUNTQUANTITY
F. 00
4 f,:j 00 46.
00 157�: 119
5000
RED/Ii/FB/67 1. 5
L.B F Y03
ARGE
1. 0 124781U 8 FEL. SURF,
I.. oo i;�027.4'9'ENVIRONMENTAL CHARGE
Cash 'Check # Auth Code: Signature: of Driver Receiving Cash: Cash Received: Total COO Order Am I ount to Collect
Without Standby Charges:
Check
Charge
Comments:
WATER ADDED: _GAL YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
SIGNATURE
E) LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for Important
control after delivery, this Company will not accept any responsibility for the finished results. No creditfor safety h �dl�ng information, and to the adq i I safety data sheets for additional information.
ror saTel returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHO IGNATURE:'
within one business day after the receipt of materials. 010 h it to 0
6BUNIVERSAL PREV TRKt 10025332 INVOICE
LOAD NUM 5
This Delivery Ticket incorporates herein by reference Buyer's previously executed C—dit Application, if any, Seller's Standard
Terms and Conditions, Seller's Quotatii f any, and. Seller's Order Confirmation (i ding limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agre�...,,.it"). Seller will provide the Standard Tom., and Conditions upon request. Buyer agrees
that, unless otherwise noted on. the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with th& Agreement.
/:Ll'T- : hlTl U�I'►/l� J ►/IIJ ► : lKi��'C/I� J ,I fI ' : t�i ilTlK`�j��ii/.T`j:'l
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products .include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and
other sil..iceous materials. These products, including fly ash, may contain more than 0.02.5% crystalline silica.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling,
crushing, grinding, cutting anal/or drilling may contain silica, which may cause silicosis and cancer if inhaled.
If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose, throat and lungs. See physician., Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
dust above recommended limits (see NMSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust .is inhaled, move to fresh
air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www.cenrexL15a cep.
Este ticket de entrega incluye comp refcrencia al comprador (ya previamente ejecutada on su aplicaci6n do credito); cualquier
termino estfrndar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y
garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveera los tertninos est6ndares y condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que las c�_:..idades
y materiales fueron entrcgados Como se expresa en et mismo. Acepta pagar el monto de acuerdo al contaato; al mends que se identi-
fique con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, coca volcdnica, arena, Brava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azul.ejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, coca volednica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025% de silicoo crystalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y ojos, y
reacciones ale.rgicas en la piel.. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel y/o en
la zona respiratoria. Po.lvo del manejo en el trituramiento, pulido, corte y/o perforaci6n puede contener materiales
silicon, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse
en temperatura caliza, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad• La humedad puede causar la l.iberaci6n del amoniaco. La inhalaci6n del. amoniaco puede causar toser, irritaci611 o
quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en la salad depende en
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto prolongado con la piel. Use guantes, protecci6n en los ojos y ropa
Primeros adecuada para protecci6n. Ldvese ]as manos con jab6n suave y agua despucs del manejo de materiales. Evite inhalar
auxilios• polvos. Si se expone a polvos mas de los limites recomendados, use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la parte afectada por 15 nunutos.
Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fondo con
agua. Acuda a atenci6n medica inmediatamente si la irritaci6n continua.
CEMEX, Memorial .Hermann Tower
929 Gessner, Suite 1900
V7 conrbinado Houston, Texas 77024
02/12 Para mas inform.aci6n. visita www.cemexusa.com.
Financial Project No.: N/A
F.D.O.T. Plant No.: N/A
Concrete Supplier: CEMEX
Address: 6100 Midway Road
Ft. Pierce, FL 34981
O f
Serial No.:
33296504
Date:
August 12, 2014
Delivered To:
Day & Zimmermen
Address:
5601 Ocean Blvd
FPL Nuclear Plant
Truck No.
Class
Mix No.
Cubic Yards (M3) This Load
64623
5000
1572119
6
Time Loaded
Arrived .
Discharged
Cubic Yards (M3) Total
7:43
46
Allowable Jobsite Water Addition
Jobsite Slump
Jobsite w/c Ratio
16
DAREX
Cement CEMEX TYPE II
3510
WR GRACE
N/A
Brand
Amount
Source
Amount
WR GRACE
Coarse Ag! 87-090 1.1%
10240
WRDA60
423
Pit # % Moist.
Amount
Source
Amount
WR Grace
Fine Agg. 87-090 4.1%
7960
ADVA 120
212
Pit # % Moist.
Amount
Source
Amount
Propex
Batch Water (Gals)
125
300 Fiber
9
Amount
Source
Amount
OUaIMOU ILII110 LIUINVIL w1JbL1LU Cs uGnnivauon mat me con creie Daicnea was proaucea and
information recorded in compliance with Department specification requireents (347-5).
Sig
Water added at Jobsite Gal./Liters
er
Issuance of this ticket constitutes certification that the maximum specified water cementitious
ratio was not exceeded and the batch was delivered and placed i mpliance w' Department
specification requirements (347-5)
Sig ture of Contractors