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Customer Code: Customer Name:
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Customer Job Number: Order Code / Date:
S,Prc, ect P:ONumbe�' ,' 7 Order P.O. Number
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Dispatcher:
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Due On Job: Slump: Truck Number: Driver Number: Driver Name: End Use:
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LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY I QUANTITY I QUANTITY
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Cash Check # /Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
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Check
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Comments:
WATER ADDED: j� -� GAL YARDS IN DRUM:
P WHEN ADDED.
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SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
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P ~w( .(-ir._ FULL L l..OAD _ � Y'�I�?r?:i ❑ 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 handling information, 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 i IR F Y 1 R'K w INVOICE l 0(11r, IvUlyi'. J.
This Delivery Ticket incorporates herein by reference Buyer's previously executed credit Application, if any, Seller's`"Standard
Terms and Conditions, Seller's Quota if any, and Seller's Order Confirmation iding limitations of warrantie-1),.as if fully
set forth on this Delivery Ticket ("Agi .nt"). Seller will provide the Standard Tc nd Conditions upon reque-C.'Br grees
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. j
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Aggregate Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials, Cement products include Portland cement, mInry, pozzolan (Type IP), roof tile, and stucco. Concrete
'
products incl;;de Portland cement and aggregate products including �ftestone, dolomite, granite, volcanic rock, sand,.gravel, and
other si.licev)ns materials. These products, including fly ash, may co, ntaiti more than 0.025% crystalline silica. i
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skid 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.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www.cemexusa.com.
Rste ticket de entrega incluve como referencia al connrador (va nreviarnente eiecutada en su anlicaciOn de credith): cualardei
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 proveerd los terminos estandares y condiciones detal-
lados eri caso de asf ser requeridos. Con este docum.ento, 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 Contrato; al menos clue 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 albanilerfa, pozzolan (tipo 1P)i, azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, roca volcanica, arena, grava, y otros materiales sili.ci.os. Estos productos .incluyen cenizas volantes (fly ash) .la cual puede
contener m1s 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 alergicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, peel y/o en
la zona resp.iratoria. Polvo del .m.anejo 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 calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
5eguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar, toser, irritaci6n o
quemaduras en .la nariz, garganta y pulmones. Acudir .inmediatamente al. medico. El riesgo en la salud depende en
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el. contacto con ojos y contacto prolongado con la piel. Use guan.tes, protecci6n en los ojos y ropa
Primeros adecuada para protecci6n. Lavese las manor con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar
auxilios: polvos. Si se expone a polvos mas de los limites reeomendados, use protecci6n respiratoria.
Pr.imeros aux.ilios: En caso de contacto en los ojos, inmed.iatam.ente fluya agua en la parte afectada por .1.5 minutos.
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 m6dica inmediatamente si la irritaci6n continda.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para rnas informaci6n visita www.cemexusa.com.
ASE Engineering Services, Inc.
Consulting Structural Engineers
At Threshold Inspectors
Certified MBE
June 25, 2015
Building Department
Re: CMU Wall inspection requirements for Riverbend Lot 45
To Whom It May Concern:
In regard to Masonry Wall Construction Note #10, so long as the building inspector inspects
the unit masonry, no special inspection shall be required.
FILE
COPY
Sincerely,
Mason xie, Ph.D., P.E.
o%0111"" 111"'
%,--
Mason X i e
'VCENS
` •
2015.06.2
NO: 51161 -
*� S Tt,
5 15:36:25
-04'00'
10244 East Colonial Drive, Suite 202, Orlando, FL 32792
Tel. (407) 677-5565, Fax (407) 730-2999