HomeMy WebLinkAboutInspection Docs CEMEX
i 5-o 7 (2 Z-/0
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:
— *1 k' -"ij
43 f I
%
Project Code: Project Name: Project P.O.Number. Order P.O.Number:
Ticket Date: Delivery Address: Map Page: MapiRow/Column:
Delivery Instructions: Dispatcher.,
17
0
Ticket Number:
----
Due On Job: Slump: Truck Number. Driver Number: Driver Name:Name: End Use:
C 1-3 0 Z L T 113 C-11 I-T'};:'i 0 TI-1,--t-,�'
J
LOAD CUMULATIVE ORDERED
QUANTITY QUANTITY QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION T U70M UNIT PRICE AMOUNT
A
i T
iE'i Is_
T A ,L C)--i GO—
:7 i
Nk- -j 01 7,
ICash Check#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Without Standby Charges:
Check
Charge
Comments:
14,
WATER ADDED: GAL YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
SIGNATURE
T-)S
Q 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 handling,inforrilaillon,and to the material safety data sheets for additional Information.
kreturned
concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE:
one business day after the receipt of materials.
IVERSAL
INVOICE
Phis Delivery Ticket incorporqs herein by reference Buyer's previously ecuted Credit Application, if any, Seller's Standard
-1*dd Terms and Conditions upon request.Buyer agrees
Perms and Conditions,Seller'Motation,if any,and Seller's Order Con ion(including limitations of warranties),as if fully
;et forth on this Delivery TickeTrAgreement").Seller will provide the Stan
,hat,unless otherwise noted on the front hereof,all quantities and items were delivered as indicated and further expressly agrees to
)ay in accordance-with the Agreement.
AGGREGATE MEMENT CONCRETE PRODUCTS /FLY ASH
Aggregate products are naturally occurring materials including limestone,dolomite,granite,volcanic rock,sand,gravel,and other
C, ti
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.
CAUTION!
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation,skin and eye bums 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 silicp
M, C) -sis-and cancer-if-inbaled-,
If ingested,keep warm,at rest,and drink large-amounts of-water.-Fly A§hmd-yc6ntain trace amounts of ammo-
nia.- Moisture can-cause-tlie—ammonia to bexeleased. Inhalation of ammonia can cause coughing and irritation
C�
or bums 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.cemexosa,com.
Este ticket de entrega incluye come, referencia al cornprador (ya previamente ejecutada en su aplicaci6n de,er6dito); cualquier
tdimino estAndar, condiciones del vendedor, propuestas del vendedor y Orden de confirmaci6n del vendedor (con limitaciones Y
garantfas),coma acuerdo total del ticket de entrega("Contrato").El vendedor proveerd los t6rminos est6ndares y condiciones detal-
lados en caso de asf ser requeridos.Con este documento,el comprador acepta los mismos ya-antes mencionados y que]as canticlades
y materiales fueron entregados corno se expresa ell el mismo.Acepta pagan el monto de acuerdo al C011tracto;a]rnenos 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, dolon-ata, granito,rota volc6nica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albagilerfa, pozzolan (tipo IP), azulejo de
azotea y estuco.Los productos de concreto incluyen cemento Portland y productos de agregados come, piedra caliza,dolomita,
granito,coca volcAnica,arena,grava,y otros materiales silicios.Estos productos incluyen cenizas volantes (fly ash)]a coal puede
contener mos de 0.025% de silicio cristalino.
1CUIDADO!
Peligros: Mezcla de cemento fresco y/o cenizas volantes pued6n causar irritaci6n en los Ojos,quemaduras en piel y Ojos,y
reacciones aldrgicas en la piel.Concreto seco y polvo de agregados,pueden causar irritaci6n en los Ojos,piel y/o en
la zona fespiratoria.Polvo del manejo en el tritUTamiento,pulido,conte y/o pelforaci6n puede contener materiales
silicos,los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,mantenerse
en temperature cdlida,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contener amoniaco.
V -
Seguridad: La humed'ad puede causar la liberaci6n del amoniaco.La inhal.aci6n del arnoniaco puede causar toser,irritaci6n o
quennaduras en la nariz,garganta y pulmones.Acu'dir inmediatamente al medico.El riesgo en ]a salad depende en
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con Ojos y contacto prolongado,con ]a piel.Use guantes,protecci6li ell los Ojos y ropa
Primeros adecuada para protecci6ii.LAvese]as manos con jab6n suave y agua despu6s del manejo de materiales.Evite inhalar
4D
auxilios: polvos.Si se expone a polvos mos de los limites recomendados,use protecci6n respiratoria.
Primeros auxilics: En caso de contacto en los Ojos,inmediatamente f.luya agua en la parte afectada par 15 minutos.
Si se inhala polvo,expo'ngase a aire fresco. Si el cemento fresco tiene contacto con sus Ojos,]Avelos a fondo con
agua.Acuda a atenci6n m6dica inmediatamente si ]a irritaci6n continda.
CEMEX,Memorial Hermann Tower
929 Gessner,Suite 1900
V7 combinado Houston,Texas 77024
02/12 Para rods informaci6n visita www.cernexusa.corn.