HomeMy WebLinkAboutCONCRETE RECIEPTRi7r�nwrRFTIEIASI
uyz
1142°Water Tower Road;,:
Dffice:1-877-484b944 /1Fax:561
South East Florida Division Dispatd
-
{ 5
Iivlslon'Disoatch 407-339-5311
:. .
r Water d at Custdmers
`Concrete .. ❑ Yes. .:- o "LOT # • - ,- ero ' _•
_
equest `l
-Tested
C Ifnders Taken '❑ Yes' 0 -
Y
' `1 full load: `•?
- xr�-
gals.'to
•Commentsgals:�to,
2/3'load;
gals. to 113 load
L
.- :... ...., 4 . ... C
, Water Added';-;
NOT.RESPONSIBLE FOR WARNING " IRRITATION TO THE SKIN AND EYES '' _
,pDr iTIONAL WATER ADDED TO THIS11
;, VARIATION IN COLOR OR Cement polymer or freshly mixed concrete may cause 31un injury. Avdid contact with,
VARIATIONIN with water_ If'any cement pa a?, or
CONCRETE WILL REDUCE ITS STRENGTH -
OLORATION %skin and. wash exposedakln"areas promptly
SUR into eyes; nose immetliately,aod repeatedly vnth water_antl get prompT,
s AND DURABILITY, ANY WATER ADDED tS
,.-• mixture gets
attention -Keep children away from cement powderand all freshly mitred'
-pT CUSTOMER S OWN RISK r,
�7 E a- medical
9IT 93:w'1 �)Ilb,< cement products -. -
�, ",'ari_•. .i
..., .. --.,
At Plant
On Job Begin Pou
To Plant
-
PLAIJi.^_i' TICKET# ''- K ORDER TRUCK# LOAD SIZE' MIX , '
SLUMP DATE"
��sx�+a ..'-7 v"i:, F
^,
CUSTOMER# SOLDTO - - - PO�:#•
' CONSTRUi�iTal7tV IR4� � .
FROJECT# w i
•+' '"` �6 1'���g�
£�'� , � � RF°; COt��:k��l-L ,
a
DELIVERY ADDRESS,,__ ,ZONE# USE
b#: STI lSr TGit
DRIVER
�!ZI�N ,Ftar,s
�YAIr Ghemica2„ F act .S�ahi'Dri
Y' S 6m t
INSTRUCTIQNS E6 TIME OUE� -
Et?, It ,t h Tp.r� il�vYrS� 1;Afra=eEfin;
411
PRODUCT DEStRIPTION
U.O.M.
q 4 -
iOn tot
46. it
3554E1%
REG , .`
Yd
! »
ENUIF3n •
' ENV-11RONMENNt , P1,16b
ea ,
k,
A..
0 t00
2
� F'CIEL•,�LlftGH�RC,E �
ec2
3 'n,
v •
•
SIGNATURE
SUB -TOTAL,-
OR RECEIPT-CONCRETEANDACKNOWLEDGEMENT
asc me er gncrete- Cam-panywl opt assume Iffiabilityl any property carnage or any.
', ,. ..
,.-•equip. dam" for any deliveries. beyond the curb Tine.
TAX
TOTAL
_-
AUTHORRED B1
SHIBME T`SUBJ
_.
T TOCONDITIONSON'REVERSE
SCANNED
BY
St. Lucie County
mom
_171 IL
�142`Water-Tower Road, Lake`
Offlce t S77 484-9994 ! Fax: 1444-T
f-S th East Florida Division Dis 404131
/
>ark 33403
g,`=='746213
f2 1 �(}+�
n DDoe LI CanhdId �Initlda Dmisind Dlsoatch. 407-339 5311
ou -
at dad at Customer
Concrete Tested. ❑Yes LI r ? LOT #
` f
-"'
Request
Cylinders Taken Yes ' No 1 tit .
