HomeMy WebLinkAboutInspection Docs (2) 1 ,
At il�I. � { � tlki sub ii f
4
1142 Water Tower Road, Lake Park FL 33403 It
Office:1-877-484-9994 / Fax:561-844-7102 757279
South East Florida Division Dispatch:561-844-9994 / Central Florida Division Dispatch:407-339-5311
Concrete Tested ❑Yes ❑NoLOT# 1 Water Added at Customer's
Cylinders Taken ❑Yes F-1No / �) -- QS !) �.� Request ¢
Comments r�' gals.to full load
_ gals.to 2/3 load f
gals.to 1/3 load
Customer's Rep-Water Added
NOT RESPONSIBLE FOR WARNING IRRITATION TO THE SKIN AND EYES ADDITIONAL WATER ADDED TO THIS
VARIATION IN COLOR OR Cement polymer or freshly mixed concrete may cause skin injury.Avoid contact with
"'IRFACE DISCOLORATION skin and wash exposed skin areas promptly with water. If any cement powder or CONCRETE WILL REDUCE ITS STRENGTH
mixture gets into eyes,rinse immediately and repeatedly with water and get prompt AND DURABILITY.ANY WATER ADDED IS
TIME medical f attention. Keep children away from cement'powder and all freshly mixed cement products. AT CUSTOMER'S OWN RISK. .
PLANT TICKET# ORDER# TRUCK#I'LO_AD SIZE MIX SLUMP DATE
.`':.��i l..'!- i1• ' I/7 ' it - �. `r'}< ;it t +I'?1 '; ti. "'Wi l•7�,,,'�,:,`.'i. 4
CUSTOMER# SOlDTO _ P.O.7t PROJECT#
DELIVERY ADDRESS USE RIVERZONE#
I
. .. f i'i.:iJi Ir i t't .I � r' .. .I Y..t'- r� i - t-i i• .'!P .. .:4. 'r.�.?t)
INSTRUCTIONS TIME DUE
LOAD CUMULATIVE ORDERED PRODUCT CODE PRODUCT DESCRIPTION U.O.M. =UNIT PRICE 0 1 kil
QUANTITY QUANTITY QUANTITY
.r �r1_� f`i, 'lit�i :I^i••' 'i'f:.. .-. I
II
ry yl
SIGNATURE OR RECEIPT CONCRETE.At,D ACKNOWLEDGEMENT OF HAZARD WARNING"
maschmeyerL-CorTcrele Company will not assume 11513111ty for any property damage or any SUB-TOTAL II
equipment damage4or Any deliveries beyond the curb line.
I �✓` 1; TAX
SHIPMENT SUBJECT TO CONpITIONS ON REVERSE SIDE.
BY
{ TOTAL
,. , � -, '- � . .. �:C.. :i: "i'`1'," r y t a t'I r •r Ly. ,rY' !:7r
1.,1•I
� c ,.. .,., . :., .. .•, -, _• .i: ,._:_�: ,.,`. .:;� �.. .•,.d.:.,+;' � .....• , .... �F.a: . .4 .. ult,.li;aau, tf t,. ..� .L:} ,. .n.
.. , � � .. , � t � � .� � J ,... , � i' t �- ,. � , ..tet .. . .i I .•_ ,
I
1
I , q
I