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Home My WebLink AboutInspection Docs (2) `ecamcx 5 7 4 251 �� Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: Customer Job Number: Order Code I Date: J Project Code: Project Name: Project P.O.Number: Order P.O.Number: Ticket Date: Delivery Address: Map Page: Map/Row/Column: Delivery Instructions: Dispatcher: Ticket Number: Due On Job: Slump: Truck Number: Driver Number: Driver Name: End Use: LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT QUANTITY QUANTITY QUANTITY J T 14'p— r) J Cash Check# Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Check Without Standby Charges: Charge Comments: WATEkADDED:-GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: ' ' SIGNATURE '- El 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 guarantee d:'�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 handling infompation;and to tF e,material.gafety 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 C"i CUSTOMER J,1, 1 This Delivery Ticket incorporates herein by reference Buyer's.previously executed Credit Application, .if any, Seller's Standard Terms and Conditions,Seller's Que in,if any,and Seller's Order Confirmath ncluding limitations of warranties),as if fully set forth on this Delivery Ticket("A,--ment").Seller will provide the Standard .-..ns and Conditions upon 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 /FLS' 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, 4nd 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:.'riiling may contain silica,which-may-cause silicosis and cancer if inhaled. If ingested,keep 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 protective clothing. Wash hands thoroughly with mild soap and water 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 wet cement contacts skin,rinse thoroughly with water.Get proper medical attention if irritation persists. CEMEX,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 comp referencia al comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier termino estdndar, condiciones del vendedor, propuestas del vendedor y orden de confirrnaci6n del vendedor (con limitations y garantfas),como acuerdo total del-ticket de entrega("Contrato").El vendedor proveera los terminos estdndares y cond.ic.iones detal- lados en caso de asf ser requeridos.Con este documento,el comprador acepta los mismos ya antes mencionad.os y que las cantidades y materiales fucron eritregados como se expresa en el mismo.Acepta pagar el monto de acuerdo al contrato; al menos que se identi- fique con una nota al 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, Brava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albaflilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de concreto 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 cual_puede contener nnas de 0.025% de silicio cristalino. -CUIPADO! Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos,quemaduras en piel y ojos,y reacciones alergicas en la piel.Conereto seco y polvo de agregados,pueden causar irritaci6n en los Ojos,piel y/o en la zona respiratoria.Polvo del manejo en el trituramiento,pulid.o,torte y/o perforaci6n puede contener materiales silicos,los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,mantenerse en temperatura edlida,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 toser, irritaci6n o quemaduras en la nariz,garganta y pulmones.Acudir inmediatamente al medico. EI riesgo en la salud depende en la duraci6n y el nivel de la exposici6n. Seguridad: Evite el contacto con ojos y contacto prolongado con la piel.Use guantes,protecci6n en los ojos y ropy Primeros adecuada para protecci6n.Ldvese]as manos con jab6n suave y agua despues del manejo de materiales.Evite inhalar auxilios• polvos. Si se expone a polvos mas de los limites recomendados,use protecei6n 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 fondo con agua.Acuda a atenci6n m6dica inmediatamente si la irritaci6n continda. CEMEX,Memorial Hermann Tower 929 Gessner,Suite 1900 V7 combinado Houston,Texas 77024 02/12 Para mas informaci6n visita www.cemexusa.com.