- r t r:1 p
r. _
gals. to full load
t
Comments
s. to 2/3 load,
- ' - • -
` als. to 1/31dad `
P—P al
Customers .Water Added •_
NOT RESPONSIBLE OR - WARNING �LR [ONTO,THESKINAND EYES
may cause skin injury. Avoid contact wph
' 'ADDITIONAL WATER ADDED -TO THIS
= VARIATION.IN COLOR OR. Cement polymer orj' tes mxed wncrele
' e dead areas prompptly with water Ifany cement powder or
,CONCRETE WILL' REDUCE ITS STRENGTH ;
s a1,Utwas skin
- SURFACE'DISCOLORATION rinse immediately and repeatedlywnh water,antl get, prompt
AND DURABILITY,Y_ ANY WATER ADDED IS
mixture gets into eyes,
medical attention Keep children away from cement'powder and all freshly mixed
CUSTOMER S OWN"RISK
t� products ;,' _ _
,,AT _
::� .i rr '
To Job On Job Beginlp�r
_ ...,
PLANT TICKET#�ORDEfl# TRUCK# LOAD SIZE MIX i- -
j SLUMP DATE
Z,Q!v '8.i,3212t ..�� - -.. i7a ' '1:0: i� .. �}L ",�iEC-..y
CUSTOMER#, - SCIOTO. :. . : `s z 2290 ,�
uer sors, sec
7� .. _tar cork r cars r t
a
DELIVERY ADDRESS„ - ` ,' - ZONE# t '. USE _
t'Ei @t''.$c'f�:. {f.Tl it�i `= tJ'TL_UCIE-wtit�,�'t,
DRIVERgi-_•' ' ,
"A.."t'1 E;t0.1 Ci
TIME DUE i e
.INSTRUCTIONS
.Nvy.
PRODUCT CODE -PRODUCT DESCRII TION
'Ft 0
40.00
�35045480. t,5500- R"G
k�
k k1k1
G3; IiO
_' ENVIRd 640RONVIENTAL..'Ll
PO
ea
CIO;
S FUEL SURCHA116E
T
,
', .. . :IGNATUR
WLEGEMENTOFAAZARD WARNING
kit -not assume Ia r I or any property damage or any
Il verses beyond the curb Ime _ -
.+f
-
SUS -TOTAL
„
r
LqCRETE:AN5 CKN
g( e•,. agrpap
egGi`, edt:damage torany de
_
-
. .
TAX
- . .. • - e - AUTHORIZED BY'
- -:
DOTAL
ON REVERSE SIDE. -
. SHIPMENT SUUJEC
•TO CONDITIONS
Concrete TestedQ YeS }" LOT i€ -� ' r+T r
r a t ; -1 Fi _r2 9xv
;, Water Atlded at Customers ,
Re9yest
CyhntlersTaken *QsYes b]Na <s` ram'6,-
_
`��..§'ttlDad
'
_47�m ` gals'tD 2/3load=
-
IDad
�,
r:
m } y. I"
.+ �„
v c - ...3
-
�.� f Y
.F.
NOT RESPONSIBLE FORS �.
-:WARNING',.IRRiTATION TO THE"SKIN AND EYES
ADDITIONA WATER ADDEb,TO,THIS`"`
VARIATION IN _COLOR OR;;
Cement pyygle%oc-freshly mgad concrete may,cause; skin injury Avoid contact wuh
'CONCRETE W L-REDUCE PI'S,STRENGTH .
;'SURFACE DISCOLORATION'.
sMIn antl wash exposed. Skin areas promptly whh water It,any,cemenf powder. or:
mixture gets into eyes rinse immediately-- nil repeatedlywith water and get prompt.
