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HomeMy WebLinkAboutInspection Docs I I+ W ' - ) 11 1, +�1+ 4i6�:I�ll. J&A C� 1142 Water Tower Road, Lake Park FL 33403 Office: 1-877-484-9994 / Fax:561-844-7102.. South East Florida Division Dispatch:561-844-9994 / Central Florida Division Dispatch:407-339-5311- Concrete Tested O Yes O No LOT# j (�/ - Water Added at Customer's Cylinders Taken O Yes O No l 0 7 6 7 t Request Comments gals. to full load gals. to 2/3 load 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 SURFACE 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 BATCH TIME w medical attention. Keep children away from cement powder and all freshly mixed cement products. AT CUSTOMER'S OWN RISK. -72 U 17M PLANTTICKET# ORDER# TRUCK# LOAD SIZE MIX SLUMP DATE CUSTOMER# SOLDTO P.O.# PROJECT# DELIVERY ADDRESS ZONE# USE DRIVER INSTRUCTIONS TIME DUE ORDERED ! ! QUANTITY SIGNATURE OR RECEIPT-CONCRETE AND ACKNOWLEDGEMENT OF HAZARD WARNING TE-1,117:4-.11111 asc meyer concrete company will not assume is i ity or any property amage or any SUB-TOTAL equipment damage for any deliveries beyond the curb line. TAX AUTHORIZED BY SHIPMENT SUBJECT TO CONDITIONS ON REVERSE SIDE. TOTAL S)MIL Y..,nrov-id'� Uiable "OF 0341u ' from, he street pavement V.)inn,p Ice t)#° ,V',:il,Wery of i i3Wris3';. oeliverie s until conditions are remediLo=iris, in su,.V: . wig s. . . .�° ,.:t .`'IF!,57 .% r)o.C...`a+:.. ;.Ji iar��/ ....)ss`'4usp t(�!4�•2'�e-'-1. oven Ave =: r., o�: `�• �t�;re C rrt €r t}S vf�t�r tlrr' � �'1 i request,any darner es i?cii icing. E V tc .^,it .?� i.��Y ei C ;rte .;S..iEVr'z.i+`c�S :.$e J', W?t;�' },... :%Id', ,.a ^;t C'.ti'1 , i`,t,ddi gs, `:r ?S, St"rULV sry, septic tai?ks and SepOc ysle,-s, including 1h- CliF, , t :' - Itiy tS� 3�tr1e arC1q1ECtre`t by reason or such o es K:ry, -. X11."•=z+i`.1 to ;'_i ,+ i;•;i!. _u •?;`, riarnOs sod Viorn any and a!i^,iairns,C2eS7i;✓.nds and sugs for or On accoimt o Cir In M?!'v r"."`.�';."' rkriau'F. 'J:07 ,:r ai 7 '?ir(,,i ','�1°�i�.ata,,,. is`r".fi�"r`I(:3 6.-:,':very 1 _ ti ;c 1- ;�`h�t t� Mai d �: .<, td c 'cw'sh v,n nave been 3 tat ru k Imes s showr.�awn fii .. 5.t ;"e7� .(+� � :�,.h'a _. {j �,:e�VV(ks*��,t t. a � p t �c s;:'t, an e ...�110 ..;�1'0"'. ........ '.A�.tt; ad t+.. J:&' +;2�3 i�.J11.',}ir '� .��.�i.i'C:��`f i-s shown corre--tiy. �Jf'0#J�3\. -`,,, . I4i'ie addticfi 011-nmer ti i nt j c.r;[sr tv Viiia nn :t, bt 2 d 6 i Sn eye rt °;4 3,,; €, �. =�'y .a ��:f 1�t � �l r��il,ad=� � €.b`. .cd., rr�th��t�a�of^oricr6 t�,irsas�y€mac,<af �factors,af�r�ct:r., e�#a:�r�te `a'..r....i }.f.ti' 'vC.";T..`.r..,,!�' L i�''_. .,ejF£)? d ^...:s�Ei Gt rE-.s,,-!nsibifty and uC3'r voL 5 A Yme of FACIJ nil"uies par cubic yard unloading t me is Exceeded, .. .:�ter e e ',at? ,.,`n : Wil o �;','a_r_,lolash dcvvn facii''ty!Mr our trucks Fzno tools at the,place of doiNfery of m teriai. 'R`,r.;customs`'''� �: `:)t �a'_�r"�_%:;;i ous and expenses of co" lwion,including a rer`3sonable Wtorney s tee, if he S%"O I .IaO ;gay fc r � ,me?c iaildise re.!ac""t a s this it vo c ,when cNe. lest€ue accounts are subject to 1-1/22%o ser ice ,:$a or the d 0d zast due ba!u ,,t:.The customer hereby acknowledges receipt of the complete copy of this cantra'.t. , . 