HomeMy WebLinkAboutInspection Docs � 8
6 � - 'W ,
1142 Water Tower Road, Lake Park FL,33403 836325
Office:1-877-484-9994 / Fax:561-844-7102
South East Florida Division Dispatch:561-844-9994 / Central Florida Division Dispatch:407-339-5311
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Concrete Tested ❑Yes ❑No LOT# Wa ec A ded at Customer's
Cylinders Taken E]Yes F-1No /' Request
l gals.to full load
Comments
gals.to 2/3 load
- I"Y r�Y♦r f.6 T t"}1 tC`, 'F-P.5!If^L� � ��- 9a.s.-to 1/3 load
Customer's Rep-Water Added I
�
r'Y1 -.p;
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
medical attention. Keep children away from cement powder and all freshly mixed AT CUSTOMER'S OWN RISK.
BATCH TIME
JAN'
sx� , . "cement products.
9,}'!1 N'203)�;�: 't•.r6iR �-,
fl qLoad To Job 1 a r-1 Begin
161
L,.1� up�ry� s:79-9 ,a�r'"r tit- -
PLANT TICKET#_ ORDER# TRUCK# LOAD SIZE MIX SLUMP DATE
11��La 8F, 1 � 1 z1 X11 5u �° �t�EZI ..,47117irLl RED 5° 00 0i J23 16
CUSTOMER# SOLDTO P.O.# PROJECT#
31700 I 0 P. w' 3h awn Baia 1040
DELIVERY ADDRESS ZONE# USE DRIVER
GO 10 Ra i nf;r4t,� �'r=ail, �.��f�Bi l Cii�i STl_LIC 1E.. SI-iane Tr,asp
INSTRUCTIONS TIME DUE
� 8°57 AM1=P I`-ndi�-riwi.�lcr, Estates
• •
U.O.M. UNIT PRICE
PRODUCT DESCRIPTION AMOUNT
5°'0t7i . k'1t7.1 5..00 300400110 30170 RED yd 10. 4 0 X550° 00
1° 00 5° 00 1. 00 I'.IBERR Ri4?s:LdE~n- : a e a v`r° ILbo `30. 00
1. 00 0. 0121 ENVIRO ENV IRONMENTAL. LIFP0 ea �15. 0(�1 $15. QAV)
1. 00 0. 00 F"t IEI_. SIJRO'F-0ARGE ev� 21�° 041
5° 1-7071 0. 00 SHIT SATURDAY URDAY DELIVER`r $5. 00 00
SIGNATURE OR RECEIPT-CONCRETE AND ACKNOWLEDGEMENT OF HAZARD WARNING I ��' I"E:E ! a ISO. L710
asc meyeMr Concrete Cornpany will not assume liability for any property damage or any $795. 0
SUB-TOTAL
equipmesneaamage for an. eliiverries/beyond the curb line. c
,I�..orM4s✓!✓� I.0/`�" •^:r,�-s TAX 8 A 1„ 613
AUTHORIZED BY 1 8A6° 613
SHIPMENT SUBJECT TO CONDITIONS ON REVERSE SIDE. :•l" J Q TOTAL