medical attendon�Keep children away it oament powwder and ali.;keshly mixed;
roducts Xi
_
,3 AND DURABILI AM1Y WATER ADDED�iS
„ qT CUSTOMER S OWN RISK'*"`
.... �'�
BATCHTJME a --
g k
cement 4'.:� _ .. �,, a^
.>rrr•.., 5 ,
STRUCK
4LA T. TICKET# ° ORDER # # LOAD SIZE' MIX SLUMP
E>�C� ',;v tZt3f±1f;
iQ '€ice Rt�y `. 3fa ;;22i7k %tA.c� 35ytttT.RL'fr�+ > ;zt .*�
'• ,. `� f;: ^:y ': k.; `, PROJECT# p i� -fit
CUSTOMER SOLDTO ,APO ,�#;'�
GG.._ ./
IA�LtW14} }
Ya£J*a 3 ASig 1tiJr.,rSiC tGndk.etrr
..*tit<�A
DELIVERY ADDRESS �- p - � -: ZONE# USE DRIVER ,.. � � x-p
�„ F
C!%emtcal� t = fi t finis > kd r STLL�GI a togs
INSTRUCTIONS',,' s'< .,�{' 3' a r. T v n + x rTfIME DUE .� i •�
' - xg;_k s. `rs �` "'@ � t•r x '�".'� pn}�•� �r�G inn'
C5.0'�OY'✓r Nr�ily #a4.s11 PRiy.58Uttt- `.,, <o.,s. ,=:_
r�F"r-sr�viv�_�>= sF
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PRODUCT ••
PRODUCT DESCRIPTION
•
••
•
1"i' .
' < k%J..tD
FNiR�
EiV41Ifd71tfi1l4TAI BIB
D e
,��
w /S
y
�.
2, IGNATUREOR
RECEIPT -CONCRETE AND ACKNOWLEDGEMENT
OFHAZARII
111NG-
Mascr 111&11 one a ompany w not assume liabilit lIo any grope Image or
the curb Ih n r
SUB -TOTAL
- egwpme t n etivedes beyond r .- ,
v
f AUTRORRED BY
w cu�oElcnlT ci to IcoT Tn !`nNNTIr1NC !1N RF\/FRCP CInF �:
_
TAX
.�V rML
. _' I. k��
I/—m ^ -;--
1.142 Water T
Office: l 377-484;
South East Florida-
ozrk FL 33403 % 46215
L44-9994 / Centl FI`orida Division Dispatch 407, 339=5311
Concrete Tested . ❑ Yes -❑ No .LOT # _
.�_..
Water Added at Customers
.�iequeSt '
Cylinders Taken: ❑Yes [] No r 1 :! `, r!. j (-� +;: _
-,..
�, (J '
...r.. . ...:. _
"Comments
als.,tofullload'.1
gals: to 2!3 load. q
�
s rtFer's Rep WaterA i
f„
RESPONSIBLE FOR:- WARNING- fRRITATION TO THE SKIN AND EYES
Cement polymerorfreshly mixed concrete may cause skin Injury. Avoid contact with
' pDDIT10NAL 7E ADDED• THIS'.' 1
F-NOT
RIATION' IN COLOR OR •
skin and. wash exposed slun.areas promptly with water: It any cement powder or
CONCRETE WILL REDUCE ITS STRENGTH
RFACE DISCOLORATION mixture gets into eyes,: rinse immediately and repeatedly with water and get.pmmpt
AND DURABILITY. ANY WATER ADDED IS,-'
AT�{H RME (-` - - medical attention. Keep children away hom.cement,powder and 'all freshly mixed
pT CUSTOMER'S bWN,FiISf4
"O HM rJ.40.. - .,1'. '_. cement Products.
k
PLANT
TICKET#
ORDER#
TRUCK#
LAD
MIX` -
SLUMP .DATE
10�
Og.±kf 4 ..
4iG,
hi7fi
10'.0
3500 i2ECi!'<4 _
4 00 0/09/15
,
- CUSTOMER #
SOLDTO - - -
PO #
-
P ROJECT #
s7r
�FtF rnNer�ET ONSTRUCTzOWING
DELIVERY ADDRESS' - '
ZO NE#
USE -
DRIVER.
"'
AIA` Chem'ica-i' Fe,ezd Stat-iarr;' W-•`'
STLUC'IE
SLABS
1:eo Acosta
INSTRUCTIONS •' _„ •... T' c .-...' `i ^ . .s
_.. �., —
TIME DUE -
FP Jk st 5ef6.ra idavy Sea1T fA!seLtm
6:37 'AN I
':
/+Q+, ti0
?5045480
,; i00 �FtEG-1.00
7PRODUCTCODE141.00
ENVIRO--
ENVIRONMENTAL -DI
PO
ea1.00.
