The URL can be used to link to this page

Home My WebLink AboutInspection Docs Aikccmax -_ _ 1'.� ij, fes,• � Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: 1 ,`) Customer Code: Customer Name: Customer Job Number: Order Code/Date:' :('....,17 ' i d. ?t'?' t._.—fJj`-# t.l-lN RP—EP_ Project Code: Project Name: Project P.O.Number. Order P.O.Number: Ticket Date: Delivery Address: Map Page: Map/Row/Column: :'}1i: - Delivery Instructions: Dispatcher: Ticket Number: rf•1•:., Due O"ii!Job: Slump:,`_-;g ! 1_+ .!t7 ruckNumtieF; 1 1(brfde7:N6m6er: 1 iDriveiiName:'i End Use:'—"•-�1 LOAD CUMULATIVE ORDERED AMOUNT UNIT PRICE AMO QUANTITY QUANTITY QUANTITY MATERIAL CODE 'PRODUCTION DESCRIPTION UO _ ' w{ :..i� -_� . •.�1..: ._:� �„1.;f .../l...s../ - y'r i,/t-),_ �1{..IJI l•' r C.li _ .. i .... L...._ _.u7 ,. - .. � '.,-. ,.r. ... .fz .. f URi Ri; j P, ,` LOF'f Dy I.:,iyt211•,G F i.4:1'c?. •_:'r _.. .I,:..a:}a -i0 G2 l Cash Check#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Without Standby Charges: Check Charge Comments: WATER ADDED: '_ �' GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE ._1 T S P �iI,., ,`;- ;-.�y' CURB LINE CROSS EDAT OWNER'S/AGENT'S REQUEST: . 1-`f—i 7 t'.d.t-'ii_ FULL +_.(-)e./ 9 SIGNATURE O 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 information,and to the material safety data sheets for additional information. returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us In writing AUTHORIZED SIGNATURE: within one business day after the receipt of materials. I j X r 68UNIVERSAL INVOICE This Delivery Ticket incorporates herein by reference Buyer's previously exec-i—I Credit Application, if any, Seller's Standard Terms and Conditions, Seller's Qui )n, if any, and Sellers Order Confinnati ncluding limitations of warranties), as if fully set forth on this Delivery Ticket('V _ .ment"). Seller will provide the Standard tuirns and Conditions upon request. Buyer agrees that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to pay in accordance with the Agreement. AGGREGATE / CEMENT / CONCRETE PRODUCTS / ELS' ASD Aggregate products are naturally occurring materials including limestone,dolomite,granite,volcanic rock, sand, {(-ravel,and other 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°Io crystalline silica. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns 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 silicosis and cancer if inhaled. If ingested,keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of amino- nia. Moisture can cause the ammonia to be released_ Inhalation of ammonia can cause coughing and irritation' or burns 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 i dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection. - f 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.cemexusa.com. Este ticket de entrega incluye como referencia aJ comprador (ya previarnente ejecutada en su aplicaci6n de Credito); cualquier tertnino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y garantfas),comp acue.rdo total del ticket de entrega("Contrato").El vendedor proveera los terrninos estandares y condiciones detal- lados en caso de asf ser requeridos.Con este documento,el comprador acepta los mismos ya antes mencionados y que las cantidades y materiales fueron entregados como se expresa en el mismo.Acepta pagar el monto de acuerdo al Contrato: al menos 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, dolomita, granito, rota volcanica, arena, Brava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albaflilerfa, pozzolan (tipo lP), azulejo de azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito,rota volcanica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede contener mds de 0.025% de silicio cristalino. -CUIDADO! Peligros: Mezcla de cemento fresco y/o cenizas volantes-pueden causar irritaci6n en los ojos, quemaduras en piel y Ojos. y reacciones alergicas en la piel. Concreto Seco y polvo de agregados,pueden causar irritaci6n en los ojos,pie] y/o en la zona respiratoria. Polvo del manejo en el trituramiento. pulido, Corte y/o perfor aci6n puede contener materiales silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingericlos,mantenerse en temperature calida,.reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco. Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. EI riesgo en la salud depende en la duraci6n y el nivel de la exposici6n. Seguridad: Evite el contacto con ojos y contacto prolongado con la pie]. Use guantes, protecci6n en Jos ojos y rope Priujeros adecuada para protecci6n.Lavese las.manos con jab6n suave y agua despues del manejo de materiales.Evite inhalar auxilios; polvos. Si se expone a polvos mds de los limites recomendados, use protecci6n respiratoria. Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la parte afecracla por 15 minntoS. Si se inhala polvo, exp6ngase a ai.re fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fondo con agua.Acuda a atenci6n.mddica inmediatamente si la irritaci6n continua. CEMEX, Memorial. Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston,Texas 77024 02/12 Para mds informaci6n visita www.cemexusa.com.