HomeMy WebLinkAboutInspection Docs (3) ilT
1142 Water Tower Road, Lake Park FL 33403
Office:1-877-484-9994 / Fax:561-844-7102
South East Florida Division Dispatch:561-844-9994 / Central Florida Division Dispatch:407-339-5311
Concrete Tested ❑Yes ❑No LOT# Water Added at Customer's
Cylinders Taken ❑Yes ❑No �� Request
als.to full load
Comments i
gals.-to-2/3-I"oad
r" gals.to 1/3 load
Custo'mer's Rep-Water 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 TIME., _ medical attention;,Keep.children away from cement powder and all freshly mixed AT CUSTOMER'S OWN RISK.
cement products.
Begin Pour- To Plant At Plant
PLANT _ TICKET# ORDER# TRUCK# LOAD SIZE MIX SLUMP - DATE
CUSTOMER# SOLD TO P.O.# PROJECT#
DELIVERY ADDRESS ZONE# USE DRIVER
INSTRUCTIONS TIME DUE
11111[111]IF-A I LWIM1111 N I]=1"1:41 PRODUCT CODE PRODUCT DESCRIPTION U.O.M. UNIT PRICE AMOUNT
07
SIGNATURE OR RECEIPT-CONCRETE AND ACKNOWLEDGEMENT OF HAZARD WARNING
asc meyer Concrete Company wi not assume liability for any property damage-or any SUB-TOTAL
equipment damage'for any deliveries beyond the curb line.
TAX
} AUTHORIZED BY
SHIPMENT SUBJECT TO''CONDITIONS ON REVERSE SIDE. TOTAL