HomeMy WebLinkAboutInspection Docs (2) g
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1142 Water Tower Road, Lake Park FL 33403
x:561-844-7102 .837936
South EastFlo
Oda Division Dispatch:tch:561-844-9994 / Central Florida Division Dispatch:46 ,-334=530��� r
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Concrete Tested ❑Yes ! No LOT# Water Added at Customer's
Cylinders Taken ❑Yes ln'No ' Request .
f gals.to full load
Comments gals�to 2/3 load
P1rzr_-rI Trl 1{w -1-01 rre.r „ .I ter.. gals.to 1/3 load
E- -Customer's Rep=Watdr•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 TIMEaua -j(4,1A,Lj.-i Z medical attention. Keep children away from cement powder and all freshly mixed
cement products. AT CUSTOMER'S OWN RISK.
. .. • .. Begin Pour
7P�ANTTIKET# ORDER# TRUCK# LOAD SIZE MIX SL'LIMP- ".�o DATEt 0'--3tJltl 5 21179 1Ind, CA .�f;?ilellel RE-G, -�, 03/414%1G
CUSTOMER# SOLDTO- P.O.#
1PROJECT#
�-d -SEN & SONG CONTRACTING I 1
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DELIVERY ADDRESS ZONE# USE DRIVER
6320 L.ENAPE FST *-r-F IBER* STL_UIC iE :Jvic:qu s Wi I I i S
INSTRUCTIONS TIME DUE
NORTH PT ST L_UL4E•`1'T PIERCE 8'.- 3 GidLOAD CUMULATIVE ORDERED PRODUCT DESCRIPTION U.O.M.
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• • QUANTITY
10. 00 1.tri. 0I-A 21 r 0Q4 :P00�a ST t� �J710,'al ;SEL; � ,;d
1.nIgl�l 1.0 0 1 1ti00 �1 ERR �y !��.��� 'RLQid,-ntis ',aa
1.o 00 I la 00 ENV I RO ENVIRONMENTAL D I��.-_PO ea
1 W 00 0. 170 E FLIEL. SURCHARGE ea
SIGNATURE OR RECEIPT-CONCRETE AND ACKNOWLEDGEMENT OF HAZARD WARNING
asc meyer Concrete Company will not assume liability for any property damage or any SUB-TOTAL
equipment damage for any deliveries beyond the curb line:
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AUTHORIZED BY ( ;
SHIPMENT SUBJECT TO CONDITIONS ONREVERSESIDE. TOTAL
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THUS DELI' Y IS MADE SUBJECT TO THE FOLLOWINU CO0D0F����� �
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1Custorner agrees to provide a suitable roadway for our trucks from the street pavement to the place of delivery of material.
|fsuch suitable roadways are not provided,wereserve the right1nstupde|ivohemunb|conditionsarmremediedand,insush
event,customer will bohold rboponaib|efor any loss caused thereby.
2. When delivery iSmade beyondthe curb line edthe customer ovcustomer representative's request,any damages including,
but not limited to, sidewalks,driveways, buildings,trees, shrubbery, septic tanks and septic systems, including the drain
field, are adthe owner's risk. '
3. The customer agrees toreimburse said Company for loss oftime and equipment bvreason nfsuch delivery,and also b}
indemnify and save harmless said Company I rom any and all claims,demands and suits for or on account of or in any
manner caused bvorarising from private driveway delivery,
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4. Customer acknowledges that all material and services shown have been,neoeiv8d.that truck times shown are correct,and
that the amount of water added at the customer's request is shown correctly.CAUTION:The addition of water reduces -
concrete strength and durability.
5. VVmare not responsible for finished n3sulf�obtained from this load ofconcrete;cna~ important fscbons�3ffeoingthe ultimate
quality oYthe completed job are beyond our scope of*responsibility and control.
6. Acharge of$1.00 per minute will be charged after 8 minutes per cubic yard unloading time is exceeded.
7. The customer agrees to provide a suitable wash down facility for our trucks and tools at the place of delivery of material.
8. The customer hereby pgrees to pay all costs and expenses of collection,including a reasonable attorney'sfee,if he shall
fail to pay for the merchandise reflected in this invoice,when due: Past due accounts are subject to a 1-1/2%servica'
charge"'.the unpaid past,umebalance. ///e customer hereby acknowledges receipt of the comp)ete copy of this contract.,-
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