2
FUEL SURCHORGE'
ear
SIGNATURE
OR RECEIPT - CONCRETE
AND ACKNOWLEOGEME
J OF HAZARD
WARNING -
-
.: asc meye Concrete Company will no assume liability Or any property amage or any
,-
L
SUB -TOTAL'
e/,,q/urp a It d e for any deliveries beyond the curb line.
..
TAX
_
% AUTHORIZED By
SHIPMENT SUBJECT TO CONDITIONS'ON REVERSE SIDE. -
TOTAL
'
+ i `
L °
Mj
SC,H'N�
rnNCAETE=COMPANY
OF
1`1`A7 to/-�+,'TA... nr Qn53 .I.alra Pare
Concrete Tested . Yes �,f] No LOT # - Water Added at Customer's '
Cylintlers Taken Yes No %`j -Request' ,
'+i ''„ - •
to full load
_ r _
gals
CornmeMs -
galL to 2/3 -load.
L, I gals- to'1/3 load-
?-
u to s Re WajerAdded'
P NOT RESPONSIBLE FOR:. +'� WARNINCs "— IRRITATION TO THE SKIN AND:EYES
R A11 DDED TO THIS
, .VARIATION IN COLOR OR Cement poty`mer or freshly mixed concrete may cause skin injury. Avoid contact with
inrand.;wash,exposed_•slun areas: promptly wah',wateu if any. cement pdwdeq dr.
,ADDITIONAL
^ -
' `CONCRETE WILLAEDUCE ITS. STRENGTH _�
SUPFACE DISCOLORATION -si
.. 'mixture gets imo,eyes,.nnsevmmediately and repeatedly with water and,get prompt
,AND.DURABILITY. ANY, WATER ADDED 1S:!
ctuTtM - .. medical attention Keep children away from cement powder and alt freshly mixed
•cement
'.pT CUSTOMERS GWA` RISK
:s ;:a j?' 7.s'y�'., products
lo Plaint
At Plant
PLANT TICKET# • ORDER # .TRUCK # LOAD SIZE MIX_SLUMP
¢I :7500'`'REGf 48 .,
DATE '
7.i s 8�,?t2tcr
CUSTOMER#
lSqLDTq. 'y _ :,+ °' _ -
ftr`. G 1haGt ET i3idSTRiJ TI(-W-,;INC
RO.# -
-,
PROJECT# '
t .�
•.
DELIVERY ADDRESS. 20NE#DRIVER
�hm Ghertilc4a' €e3d-u5t�t�i'cr, W- �TL'UCI� �aLF7?t�'�
Wilj'i r Rkes ° r
INSTRUCTIONS �:: - ,' k '' -- `. �_ ,
Jti`st fVavy Oe' 1 pbs`sefam
s TIME OUE j
AM''
,bef'fa
PRODUCT DESCRIPTION
U.O.M
•G'. QIQf
° '{e'
LFC'_a CAS
,.. 51EIil'�t0.
ve5ul fiEC]ViF,-'
-
!,.E7OrRO
EPtUIRONMENTRL,xitL_C1D
,ea
BI:Est
` - _
FLIEL, sclflcHpqREE
ezt°
SIGNATURE
WARNING;
_ �f
OR RECEIPT - GONG
AND ACKNOWLEDGEMENT
OF HAZARD
_ asc meyer n ete nywi no assume; is I I or any propertydamage or any,
SUB -TOTAL
ge fo any d 'es beyond the curb Imo
..
i
TAX
- - - - A THORRED 9Y'
SHIPMENT, SUBJECT TO CONp1110N5 ON REVERSE SIDE,
a
��rT _�;.e..._.v �_.,_a_.�__..^."*>1N.:.r-'-...:.�.-,-,__-r--..�-,--:-.,_—.-.-.-.-.a_..._----•—�'`.v'� 4.✓.J_.."_``§st',.k" � i. ,�„_,,...�t
1142 Water Tower Road, Lake, Park FL 33403
Office:1877 484-9994 /Fax:561 844 7102
South East Florida Division Dispatch 561 844-9994 / Central Florida Division Dispatch: 407-339-5311
746'212
Concrete Tested Yes 119& .LOT#
Water tl„at Customer's
Cylinders Taken Yes o .r.
eglieat
gals. to full load
Comments
gels. :2/3 load
gals. I 1/3,load
V.
