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Home My WebLink AboutCEMEX CONCRETE,5,5771M D SCANK BY Plant Begin JLpaoing. Job J r Arrive Start Unload: Finish AllLAI Leaye�Job: Re turn Plant: .1ro ,Job:. Customer Code: Customer Name: Customer Job Number: P - roject Code:I Project Name:' Project P.O. N - umber: Ticket Date, Delivery Address 0 L"L, 111i C, f", 7V EN rP L A It, I Delivery instructiqr�s: Job Slump: Truck.Nurpber: Driver N6rnbar. i Drivrr Name: J.... Order Codb / Date: I J Order P O Number -Ir Map Page: _ Y.apfi�ow/Column: Dir!cher: Ticket Number: Due On End Use: LOAD CUMULATIVE QUANTITY QUANTITY ORDERED QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT T PRICE AMOUNT 'J R 4 V C L' I f f" A V Cash Check # 1 Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect I Without Standby Charges: Check Charge Comments: WATER ADDED: GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: V SIGNATURE Y El LOAD, WAS TESTED BY: Notice: Our d0lers 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 assunes 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 a a delivery and accepts concrete as li�. Due to important factors which are out of our may be hazardous to your safety aQqSeA[U Pleas9'refer to the,backside of this ticket for Important control q del{ 6ry, t -'r -af-e�' h for additional information. . , his Company will not accept any responsibility for the finished results. No credit for safety handling information, and to the n�terial safe d r returned cre . Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNAfORE—.— within on us tv .4� - �J s-�Pay after the receipt of materials. 70 oV LOAD NUN: I 6BUNIVERSAL CUSTOMER 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 Del Very Picket ("Agrei it"). Seller will provide the Standard Teri ad 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 Agrcernent. i I AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH I1' 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 stuc6b. 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 skli'n 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 Mind 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 appropri�ie 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, Bove to fresh air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritat.i >I persists. CEMEX, Memorial .Hermann Tower 929 Gessner, Suite 1900 I V7 combined Houston, Texas 77024 I 02/12 For more information please visit www.cemexusa.com. Este ticket de entrega incluye comp referencia al cornprador (ya previamente ejecutada en su aplicaci6n de cr6dit;o); cualquier t6rmino estandar. condiciones del vendedor, propuestas del vendedor y Orden do confirmaci6n del vendedor (con litn.itaciones y garantfas), coma acuerdo total del ticket de entrega ("Contrato")'. El vendedor proveera los terminos estdndares y cond iones 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 uc se identi- fique con Una nota al frente de este documento. I ' AGREGA OS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOILA ,' TES i Los productos de agregados son materiales naturales como piedra caliza, dolomita, granite, rota volcanica, arena, gi- va y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albai ilerfa, pozzolan (tipo IP)H azulejo de azotea y estucO. LOs productos de concreto incluyen cemento Portland. y productos de agregados como piedra calizir;, dolomita, granito. roca volcanica, arena, Brava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) ]alcual puede contener m s de 0.025% de silicoo cristalino. 1 i Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y Ojos, y rc cciones ;11rgicas en la pie]. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos i piel y/o en la zona respiratoria. Polvo del manejo en el tritu.ranuento, pulido, corte y/o perforaci6n puede contenerj ixnateriales silicon, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, rPaantenerse m en teperatura cilida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener �moniaco. Sc'guridad° La hurnedad puede causar la liberaci6n del amoniaco. La i-nhalaci6n del amoniaco puede causar toser, �kritacion o qucmtiduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. EI riesgo en la salad c epende en la duraci6n y el nivel de la exposici6n. I, Seguridad: Evite el contacto con Ojos y contacto prolongado con la piel. Use guantes, protecci6n en los 6jos y ropa Primeros adectiiada para protecci6n. Lavese ]as manos con ab6n suave y agua despues del manejo de materiales. Ev'lite inhalar auxilios: pot vos. Si se expone a polvos rnas de Jos limites recomendados, use protecc16n respiratoria. Primeros auxilios: En caso de contacto en Jos ojos, inmediatamente tlraya agua eri la parte afectada por 1. minutos. Si se inhala polvo, exp6ngase a afire fresco. Si el cemento fresco tiene contacto con sus Ojos, ldvelos a fondo con agua. Acnda a atenci6n m6dica inmediatamente si ]a .ir-ritaci6n continda. CEMEX, Memorial Hermann 'Power 929 Gessner, Suite 1900 V7 combirwdo Houston, Texas 77024 02l12 Para mas informaci6n visita www.cernexusa.com.