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Home My WebLink AboutInspection Docs I! L 5 7 ZZCC_MC_X ;; � - JOT Plant: Begin Loadi!1g: To Job: ArrIv7eJo7 E- ] Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: Customer Job Number: Order Code Date: �,r6lect Na.r�b�.)i 1i Project P.O.Number: i5rder P.O.Num6eP� c. �A _"A'1%! Ticket Date: Delivery Address: Ma -e Map/Row/Column: vely 1pstruct ons: ....9_ , 1'F"T P Z Q X,r_� Dispatcher: r -7 'T r� o j*) ficket%Ael 3.3, Due On Job: Slump: Truck Number: Driver Number: Driver Name: End Use: J. LOAD CUMULATIVE ORDERED PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT QUANTITY QUANTITY QUANTITY MATERIAL CODE _G/F 1'!L 7 rl H` T('1 L.`Hi- ]5 E F)V E vj IJ 3t' 1 RljlT-1.F i Niol_ 1.'HCUYEKU'413 ILL, 2 G tr 1 1 Cash Check#1 Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Without Standby Charges: Check Comments: WATER ADDED: %' GAL YARDS IN DRUM—) WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: r,r JIf. SIGNATURE P,P F,7 1�,�l F U L 1 1", L_ D R,D S. 11 LOAD WAS TESTED BY: Notice: Our drivers will make every effort to place materials where the customer designates,but the SPECIAL TERMS: Any water-added is at customers own risk. If water is added on job,concrete strength Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material terms of sale 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 control after delivery,this Company will not accept any responsibility for the finished results. No credit for safety handlli_tJ information,and tDthe material safety data sheets for additional Information. returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE: within one business day after the receipt of materials. 68UNIVERSAL INVOICE This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any. Seller's Standard Terms and Conditions,Seller's Quotati< any,and Seller's Order Confirmation (in( no limitat4,)ns of warranties), as if fully set forth on this Delivery Ticket("Agree it").Seller will provide the Standard Term: Conditions upotr request.Buyer agrees that,unless otherwise noted on the front hereof,all quantities and items were delivered as indicated and further expressly agrees to pay in accordance with the Agreement. AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH Aggregate products are naturally occurring materials including limestone,dolomite,granite,volcanic rock,sand,gravel,and other siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete products include Portland cement and aggregate products including limestone,dolomite,granite,volcanic rock,sand,gravel,and other siliceous materials.These products,including fly ash,may contain more than 0.025% crystalline silica. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation,skin and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes,skin,and/or respiratory tract.Dust from handling. crushing, grinding,cutting and/or drilling may contain silica,which may cause silicosis and cancer if inhaled. If ingested,]seep warm.at rest,and drink large amounts of water.Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or burns of the.nose,throat and lungs. See physician.Health risk depends on duration and level of exposure. Safety: Avoid contact with eyes and prolonged contact with skin.Wear gloves,eye protection,and appropriate 1 irotect.ive clothing. Wash hands thoroughly with mild soap and minter after handling. Avoid breathing dust. If exposed to dust above recommended limits (see MSDS),wear suitable NIOSH-approved respiratory protection. First Aid: In case of eye contact,immediately flush eyes with flowing water for 15 minutes.If dust is inhaled,move to fresh air. If covet cement contacts slain,rinse thoroughly with water.Get proper medical attention if irritation persists. CE.MEX,Memorial Hermann Tower 929 Gessner,Suite 1900 V7 combined Houston,Texas 77024 02/12 For more information please visit www.cemexusa.com. Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en su aplicaci6n de credito); cualquier termino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y garantfas),como acuerdo total del ticket de entrega("Contrato").El vendedor proveerd los terminos estandares y ,condiciones detal- lados en caro de asf ser requeridos.Con este documento,el comprador acepta los mismos ya antes mencionados y que las cantidades y materiales fueron entregados como se expresa en el mismo.Acepta pagar el monto de acuerdo al contrato; a] menos que.se identi- fique con una nota a] frente de este documento. AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito,roca volcanica, arena, grava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albariilerfa, pozzolan (tipo 1P), azulejo de azotea y estuco. Los productos de conereto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito,roca volcanica,arena,grava,y otros materiales silicios.Estos productos incluyen cenizas volantes (fly ash) la oral puede contener Inas de 0.025% de silicio cristalino. ICUIDADO! Peligros: . Mezela de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y Ojos,y reacciones al6rgicas en ]a piel.Concreto Seco y polvo de agregados,pueden causar irritaci6n en los ojos.piel y/o ell la zona respiratoria.Polvo del manejo en el trituramiento, pulido,corte y/o perforaci6u puede contener materiales silicon, los cuales pueden causar silicosis pulmonar y cancer s.i son inhalados.En caro de ser-.ingeridos,mantenerse en temperatura calida,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contener amoniaco. Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toner, irritaci6n o quemaduras en la nariz,garganta y pulmones.Acudir inmediatamente al medico. El riesgo en la salud depende en la durac16n y el nivel de la exposici6n. Seguridad: Evite el contacto con ojos y contacto prolongado con .la piel.Use guantes,proteccion en los ojos y ropa Primeros adecuada para proteccion.Lavese]as manos con jabon suave y agua despu6s del manejo de materiales.Evite inlialar auxilios: polvos.Si se expone a polvos mas de los limites recomendados,use protecc16n respiratoria. Primeros auxilios: En caso de contacto en los ojos,inmediatamente fluya agua en la parte afectada por 15 minutos. Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fordo con agua.Acuda a atencion medica inmediatamente si ]a irritaci6n continua. CEMEX,Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston.Texas 77024 02/12 Para mas informaci6n visita www cemexusa.com. A-' � Planning &Development Services Building &Code Regulation Division F® i 2300 Virginia Ave _ Fort Pierce, FL 34982 772-462-2172 Fax 772-462-6443 CERTIFICATE OF TERMITE TREATMENT CONSTRUCTION SOIL TREATMENT PERMIT #: /S�7 O/U S-"JOB ADDRESS: BUILDER/CONTRACTOR: PEST CONTROL CONTRACT60' PEST CONTROL LICENSE #: <-(-)A --2— We, We, the undersigned, hereby certify that we have pretreated the above described construction for subterranean termites in accordance with the standards of the National Pest Control Association. Square feet if area treated: Chemicals used: & Percentage of solution: �, _ Total gallons used: c� Date of Treatment: 77A� Time of Treatment: J �00ti� g Slab, 1A Treatment 11/ Treatment Re-Treat Re-Treat Driveway Pools 1st Treatment 1st Treatment Re-Treat Re-Treat Other Pemeter for Fina spection 1�Treatment Re-Treat 4—dWA VAft?46 Sig ture of Exterminator -- Note: There J / m must be on the job site to be pitDate ai/and a re-inspection fee charged n r FBC104.2.E ❑ I nspectlon jobsite posting board shall be pros ' - ?nt is completed, providing a files The Treatment Certificate s � Treatment ent,site location, area treated, the ble record of protective ti ?Jl,d�3�/U2t�� ,_? terior treatment shall be complete 772m461 m6526 ' � - Organism Treated St Lucie C to be placed on the electr. t� :ions. SUNRISE PEST INC. Pesticide Used 2303 N. U.S. 1, STE., 11 FORT PIERCE, FL 34946 Tech