Water Added
NOT RESPONSIBLE FOR WARNING IRRITATION TO THE SKIN AND EYES ADDITIONAL WATER ADDED TO THIS
VAHIATION:IN COLOR.OR .Cement polymer,oyjrsshly mixetl,cgngrete,may,causeskm In1ury Avoid coarse Rh _
SUEfFACE'D_IS_COLORATION Iskln andiwash exposed: skirt areas'- promptly with water •I} any cemenhpbwCairdr CONCRETE WII:L'REDUCEdTSBTRENGTH-
.� - ,medure gets mtq eyes, rinse immediately -and mpeatedly,with,water:and, get prompt AND DUFABILIT,Y ANY,�WATER�ADDEQ IS
medical'attention: Cap children all freshly mixed
I}�I 3-+
cementprotlucts, , ho, CUSTOME�80WI��RISK,�t�
f11 g44
Load To Job On Job Begin Pour Begin Wash
It w"l` , U .;.^s"
e� .
114 J / r
PLANT }o,
TICKET#
O,R4ER
TRUCK#
LOAD'j- _�
MIX SLUMP%
'
DATE
103
853021.4
Gs -1
F77
:Ef-:' 0is`
3500'1REGT. 48', ",
= �.t'.
"'+a031169/15
CUSTOMER#
SOLDTO
P.O.#
PROJECT#
>sRP-),CONCRE:TE'I:CONSTRUCTION": INC _
'; . , o rl -,I 7� -'
DELIVERY ADDRESS
IZONE#
USE
DRIVER
A`i'A. t'Chiem-i`ca7l Feed So ion-="W'"-I`STLUCIEI:,
.=SLABS
W, LIi#ia'R14s„vT
INSTRUCTI NS".=... .�-. .., .,.I.,.... ."., o.,.. v.. ::��., ., ;.:..., �.1H1. ;.,. 1::,:. 11 .. ,. .-.":.., .
TIME DUE:,"
FP 'rt•j:tist 'tiefoi^er'Navl�tcSil' :Mus'taeim„r,, v.r erse. .
LUNITPRIC
5:'58?.RM
PRODUCT DESCRIPTION
U.O.M.
10.00
10.00
40.00
3504548000
REG
yd
1,00
0.00
ENVIRO
ENVIRONMENTAL DISPO
ea
1.00
0.00
2
FUEL SURCHARGE
ea
Y
• SIGNATURE
OR RECEIPT- CONCRETE
AND ACKNOWLEDGEMENT
OF HAZARD
WARNING
asc me er Concrete Company Will not assume liability for any property damage or any SUB -TOTAL
equ dfor anya dellveries beyond the curb [Inc.
TAX
AUTHORIZED BY
SHIPME SUBJ TOCONDITIONS ON REVERSE SIDE.'' TOTAL
i
w
i IMA
42, Water Tower Road, Lake, Park FL , 403
6lfice:1-877-484-9994 / Fax:561 844-7102
South East Florida Division Dispatch: 561-844-9994 / Central Florida Division Dispatch: 407-339-5311
I INRI�MI�hI��I�Nn�I�I��IHII
746213
Concrete Tested ❑ Yes ❑ No .LOT #
W dded at Customer's
Cylinders Taken (] Yes ❑ No
Request
Comments _
gals. to full load
gals. to 2/3 load
gals to 113 load
T, • ;
_
CUS
omers'R Water Added
I
a
i+r's
NOTRESPONSIBLE FOR WARNING IRRITATION TO THE SKIN AND EYES
ADDITIONAL - ADDED TO THIS
"RIATION:IN COLOR,OF Cement��ppolymer,acfreshly mixed. concrete may,cause,sklrt inlury_Avold comact,with.,
SURFACE'DIS_COL•ORATfON 'skm an'tlr exposed'skm areas promptly with�water.1f-any'cement powder or
-CONCRETE WIWREDUCE ITS:STRENGTH
is qt
mixture gets mto eyes, rinse Immediately.gnd repeatedly watLwate.and, get prompt
A - medical attention.'Keep`childreri'away'from'cement powder and au'freshly mixed
AND. DURg61LRY ANY WATER ADDED IS
J1�i�i"3 I6 cement products.
