HomeMy WebLinkAboutCONCRETE SCHEDULEA a• r lli,h I�Iu 1� 1Ithi �.� ��� �f tFa Ii� {,
oll
Hill
1142 Water Tower Road, 'Lake Park FL 33403
Office 1-877-484-9994 / Fax:561-844-7102
South East Florida Division Dispatch: 561-844-9994 / Central Florida Division Dis 07-339 P.P,
Concrete. Tested ❑ Yes ❑ NO LOT #
Water Added at Customer's
Cylinders Taken ❑ Yes ❑ No SIL L11y, Perm-
cle Count" ;
Request
f��I�
0 ANN,go
gals. to full load
Comments
gals. to 2/3 load
gals. to 1/3 load
Customer's Rep - Water Added
St Lucie l .R pa
NOT RESPONSIBLE FOR
WARNING IRRITATION TO THE SKIN AND EYES
ADDITIONAL WATER ADDED TO THIS
VARIATION IN COLOR OR
Cement polymer or freshly mixed concrete may cause skin injury. Avoid contact with
SURFACE DISCOLORATION
skin and wash exposed skin areas promptly with water. If any cement powder or.
CONCRETEWILL REDUCE' ITS STRENGTH
mixture gets into eyes, rinse immediately and repeatedly with water and get prompt
medical attention. Keep children away from cement powder and all freshly mixed
AND DURABILITY., ANY WATER ADDED IS
AT CUSTOMER'S OWN RISK.
BATCH TIME
cement products.
i
7�_-,7
PCANTr
TICKET# r . -, ORDEFL#
TRUC4� #
LOAD SIZE
'
MIX „ r .,
i
CUSTOMER#
q'-,
SOI,DTO._
P.O. #`., ,
PROJECTtI,_
DELIVERY ADDRESS
ZONE#
USE
DRIVER
YY
-I.`_
I
INSTRUCTIONS
TIME DUE
•
^),
SIGNATURE
WARNING
OR RECEIPT - CONCRETE
AND ACKNOWLEDGEMENT
OF HAZARD
asc meyer Concrete Company will not assume liability for any property damage or any SUB -TOTAL
equipment damage for any deliveries beyond the curb line.
TAX
'
AUTHORIZED BY
SHIPMENT SUBJECT TO CONDITIONS ON REVERSE SIDE. TOTAL
I S ek-1 A OFF Sfoi?>'JEC, f ±i "HH(" CYLLOVANG CCYND I IF ON S-
N r) Vie PiF to zo ti W"very ofrnal ?ni,l,
"73u, �;to4i-tef,aqvees 3 14"
3cn I e :o a dvv �ns Z;r'_ no arov It", {.,no, vv-- f0e,. , e V I e (I q to Floe -�rAvet ie�-
,,.AnV1 condilaps ate rnmed-4:,;d an(k such
r'l, cwf�tom��.OMI ;4, heid re -ny p tht,��ebyvo��84e, f
Wi i ceprem-.ntativa',s reques�arw d�arnagos
,VfZfy )5 M!VVI- "111*0r.'t cOSt
but rot Iinited to, sicle '068, rw)0sry. tars and oeptic systema, includirg the dreJn
are 3'L owner's rl�'
Trg� custlomiof agteos lo rernbuize sa'd C�lmpariv 'i-r los, of firpe an equipmsra b,,,r bts:r,)n of sudh delivery, and also to S,
i,Ywwn�fy save fkarm,-;e�ssaid kCon)pany from any andall. dernanis and ,wts is oion account ofor ir, any
(r!?;, ne,,a (j�w,;d s v r arisiNi from pnvvate dv;'V1?Vva'V 01,010P{ ry
ac.know!s diges that al; rnatereal and. servlcos shovvn riabeen rscqi;,id, that truck times shown are oorrect, and
Tna, tbeianncunt of water added at the custorner's request is Shown correctly, CAUTION: The addition of water reduces
d"imn,'ith aJ d,4rabil�-tv,
Tie not RSponiible for fin'4shed results obtaine,d,"Mrrl ��,iis load of concrete', m, any important far..Ilos affecting the ul t
fr,c "'orripleted job are beyond our rosponsibility and contre).
6, A p.,,vminute will be charged r`er cubicrd unloading ticnp, is eix0edqd, 0, 1
Ph) apeas t orovid,, :a sutp_Na wash 6ovin fcij�,iiW for andt3ols aJ tile Place of dellv-ery of rrab?riaU
Tni, c�lislxrer herebv grp_6st.',) 'pay 4 zfld c,,xp9i,,1r-p;s fncluding a, real or�able afytorn*'S fee"N he
1? ! to na�v ',o,, oc-fiected ht Vnis �ov�):ce, v,;he.n Jue- are, ssubiectto a 1-1;2".- Sr.`,
RECEIVED
OCT: 0 8 2018
Permitting Department
St. Lucie County
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BeginLoiidingf - ToiaEa Itrr6vr..fo'b '^
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r7lcket.Qe - QeLlreryAddiess
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DuoQrt,loo=
Slump: -
Tnrck Number
' Driven umber.
