HomeMy WebLinkAboutRECEIPT FROM MASCHMEYER CONCRETErNFE
1142 Water Tower Road, Lake Park FL'33403
1 Office:1-877-484.9994 l Fax:561-844-7102
I South East Florida Division Dispatch: 561-844-9994 / Central Florida Division Dispatch: 407-339-5311
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Concrete Tested. ❑.Yes ❑No LOT# SCANNF[)
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Water Added at Customer's
-Request
Cylinders Taken E] Yes ❑ No
BY
gals. to full load.
Comments.Lucie cour
y:gals. to 2/3 load
gals. to 1/3 load
-
_
_
Customer'sRep -. Water Added
NOT RESPONSIBLE FOR
NARNING IRRITATION TO THE! SKIN AND EYES
ADDITIONAL WATER ADDED TO THIS
VARIATION IN OOLOR.OR
Cement polymer or freshly mixed concrete may cause skin m)Gry.Ayoid contact wfth
skin and wash exposed skin areas prpmptly with water. If any cement powder or
CONCRETE WILL REDUCE ITS STRENGTH
SURFACE DISCOLORATION
mixture gets into eyes, nose 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
A} CUSTOMER'S OWN. RISK.
eATCHnME
i r P>
cement products.
,
Begin Pour Begin Wash To Plant At Plant
'PLANT
TICKET# ORDER#
TRUCK#f
LOAD SIZE
'MIX
SLUMP DATE
�rIy.IWA I'_,�.)f'!'1
sr., rif"
CUSTOMER #
SOLDTO - -
P.O. # ,,
PROJECT#.
ll�n-!F,
kill{<f'fii:'�'
L;t:I,tf�l �-E_ >_,:a LI_f,
n,_a•k ritJcel.'1
DELIVERY ADDRESS
ZONE# -
USE
DRIVER
_
i;1`L.r
31 11 i{ 111
INSTRUCTIONS - -
TIME DUE
•••
ORDERED
PRODUCT CODE••r
DESCRIPTION
•orpiffirky"M
•
I QUANTITY
QUANTITY
Prl,
1,17, Tpt
1.:<.;141
400f) Pf,N'l
y(l
1 . %illj
].i ., v7 7
o 0;
F-fM Itl:
!'I,rk%I11" - 12••c iriotii,
i'• I-,-
::1„0)
fKTVIRO
E.AIUYI!:)i'Jt%rtaIT1?L 't•"„'x)
y
S t i r
0. 1,110
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I IJS D .0 fid6;I iF tit'}IL
.t al. (1111
0. nip.)
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17Y11I IR, 0(:.Ili. r l'f T Vr:
_ SI NATUREOR
WARNING
RECEIPT ".CONCRETE
AND ACKNOWLEDGEMENT
OF HAZARDS
.: asc meyer.Concrete Companywl not assume Hau l dy or any pro y.cam7or SU&TOTAL
damage
equipment for any deliveries beyond thecurb'line. jj, ,I� ,V �j
I TAX
AUTHORIZED By
S IPMENT SUBJECT TO CONDITIONS ON REVERSE SIDE.TOTAL
"
'1
TiiiS[)nLIVr $ MADE SUBJECT TOTHE OLLOi' N JNDiTIONS:
1 cmtr rm e e , to l rot°de a,uitahle roadway for our trucks from the street pavement to the pla of de'lv`=t* c r <-,,: a+
I .oc*i 3' 4t MIS.. A,c.� ij ays ar* not providea, we re"`.-.erve the right to stop deliveries until con&6t. ns arQ''.'�7r�., B iC7 atr c `n 3.'vh
oo hr id responsiblo for ar?y loss caused thereby.
i
2 a'+h c'c v ;: is ma..;o �-, cnd thac,;rp line at the customer or custorr,,er representativs n r .c; ' any damdges i
nu. I.r.0 cdto, sidewa,ks, dnvew2ys, buildings, trees, shrubbery, septic tanks and sept,. 5y>terns, i n'41dingthe drsin
are ,atthe 0><vner's risk, 4
I I
he costOmer agrees to rcimourse safd'Company fdr toss of time and e4uip,memt by reason cf such defival j stud al o tc
':icP.mnify any wire harmless said Company from any and al! claims, demands and suits for or on acrean411a` or in an':
wanner caused by or ansing from private driveway delivery.
Ct s,'omorack'iowladges that all material and services shown have -been received, that truck times stilawjr, alp cogt;c ai,jl
Vim the urncitnf of water added at the customer's request is shown correctly. CAUTION: The addtior+ of orator and: :s
.;urrefestrenptl and durability. III
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ri, Wo are not respomsiblo for finished results obtained from this load of concrete; many important factors affectiNg the UINT12.10
qua!lly of the completed too are beyond our scope of responsibility and corttro'i. I
i
a A nha-ge of $1,00 Pei minute':;rill be charged after S minutes per cubic yam unloading time is excecd od
1. ,^is .;ustomer:agraesto provide a suitable wa h down facility for our trucks and tools at theplace of delivery o; mz-e,:9l
!'.
cl� tcmcr 1- c—c by nr es to pay all costs and expenses of Collection, including a reasonable aUor. . oy sjfee. If lH l>`1Il
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F3 ' ^, ?}2y f0'ih2 n'EtCFanCisP rafle0te(i In tills .mVfiSOe, when due: Past dUe account,; are si1t71^^, .0 Si `.
1 Cj^. on the u� ipa d p&!,t due U?ldn, e. the customer hereby acknowledges receipt of the i;xnpliste. Cony ?'fill CS -Si-,e,t
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