h;I,ATCUS�OMERSWHRISIC:
ai
„ dk:yy v .
Load To Job On Job Begin Pour Begin Wash
+`. (iC"n.� II ,',_ _i r;.J�', ��E'f5_k;,,'�: j;•�'-D {. n.;'11..
i
7fl l,•_��.
'DATE
PLANT
TICKET p ". ORDER #
ITRUCK #
LOAD SIZE
MIX ( SLbvp
')3500' REG/.'48``-
a '
4. /1.5
CUSTOMER #
SOLDTO
P.O. #
PROJECT#
67,74'rtl t�� V,`
_`= ;t3F CONCRETE 'CONSTRUCTION INC :
u ` T`2229 x
DELIVERY ADDRESS
ZONE#
USE
DRIVER
Feed'USf at'i'on - W'=•'''STLUG4E�
'
' ' SLABS
INSTRUCTIONS,
FP jrc'st 6e-fore''Nav'y-Sea'I' MurseiCmT- = „ „ q -.'
`67.A-3 'AM
PRODUCT DESCRIPTION
U.O.M.
UNIT PRICE
AMOUNT
10.00
20.00
40.00
3504548
3500t}��
d
1.00
0.00
ENVIRO
'EhjV3RDNNENTAL DI
tEL
PO ea
1.00
0.00
2
SURCHARGE
ea
SIGNATURE
OR RECEIPT -CONCRETE
AND ACKNOWLEDGEMENT
OF HAZARD
WARNING
as yer one a ompany wl no assumeliabilityor any propertydamage or any
SUBTOTAL
nt da ter y delIVerles beyond the curb line.
TAX
AUTHORIZED BY
SHIPMENT SUBJECT TO CONDITIONS ON REVERSE SIDE. TOTAL
z
1142 Water Tower Road, Lake, Park FL 33403
Office:1-877-484-9994 / Faz:561-844-7102
South East Florida Division Dispatch: 561-844-9994 / Central Florida Division Dispatch: 407-339-5311
7.46214
Concrete Tested ❑ Yes ❑ No LOT #
Water Added tat Customer's
Cylinders Taken ❑ Yes ❑ No " '
Request
Comments
gals. to full load
gals. to 213 load
,,;� . to 1/3 load
_
u e ep en Added
NOT RESPONSIBLE FOR
VARIATION IN COLO@.OR
WARNING IRRITATION TO THE SKIN AND EYES
Cementpolymer or�freshiy mixed,concrete may. cause skin inlury. avoid-pontact with.,
pDDITIONA WATER ADD D TO THIS
SURFACE DISCOLORATION
skin an wash exposed�skln areae`promptly with water If any.celhent3powder'or
-^ CONCRETE%W �LAEDUCE- S,STRENGTH
- - - - -- -.-.- ._
eATCH TIME
,mixture getstlntc eyes, rinse Immediat11
ely pad repeatedty with water,and get prompt
medical attention.'Keep"ghildren away from cement powder and all'freshiy mined
',,AND DURABILI ANY TERtADDED Is "
-
cement products.
S OWN RISK.
11 Ii�TgTIjA�CUSTOMER .
. #l�" 'ci'��J`" 'i�,i: .., I-. C,Rv 3'B �:! `v'11t`F9:9/; �t1i8:,f.•r
J`�. J.+�
VI
P T'
TICKET# ORDER'#
TRUCK# LOAD SIZE
MI% '-.
