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"The On Time Concrete Company"° � 7 — D j EY
CENTRAL CONCRETE SUPERMIX, INC. n, nr ;�� , a , ,
-l? CONCRETE DISPATCHERS: r , i �' �' ! l j { #+ I it's f��l(� � si
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South Dispatch: (305)264-7101
North Dispatch: (561)826-9364 CUSTOMER NO. DELIVERY TICKET DATE
Block Dispatch: (305)805-3226
WWW.SUPERMIX.COM
MAIN OFFICE: 4300 S.W. 74th Ave. - Miami, FL 33155 I : ; :; I• ; :,. ;.i,; t ;-,,. ; 3 r
PHONE: (305) 262-3250 - FAX: (305) 267-0698
SERVING MIAMI-DADE, BROWARD, PALM BEACH, MARTIN & ST. LUCIE COUNTIES
SOLD TO DELIVERY ADDRESS
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QUANTITY ITEM DESCRIPTION UNIT PRICE EXTENSION
,,. a'� •,�•., '�'I, .11;:I .'''I:,:,<.1i. int;` _�,i �'��:, � -
MINUTES ALLOWABLE TIME' PER MINUTE
EXTRA UNLOADING TIME CHARGE _ = X$1.00 =
*6 MINUTES PER CU. YD. ALLOWED SHORT LOAD CHARGE y
SLUMP AMOUNT
THIS DELIVERY TOTAL ,.'t CU. YDS.
OF YOUR ORDER FOR, t"-s '':l', CU. YDS. TAX
CUSTOMER OR HIS AGENTASSUMES FULL RESPONSIBILITY FOR STRENGTH AND/OR
PERFORMANCE OF ANY CONCRETE PLACED ABOVE DESIGN SLUMP OR WHEN •
WATER IS ADDED. WATER ADDED ❑ YES ❑ NO GLS.
TIME ARRIVED ON JOB STARTED UNLOADINGFINISHED f__ UNLOADING LEAVING THIS JOB TOTAL TIME
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SUBJECT TO THE TERMS, CONDITIONS AND 'CAUTION"WARNING LISTED ON BOTH THE
FRONT AND BACK OF THIS TICKET.
TRUCK DRIVER I acknowledge that I have received and accepted the materials listed on this ticket. I
understand and agree to the terms onnbbolh the front and•back-of4 this ticket.
RECEIVED BY: X
CONTROL 21 LOADING POINTS AT 16 LOCATIONS TO SERVE YOU BETTER
[OWrMIAMI
fW I ! IBROWARD EDI
DEERFIELDBOCA RATON•RIVIERA BEACH I STUART W. FTPIERCE E.BROWARD-DE RAY l/14' �I 12L C
PRODUCERS AND SUPPLIERS OF QUALITY READY MIXED CONCRETE AND CONCRETE BLOCK NRMCA
DELIVERY COPY ^z',"—
CA TIONH FRESHLY MIXED CEMENT, MORTAR, CONCRETE OR
GROUT MAY CAUSE SKIN INJURY AVOID CONTACT WITH EYES WHERE
POSSIBLE ANIS WASH EXPOSED SKIN AREAS PROMPTLY WITH WATER..
IF ANY CEMENT MIXTURES CET INTO EYES, RINSE IMMEDIATELY AND
REPEATEDLY WITH WATER AND GET PROMPT MEDICAL TREATMENT
SAWING, OR GRINDING OF CONCRETE MASONRY UNITS MAY RESULT
IN THE RELEASE OF DUST PARTICLES WHICH, WITHOUT THE USE OF
PROPER EYE OR RESPIRATORY PROTECTION, COULD CAUSE EYE OR
NOSE IRRITATION. THE MATERIAL SAFETY DATA-SHEETS FOR THE
PRODUCTS SOLD BY CENTRAL CONCRETE SUPERMIX, INC. ARE
AVAILABLE UPON REQUEST
UNLOADING DRIVERS ARE PROHIBITED FROM DELIVERING
CONGR.E-TE EXCEPT UNQEiR. THE TRUCK'S OWN POINER, AND WHERE
SITE° ONDITIONS PED" fHE SAFE AND PROPEL OPERATION OF HIS
EQUIPMENT: DRIVERS ARE NOT PERMITTED TO ADD WATER TO THE
MIX hNa' IR TO GO BEYOND THE C-URB LINE, EXCEPT UPON THE
AUT CrRIZATION OF THE PURCHASED/PURCHASER'S AGENTAND HIS
ACCEPTANCE OF RISK FOR ANY LOSS OR DAMAGE.
BUYER, OR HIS AGENT, AGREES TO ASSUME RESPONSIBILITY FOR
CONCRETE, ANIS ANY PROPERTY DAMAGE RESULTING FROM TRUCK
MAKING DELIVERY BEYOND CURB LINE. ALL CLAIMS U T BE [WADE
T Tff4WFGF DELIVERY.
