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Ticket
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Customer Name: Customer Job Number:
DRAWDY CONCRETE CONSTRUCTION LLC .
11./13 2937 W MIDWAY RD
Ticket Number.
Due On Job:.
Slump:
Track Number.
Driver Number.
Driver Name
End Use:
i.5I; 30
5.
0 10024 5C
7 10947...
LLUYD 1'OWiVE3
UNASS CGNED
Cash Check W/Auth Code: I Signature of Driver Receiving Cash: Cash Received:
Check
Did you do l WATERAD ED: [/� GAL ' YARDS IN DRUM:
Your Circle of tY? %f EN ADDED.
Did you identify hazards .
Did you use your goggles when fit' SIGNATURE
Did you use your safety cones?" pump?
CURB LINE CROSSE OWNER'S/AGENT'S REQUEST:
Did you communicate unsa/�ondidons to SIGNATURE
dispatch/other drivers? // .__ v% ❑LOAD WAS TESTED BY:
,floe; Our, drivere will make every effort to place materiels where the customer designates, but the SPECIAL TERMS: Any water added Is at customers own risk. If water is added on Job, concrete strength
ampany assumes no responsibility for damages Inside curb or property Ilne. Customer agrees to the Is no longer guaranteed. WARNING: Product may cause akin and/or eye Irdtatlon. CAUTION: Material
rms of SO 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
oust after delivery, this Company will not accept any responsibility for the finished results. Nocredltfor safety handling Information, and to the material safety data sheets for additional infamstlon.
Imad concrete. 'Er's exception and claims shell be deemed waived unless made to us In writing AUTHORIZED SIGNATURE:
In one business day ear the receipt at materiels.
IVERSAL PREV TRN.s ORIGINAL LOAD NUM: 1