HomeMy WebLinkAboutCMEX PAPPERSI'e�� - OZl1
1. Did you doycurcbde Dfsefal
2 'Did youlden* hazards?
3 Did you use your goggles when at th
4 Did you use your safety cones?
S.Didyou mmrtxm�caleunsafe to
_PLW&*
.A vtEx
6GANNED
BY
F ;r t_ude County
,-
Cm.bnwrooae. cmrwrr Nwmw
3012688 CARRICK CONTRACTING :GRP
Pr*ctcoa Pmpd Name
Tidrpob DdWYAWrmt
09/2841S 14191 RANGE LINE ROP) INDIANTOWN
Dwwmvmbumwn
I
=5-8-92-93S$
CmwwwrJm Number CkdM Coda l Deb
1103 09/28/16
PmpdPO M EON ONVPO Nmbr
NO PO
map Pape IhyHO04com m
Dnpffbahar
GFanning
T¢bANunww
34636407
Due On Job Sup Truk Nw9w D NNmhw Dmer Name EWUaa
1c:07 5.00 -1-01723483 09023 VICTOR CRUZ UNASSIGNED
LDAO cQUANnLATrV DHC
BRomEn UITERULOODE PRODUCTM RO'rNI Ntm uNIrPmE AMOUNT
DIUMirll IUOIIANrm
10.00 20.00 20.01 15SI761 4000 REG
1.00 12478L8 FUEL SURCHARGE
1.00 1202749 ENVIRONMENTAL CHARGE
�
YeD3
jUnj A 2 2017
PERMITTING
St. Lucie County, FL
IMP28 ii+i5m
d = —I
OOnwwnb
PY WATER ADDED• GAL YARDS IN DRUM
WNENJDD£D.
6"O
-sIGwtTUM
CDRB-LINE CROSSED AT'OWNER5IAGENTS:RMUFST
CONCRETE DISPOSAL FEE
PARTIAL FULL LOAD _ YARDS Q LOAD WAS TESTED BY
T
Notim our dwan WA molm wary~ to ph= mdrmb when the mbnw. Nmgrwbmbut da SPECU.TETOIS AmyrywwNWl%ucuE nmQMnh Uwmeu maddtloapb.m/odeebwq
Cmmenyaar wrG5p0n5 *l brdwrw9bk Fade curb WM=ty Km Cum mrOpwm.btle. ambn2wour irdced. WARNSYO' Produdme'ymm WonalN6rbyeardarmn CAUIM Memel
IN,[ e of vela wd d&bMy mud a®pb. Mon m n' DW b npnWd helm lch we del OI as may bo hmmdaw m rear wf* and bmA FWn nlar b tlm heumUO of (a rrynm
mmpd dlwd* mv.dele Cme+mwclmt=cngwwrexonLt rwft Emhw Na roaeddfor a *wmdro udar�• and mtlme nuwd samy dah daft braddbm0qd5F~
SMIVERSAL PREV TRK: L00670Z 3
LOAD NUM: 2
E � -
S.0 !yvadoyou:c•eoM'sa" ye
2. D:d you Ids:r.i;.Y na:ards?
3. Cie you usP your goS�Ms Whon at &3 Puma?
g. Did you usD your sa,'ety canes?
CusYmner Code: Customer Nome.
3012688 CARRICK CONTRACTING CORP
Pooped Cafe: ProjectName:
Tkdwt Cate: Dehvery Address:
09/28/16 14191 RANGE LINE ROAD INDIAKTOWU
Dell uXtrldmns:
-5-8-9-2-a-3-8-
Cuslamer Jab Number.
Order Code/ Dale:
1103 09/28/16
ProjedP.O Number
ONa<P.D Number:
NO PO
Map Page: MaplRowlCdumo:
uspo:her
GFanning
Tided Number.
1-
34636149
Due On Joi :—Ir '
Slump -
Tr dt Number.
Driver Number
Driver Name-
-EndUW
11:15
5.00
100670331
108862
MARY. GORDON
UNASSIGNED
LOAD CUMUTATYE I ORDERED MATERIAL CODE CTON DESCRIf+710N UOY UNRPRICE AtlDUNT
QUANTITY QUANTITY QUANTITY
10. 00 10.00 19. 00 1581761 10006 R IV YD3
1.00 1247818 FUEL SURCHARGE
1.00 1202749 ENVIRONMENTAL CHARGE IISSEP281048Ah
Cash Choaflf Auth Codo. 3 Sglrmhae of Orver Rerelvlgg Cash. ,j1rmsh.ReaaWvA :_ ToteICOD OderAnwuolb Ooll.ct
Cham IMfteut8bndby1Chmf m:
Charge
Commanta•
WATER ADDED: GAL YARDS IN DRUM:
WHEN.ADDED.
SIGNATURE CURS LINE OWNER'SIAGENYS'REQUEST:
CONCRETE DISPO FEE smKINIIJKL
PARTIAL FULL LOAD YARDS 0LOAD WAS TESTED BY:
Notms Our,drwegwdU make euwy eFod m.,place(raramb MnreMm aXbmer.deefgrmms; but Tne 6PEGWLrfERM&?.fy m¢BCodrealeuabnlemromnr�r:'9laralar7amayaauseskln.aMPoreyadded an job, mnaete eVelgm
Gomparry+osamm.+nomaponei0iley�mr:dambgea inaNexurber ympefy lm6'Cuatomel egravaW the 'dnO bngorgueranteed ARNIXG ProMelmlatbn CALRWN: Molmal
terms of sale and delivery and accepts concrete as is. Due to Impodant fadom which are out of our may be hazardous toAfm safety and health. Plasm refer to the badsge of this Mau forxnporUnd
mmml after delivery.this Cemparry.11 rod socapiany remonsibllay for me ftnBhad results. Noaeddfor ty handlbg In n the materiel safety data sheets/or addamnW hdonamm
,veemretl mnaale '8vyars-ezmyfions-aud-daNssMalFbe-deerped Waned smote made to ue In W - E:
WMn one business day afterdle moaipt of metenels lie
eaUNIYERSAL PREV TRNt:
ORIGINAL LOAD NUM, 1