IF IT ltOMES .NECESSARY TO .BRING .ANY ACTION TO COLLECT
AMOti DUE ON THIS INVOICE, PURCHASER SHALL BE RESPONSIBLE
FOR REASONABLE ATTORNEYS FEES ANIS COURT COSTS INCURRED
BY VENDOR IN SECURING COLLECTIONS. INTEREST SHALL ACCRUE
AT 1 1/2% PER MONTH ON OUTSTANDING BALANCES.
is The On Time Concrete Company
CENTRAL CONCRETE SUPERMIX, INC.
-1 T CONCRETE DISPATCHERS:
South Dispatch: (305)264-7101
North Dispatch: (561)826-9364 CUSTOMER NO. DELIVERY TICKET DATE
Block Dispatch: (305)805-3226
WWW.SUPERMIX.COM
MAIN-OFFICE: 4300 S.W. 74th Ave. • Miami, FL 33155
PHONE: (305) 262-3250 • FAX: (305) 267-0698
SERVING MIAMI-DADE, BROWARD, PALM BEACH, MARTIN & ST LUCIE COUNTIES '
SOLD TO `_ DELIVERY ADDRESS
t;6�.'1`; I,,.f{,'i.l'; i,_..k, f 'r`I ' ' ,. if.. '.�i+l`. 'I`,•1',i
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�.,f'.I' FOU ' i-�,.t-il�3-_ I'::-I." i 1 �... t •s'
QUANTITY ITEM DESCRIPTION UNIT PRICE EXTENSION
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EXTRA UNLOADING MINUTES _ ALLOWABLETIME' — PER MINUTE — J
-TIME X$1.00
*6 MINUTES PER CU. YD. ALLOWED SHORT LOAD CHARGE* f
SLUMP
THIS DELIVERY TOTAL ; ,"I., i?Is'r CU. YDS. AMOUNT
OF YOUR ORDER FOR '_`' CU. YDS./ TAX rr
r
r
CUSTOMER OR HIS AGENT ASSUMES,FULL RESPONSIBILITY,FOR STRENGTH AND/OR"
PERFORMANCE OF ANY CONCRETES LACED ABOVE DESIGN S P OR WHEN •
WATER IS ADDED. WATER ADDED Q,YES IDNO GLS.
TIME ARRIVED ON JOB" STARTED UNLOADING FINISHED'UNLOADING LEAVING THIS JOB "'TOTAL TIME
SUBJECT TO THE TERMS, CONDITIONS AND `CAUTION"WARNING LISTED ON BOTH THE
FRONT AND-BACK OF THIS TICKET. 33
TRUCK DRIVER I acknowledge.that I have received and accepted trha
he terials listed on this ticket. I
�. understand and agree to the terms on both he frorf and;d`ack of th satticKe'.t'. 1;�0 ST P,?
tt::i,-•r^; { _�t�it, 1 -i - RECEIVED BY: X
CONTROL 21 LOADING POINTS AT 16 LOCATIONS TO SERVE YOU BETTER
j} _ (� SOA C�N�P MIAMI•DOWNTOWN MIAMI•WEST MIAMI-AIRPORT•OPA-LOCKA•MEDLEY•PERRINE•PEMBROKE PINES
14' ` c� V �4 DEERFIELD•BOCA RATON•RIVIERA BEACH•STUART•W.BROWARD•FT.PIERCE•E.BROWARD•DELRAY (
�,�' PRODUCERS AND SUPPLIERS OF QUALITY READY MIXED CONCRETE AND CONCRETE BLOCK
NRMCA
DELIVERY COPY �,�,
it"amit"- MOVAMONTAM alto
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Planning &Development Services
Building &Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #:j, r/Q-0.3 9'l JOB ADDRESS: 5'-Cas— , are"' pr Ar Ae-'-� 2V�gZ
BUILDER/CONTRACTOR:
PEST CONTROL CONTRACTOR: Co osrr/ CST" Co„ tn�P
PEST CONTROL LICENSE #: �-'C>C 5”
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: 0, 067 Total gallons used: 2 G
Date of Treatment: �0�2 Y//S-- Time of Treatment: 7 �
Footing Slab
1St Treatment 1st Treatment
Re-Treat Re-Treat
Driveway Pools
1"Treatment 1st Treatment
Re-Treat Re-Treat
Other Perimeter for Final Inspection
1st Treatment
Re-Treat
Signature of Exterminator Date
Note. There must be a completed form for each required treatment or re-treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re-inspection
fee charged.
FBC104.2.6 Certificate of Protective Treatment for prevention of termites. A weather resistantjobsite posting board
shall be provided to receive duplicate Treatment Certificates as each required protective treatment IS completed,
providing a copy for the person the permit is issued to and another copy for the building permit files The Treatment
Certificate shall provide the product used, identity of the applicator, time and date of the treatment,site location, area
treated, chemical used,percent concentration and number of gallons used, to establish a verifab/e record of
protective treatment. If the soll chemical barrier method for termite prevention is used, final exterior treatment shall
be completed prior to final building approval.
St Lucie County requires for the final inspection for CO,a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014