1142 Water Tower Road Lake Park FL 33403 r �' Office:1-877-484-9994 / Fax:5f;1=844-7102 75 6.�99 l(�� South East Florida Division Dispatch:.561-844-9994 / Central Florida Division Dispatch:407,-339=5311 3 sr,`t�',; ¢"?'E lsl+l;o;1!'` I ^' ;'il'+'�4 Ijl"inn` Dr,:I It _Ii i�W,i., Concrete Tested ElYes ❑No LOT#,. sill!?!; {1 �({!Water A�3dec�'�tl Custo �c's' ' Cylinders Taken ❑Yes ❑No �� �� J " (Request .a+ gals.to full load ^nrnments (, gals.to 2/3 load a't gals.to 1/3 load ;,-,; �r 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 SURFACE DISCOLORATION skin.and wash exposed skin areas promptly with water. If any cement powder or CONCRETE WILL REDUCE ITS STRENGTH mixtu're,gets into eyes, rinse immediately and repeatedly with water and get prompt AND DURABILITY.ANY WATER ADDED IS :H TIME medical attention. Keep children away from cement powder and all freshly mixed AT CUSTOMER'S OWN RISK. I A „ ! .i cement products. NT TICKET# ORDER# TRUttCK# LOAD SIZE MIX SLUMP DATE j i:i r 1 TOMER# SOLDTO P.O.# PROJECT# VERY ADDRESS ZONE# USE DRIVER RUCTIONS TIME DUE r::�`�. ' , Pii l,�,�„ . ,- '., ._ /.- .:a!%!i:3l,.r,' •�;k'.I Yip.'. ;-'f -i " ' SIGNATURE OR RECEIPT-CONCRETE AND ACKNOWLEDGEMENT OF HAZARD WARNING asc meyer oncrete ompany Will,not assume liability for any property damage or any SUB-TOTAL • ecjpipment damage for any deliveries beyond the curb line. TAX t' AUTHORIZED BY SHIPMENT SUBJECT TO CONDITIONS ON REVERSE SIDE. TOTAL THIS UES.#1iEs-, .�l�AU�l1��3 vstorner ree.s to p+ vides L#tta rt7 C!, C Cr! P ik !t such.suitable read + s area W rovid6d, ► , ' ns i, ' eL'on ,(-Usf)T,ler Wil %3 TP�t� r �tSl l tC3 l lt�"i 1 1. �• 2 1 pan delljviry s made beyond,, €rte€gr a the cu esti; ny€a( {'it not lm, Atty�'C, sp�eviyCI.kp , (i�r� ,tr ,amu ' � s�rs , , MOW n �y� ,.�Geld are at the owner's hs�J . i, s tY *,• + r cu Morn. agree:s t reg b� sand� nY fi_ t rr��� rr r:tt dsaw h rr ss. Company frorn an � � fVV nr oft 1'ri 3mer{: ! try ors �a#!1C�from,private drive�t'r��( `s,=' �. _ �, xrt Y.r'rY 14i f 1 '�5�V k"", KS 4 Cfsstortlar knovVileadgestha*lnaterialand serve f�r�# w e r�nt thattrut ct�` ih t the" unt crf'water ad SAt th:e ousiprfiP r *fit o�crew s enc th an kqy v a a pqv a• 4 S' S F, ro+ ✓+ k�(✓S�'fM�}t,� + i rig , s 't , te ire r �spons #e3 t � rhed retrEts c�ata�tts CUdiit, tlf t completed job are our Sepe<'C3 s #, ° i f. �p�,! IS 3 erg df i.''J per minute=will be charged aft s 8 pumubju}` mg Ume is 6XIO tiec E -4 ,R Th cu torr r agre�e~s.to provide a sesta b}e dvash''a bks r :toofs et t�p#tet ti' N3 r The ct�iaror here b°° r to a all costs and ex Y r Wit,incl too a Cason bl� r9 � pay , �� _ fit►rti a r tt� r erchan ref�acaat in't is.r vii r d t-M bre suit ' bar e(A e u pa _pbalance,"t"`hOt s� ��t�sfiho w <t ' • �`. r �.✓( r� '�t rd e V x ��5rY 1 �ti. J .�x�Rr r�� �a� ✓r PRc k� r# - y ✓fi3 1'7s` i s Ew s ri� 4 SF COMPANY OF FLORIDA,IN [ , ei,�i.� � -. <F }#� ��fl�'. a� "�� r.� v. �-•- fir" *cz�. a :z � r - s 't�s-�#' '�- + � � t 3 ><' `x. 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