SLUMP
�C�TE
1rLt3'
;, 853023' c
86."
it 4=LO:-`0
1'37500"RE07.48:`=
:r4 00 `�j^=r03F03/+15
CUSTOMER#
SOLDTO -
p0.4
PROJECT# AI'` e.'`7'+
677't..' ',, e
!,RF, CONCRETE';CONSTRUC.TDraN%;;INC a
'c:.;m ..t o „f„
„„^u tt !1'22901F 7
DELIVERY ADDRESS
ZONE#
USE
gRIVER -
R1A '=`Cheraidbllf-FLdeed' Stid i'Eyti'I W'---''1STLUCRE•
-
'= SLABS("
7 {iei'tf7-G'iiitroti`
INSTRUCTIONS "' t -•'117.- - -,�
Y
TIME DUE '-
�
FPs
ioG?26 AM
#
10.00
30 00
40:'0b
" 35045480.
11 35fc1J� R�E�
yd
1.00
0:00
ENV IRO
LINO-RONNENTAL DI
PO ea
1.00
'0.00
2 -
FUEL SURCHARGE
ea
GNATURE
WARNING
ORRECEIPT- CONCRETE
AND ACKNOWLEDGEMENT
OF HAZARD
any prope y amage or any
Mascrupega oncFle ompany will not assume, [jab! I oSUB-TOTAL
Mma"WrMequipme f r eliverles beyond the curb1g1I
AUTHORIZED BY TAX
SHIPMENT SUBJECT TO CONDITIONS ON REVERSE SIDE. TOTAL
'
;'t
h
y
1142 Water Tower Road, Lake Park FL 93;403'
-®9 Office:t-877-48494 / Fax: 561-844-710'2
South East Florida Division Dispatch: 561-844-9994 / Central Florida Division Dispatch: 407-339-5311
r
746215
Concrete Tested ❑ Yes ❑ No FLOT # _
Water Added at Cuspomer's
equest `
Cylinders Taken ❑Yes No
,;,
gals 4to full load
Comments
gals. to 2/3 load
gals: tcQ1/3 load
{LY 11JVa-1. 1 RVVI\.
Y
mee Re WaterA bR �
NOT RESPONSIBLE FOR
WARNING [WITATION TO THE SKIN AND EYES
ADDITIONAL ADDED".�OM1`YNYS:
VARIgTION.IN COLOR,OR_
'Cement poly(geT or,ireshly mlxao cohcrete may,caus0 skid injury,QvoiG contact with„
skin and'Wash exposed slan areas'pronlptly with'water It -any cement powtler`or
CONCRETE:WILL AEDUCE ITS 1.
�TRENGTR
SURFACE U1S_COLORATION-
... ..
mixture getsdntc eyes, nose immediately. and repeatedly with�water,anil get prompt,
- medical attention. Keep" childreir�'awatf fr6m'cement"powderand all'freshty, mixed
. AND, DURABILITY i�NY>_WATER �, DDED IS
BATr�H TIME a r
AT 6_1S N SOWN RI lell
'-
7 AM 5
cement products. 7
?JVI061uv
Joto •Benin Pour
a 1
✓VSO� t"j-� ,;1 3CJ 18li: Pv�tt '�Y11T2"ti7-�iE
kriff it
PLANT
TICKET# ORDER#
TRUCK#
LAD E
MIX SLUMP
DATE
103
8530c^^4 li '-86 '
g76r
rt'4t.1'0'4'
3500r RE5/' 48
4�+00
03/109/ T5
CUSTOMER#
SOL0T0
P.O.#
PROJECT# .
677" v °
` "''F2F' GOIVCf2ETE'" [701J81 RLJCi I'OIV"'IINb ^
r, : t I.: r u
�.� +,'1E290 .
DELIVERY ADDRESS -
ZONE#
USE
DRIVER '-
ArrR'= Cl'em`rcal`` Feed'=Stt'on W'''"`'STLUG'IE+'-'
d
" ' SLABS" '
"Led'flc'osta"
[:+ .. u�x> �:..: TIME DUE a.