Qrl'verNamec
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LOAD - : Ct1ffGULATIYE. ORQEREO _PCtCiltiGElQILiIf�GWIsGIL11G .� U�1 I� mirinaw AM12 .C.
QUANRTY QUAN�IFL _ QUAWMY' MATERUACCODE
6, r,: i.. s, V �''.:.. a_ _ .'.L•a� - ,. r
.7 � E PII'II .ca.7'u..-._? IL X:,El - $71u r
IL
Ce&fir Check#Muth Cods: Signature aill fiver Receiving Casht i - cash Raeaived: 7 a2xfiL'OIDord� AmcanCt� CIN[aott
YUitfiaut 5tatrdfiy/Cttargo3F
._;Check
-
-
comments..
J, -WATERADDED- GALL 1 S fNi 12RLfug
SdtShiEM ADME M..
I.SISNATUFM
j ':_ � _ - - - li �13�'H.Lft3�7E3�Rm'��-2Bi^,�,{+dEt��'13�i'��'iJ7"�"fRE+'�E�•_' _ � �_
LOADIWASTESrED- ELY
Notice: Cur drivers will make every effort to place rnatdrfals whore the.et:siainar designates;, but the, J5PE=L' TERM Any, watatadded hattmata rimsawrrrink caaaratbsuengttn
Company assum®s na respansitilrity for damagea fnaide curbor prepertt lute. Cusfomar agrees as the iS 1m orrgergltararR�d. 1NAannnrz P adl�cCmaylraus�sAimeradlare�iMtattbn. CITNT1t1flt ICtataiatl'
;t amr of aaia and derivew and c=Rt& c*cmftr as IS Qua to impartart fadats which aral,aut of our nr�c be hazardous yourss�a'tg, and liaatitr Eta reran tm the bm:Hafde+af t8iui dcRet fin? Impnrtautt
control 'aftardailvery,ttasCampanywillnettacaapCany'responablIty'farthe finished resultm Nauadltfar _safatghandlj infarma6mnaridltrathmmatArial'.safev datmsit fmadiiiltorraliihfmmatlarn.
iatumed cohcreta, Buyers: exceptians and daims shaft ba deemed: waved uNas&rroft Ea imwriiing AfLTK0F Z9DlSIGfi MRE
within,ormibusinessdayafterthemcelptd-materfalsr �y s ,
. atone
r
Begin4Loadtng`;
To Job"~sA"'�
��4�r3veJob 4
Stact:Unload;
Finish Unload:
.
.Leave Job:
Retum Plane:
F.
r "'
_ ccm
i Custpmer•Codei CustomerName , Cus_tomerJobNumber.: Order Coda! Date: k
f Ptoject Co59�'^ h Protect Name:" 4, Protect P.O. Num6ar pp Order P O. Number
.. ' & ,•.;.t C7 } r 1�_ � < $ .0 1,f { °-;.E ".? �,a+ 9 1., 1 Y },t _ tO R I r 3d, d.F' ..
Tlcket Date. " DeljveryAddress p� fry Map Page: Map/Row/Column, ,
3 Delivery, ,Instructions,. " Dispatcher:
TF 0t%I.� MIA j, �Ex;�•��'�.,�i .�I•,.i i`t.�r' '
s v e a'`
a r 4 - - - '
t 4 r t x t r�� # i t Ticket Number.
r `E rw 4` ISO " 7
Due On Job Slump: Truck Number Driver Number Driver Name. End Use:
rlr_J t
I
` I
LOAD CUAANTITY ORDERED MATERIAL CODE I PRODUCTIONMESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY l *. ,
i i�{S � -!. ii%xi'`f��l `.(`•!�i I �..�.
Cash Check # /Auth Code:' Signature of Driver Receiving'Cash: I Cash Received: Total COD Order Amount to Colloet'
Check Without Standby Chhrgos: '
r
Charge
Comments:
- - WATER ADDED:' ' GAL YARDS IN.DRUMu
WHENADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/A•GENT.'S REQUEST:' j
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 properly line, Customer agrees to the Is no longer guaranteed. WARNING; Product may cause skin andfor 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 sz} ety 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 handltng Information, Ito the material safety data sheets for addlfional Information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZLD,,,SIGNATURE: 'k 1
within one business day after the receipt of materials. j6t(I
'xV I
68UNIVERSAL�'..'! 1- _`s.� r, t.t"�tt Ii rI'r1AER it,`�°