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Materials for Life
Ticket no.
FORT!! Pz C
g P 4199 SEL.VITZ ROAD j; i` 282320
FT PIERCE, FI_ 34982 '
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Delivery date Plant JTruck Driver ? Trucksize Type job
04 j1Zli-i'1� E,�:B 144 � DE�'Ii�it7, WILt'IAI�i Ii ' . 11. 012Yp i DRIVEWAY
Customer no. customer,name i Zone Tax CD
90004535 ( RODNEY HALL. CONCRETE CONST � I�i ;`� T5
Tarmac project no. Customer P.O.no. Order no. Termss;code t.Charge del vere 3-CA,D. rme due
L L Charge F.0.8. 4C.O.D-F0.6.
Delivery name and address # Lot Black County
ST LUC I E COUNTY .Ery
12 SPANISH WAY, PORT CT LUC I E'
Instructions SPANISH• 1. SUBDIVISION—US 1 y TL SPANISH LAKE TR` I slump
IvIEDIT T ERANEAN PL_ N TR SILVER OAK DR TL Ir1EDITTEIv';ANE N S 50 0 V
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Quantity' Product i L _.—._ _____,• ;' d ,ItIM, unit-price
Load Cumulative Ordered Code Descripti
11. 00 11a CIO 11 00 CAF BvR 1?12500 #57 t ili � CY
-11 e 00 10--364 MASTER BER ,N35 �I r ' # CY
10 00 Ei013.IZI07 FU Ui�CHC� LD
1. 019 . 80C 014- ENV T RON SUHO LIQ
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Load Arrive job site Stark discharge Finish discharge Leave job site.i.' Arrive plant
;j subtotal
V ■ �� �� �� ~ � �� � � sales tax
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TOTAL
Additional water added to this concrete will reduce its strength.Any water added is at customer's risk.
Gallons of water added: Gallons of water added:�. Gallons'of water added:_ A'mt of CY Retained: f
Customer Approval: Customer Approval:. . Customer Approval: - I Customer Approval: •�
Tested �1 Tested properly No. F''^ Authorized a d.received by
1LJ Yes' ❑ No ❑ Yes ❑ No 0 ` y1' ✓� I
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Lot:
Safety is a constant state of mind, with
every employee feeling responsible _ Block: I` I
and empowered to act to cause himJ
Address: Correct I'; Not Correct
and others to work safely, on the belief
that all accidents are-preventable and J
that zero incidents is the only goal.
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