INSTRUCTIONS
.lea _• 1ir % i� -Y , ti 'y_\. 1,. ,. -L ti,... .,.t;G s¢. ;y �. !' .19
Ft�' w .Just be'f'o`re `Navy+ Se`aY Muse°ifm" 6';.v7 AM
PRODUCT CODE
PRODUCT DESCRIPTION
U.O.M..
kill
40.00
40.00
3504548003500
REG-
yd
71:
0.00
ENVIRO
:.EN IRO ENTAL DI
PO ea
0.00
2
FUEL SURCHARGE
ea
l
SIGNATURE
OR RECEIPT- CONCRETE
AND ACKNOWLEDGEMENT
OF HAZARD
WARNING
asc me Conerate company will not assume liability t(?r any prope amage or any
SUB -TOTAL
ip end. a for any deliveries beyond the curb line.
TAX
- AImwRIZED_er
tiHI.HMLN I bUWtU I I U UUNUI I IUNZ; VIN HCVMMOM JIVC.
1142 Water Tower Road, Lake, Park FL 834031.
Office:1-877-484-9994 / Fax:561-844-7102
• South East Florida Division Dispatch: 561-844-9994 / Central Florida Division Dispatch: 407-339-5311
N
146218
Concrete Tested Yes ❑ No LOT #
Water Added at Customer's
Cylinders Taken Yes ❑ No'
, - Request
Comments _
- qajis�. to full oad
gals. to 2/31load-
Is.
gato 1/3 load
',1-
•
m6fs Re - Water Added
NOT RESPONSIBLE FOR
WARNING'' IRRITATION TO THE SKIN AND EYES ADDITIONAL R ADDED TO THIS
- VARIATION IN COLOR,OR
Cerpent polymer or freshly-mixed,opncrete may cause slue Inlury Ayoid contact witp„
SUtiFACE D'ISCOL'OF1141
; skin and1wastr exposed skin areas promptly with water If-any'cem'ent-poWder or' ` CONCRETE WILUREDUCE ITSISTRENGTH
- mixture gets into eyyes, nnse Immediately -and repeatedly;with,water.and. get prompt - b -AND, DURABILITY ANY WATER:ADDED IS
lnedldal'attentlon:'Keep'children away from'cement freshly -ANYiWAT
D
powder'and all mixed' pT CU'ISK.
cement Products IidStu., R.,
L.
Load To Job
�, rf f
JG.+ta "a.; i1 �i", ,�.. :it•_ :, 1�.. ;�s' ,� n r ]:. f..N ,i'] •:'
.;siP F' •(1':
PLANT
ICKET# ORDER#
TRUfiKk
LOAD SIZE
MI% SLUMP
DATE
103
853027'C
�f36%°''
" 3 �7
c 00"'
'3512fW1 RECi/' ,48•' `
4 `00 '
' it "t03/09/ 15
CUSTOMER
SOLDTO -�- _ _-_ _ - -
P O. k
PROJECTp
677 • ; '
'=-)R�-CONCktETE{ C-ONSTRUG-TI-ON INC
DELIVERY ADDRESS
ZONEa -
USE
DRIVER
FifR =f Gheai•Tea'TSF�eii' Statinri' "'W" "'
STLUCIE,•
SLABS'"''W'i1Iiam"Ri%o's''
INSTRUCTIONS'..::
TIME DUE,
^FP,I. c.:jgss 6efot e''Na5ytl�S aI Museuinl>•", nt .. .,'r
r>
&:'S4 AM
01111111111111111111
2.06
42.00
42.00
35045480
3500 RAG,
yd
1.00
0.60
ENVIRO
-ENVIRONMENTAL DI
PO ea
1.00
0.00
2
FUEL SURCHARGE
ea
SIGNATURE
WARNING
OR RECEIPT -CONC
AND ACKNOWLEDGEMENT
OF HAZARD
asc meyer 4apyrere any win not assume uabiuty, for any property damage or any
SUB.TOTAlz"
eq ment ge fo any d lea beyond the curb line.
TAX
-
fix AUTHORIZED BY :
SHIPMENT SUWECfT TO CONDITIONS ON REVERSE SIDE. TOTAL
v _.