DR1201-LR131028 D�A► DISPATCH LOCATIONS TICKET NUMBER
331 N. Main
CONCRETE illiii !ll sl litif lit
Euless,TX 76039
817-835-4020 ; 7 �, , 2 0
a US CONCRETE company
YARNING:IRRITATION TO THE SKIN AND EYES:Contains Portland Cement.Wear rubber PROPERTY DAMAGE RELEASE WATER ADDED AT CUSTOMER REQUEST
Dots and gloves.PROLONGED CONTACT MAY CAUSE,BURNS.Avoid contact with eyes and (TO BE SIGNED IF DELIVERY TO BE MADE INSIDE CURB LINE) EXCESSIVE.WATER IS DETRIMENTAL
prolonged contact with skin.In case of contact with skin Or eyes,flush thoroughly with water.If TO CONCRETE PERFORMANCE.
ntation persists,get med cal attention.KEEP CHILDRENAWAY '- Dear Customer s�The Size and weight of this truck could cause damage to the t'
;ONCRETE IS A PERISHABLE COMMODITY AND BECOMES THE PROPERTY OF THE premiss and/or'Iadjaceht property if this load is placed where you desire.It iour Wish /- \'j
'URCHASER UPON LEAVING THE PLANT ANY CHANGES3'R CAAI ELLATION OF ORIGINAL TO help you in every way that we can but in order to do this we are requesting that you ( ti
VSTRUCTIONS MUST BE TELEPHONED TO THE OFFICE'EEFOR LOADING STARTS. sign this RELEASE relieving this supplier and its affiliates from any responsibility from x
VE DO NOT GUARANTEE FINISHED RESULTS OBTAINED'FROM THIS LOAD OF • damage thaTmay occur to tfj remises andfor adjacent property buildiings,sidewalks; REQUESTOR'S NAME
:ONCRETE AS MANY IMPORTANT FACTORS AFFECTING THE ULTIMATE QUALITY OF THE drive4Ways,'curbs,etc:,due to delivery ofithis material;and that you also agree to• •
:OMPLETED JOB ARE OUT OF OUR CONTROL.We do not warrant that the concrete can be help the driver remove mud•from the wheels of his vehicle so that it will'not litter the ••-- :.
sed in any particular environment or.soil conditions or that th5 concrete is fit for any particular use. public street.Further;as additional consideration;the undersigned agrees to indemnity-`
.election of of the mix design and/or specification of the,msi`design parameters are solely the and hold harmless the drive{,of this truck and this supplier and its affiliates for any and
sponsibility of the Customer,and we assume no liability the efore. FULL�COAD '/a LOAD % AD"� 'A LOAD
1 all damage to the of de esand/or adjacent property which may be claimed by anyone //��,
LEASE NOTE:THIS LOAD OF CONCRETE IS PRODUCED IN ACCORDANCE WITH to have arisen out of dektlery of this order. •:O1yf' +...„,„,r••^T'"
TANDARD SPECIFICATIONS FOR READY'.MIX CONCRETE ASTM. ANY DE-ICING
1ATERIALS,IMPROPER FINISHING AND LACK OF CURING WILL CAUSE DAMAGE OR A
(GALLONS) '(GALLONS) (GALLONS) (GALLONS)
ECREASE IN STRENGTH. - X OTICE:MY SIGNATURE BELOW INDICATES THAT I HAVE READ THE HEALTH WARNING SIGNED: X TEST RESULTS
OTICE AND SUPPLIER WILL NOT BE RESPONSIBLE FOR ANY DAMAGE CAUSED WHEN
ELIVERING INSIDE CURB LINE AND AGREE TO THE TERMS AND CONDITIONS ON WEIGHMASTER CERTIFICATE
EVERSE SIDE. IME IN EXCESS OF FREE'TIME WILL BE CHARGED AT CURRENT DELAY • SLUMP CONC.TEMP. AIR%
ATE.ALL C.O.O.DELIVERIES MUST BE PAID IN ADVANCE AND LOAD ACCEPTED BY THIS IS TO CERTIFY that the following described commodity was weighed,measured
IGNING JHIS'DE[VERY TICKET BEFORE POURING.. or counted by a weighmaster whose signature is on this certificate,who is a recognized CYLINDERS TAKEN: ❑YES ❑ NO
OAD RECEI ED BY authority of accdracy,as prescribed in/Chapter 7(commencing with Section 12700)of
�,+ _ Division 5 of the Califdrnia Business and Professions Code,administered by the Division NAME OF TESTING LAB:
r,' t� F ' VI (^ '* of Measurement Standards of the California Department of Food and Agriculture.
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USTOMER P.O.# SPECIAL INSTRUCTIQNS
USTOMER JOB ID# ^"
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LOAD QUANTITY I ORDERED QTY CUMULATIVE QTY PRODUCT ID - DESCRIPTION UNIT PRICE EMENDED PRICE
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BF.ITO1-I,.IMEl y! LEAVE PLANT. ARRIVE JOB BEGIN POUR FINISH POUR LEAVE JOB ARRIVE AT PLANT USAGE CODE SUB TOTAL
TOTAL WAIT TIME . ' PREV1OOS,T'R(fCK LOAD#+ SLUMP.. IY1Aqp P.Aff``E_,y TIME DUEgN JOB TAX RATE TAX
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TP ,.„__ O D Rot;• P,LAN7- TRUCK! - (DELIVER.P OFES I. AL`• ORDER GRAND TOTAL TOTAL
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RUM REV-AT PLANT DRUM REV-START DRUM REV-FINISH DEPUTY WEIGHMASTER CONTROL#
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DIM�X DISPATCH LOCATIONS TICKET NUMBER
331 N. Main
TCONCRETE) Euless,TX 76039 � if ii i jiiiiitiLIiI'
817-835-4020 B
a US CONCRETE company
NARNING:IRRITATION TO THE SKIN AND EYES:Contains Portland Cement.Wear rubber PROPERTY DAMAGE RELEASE WATER ADDED AT CUSTOMER REQUEST
roots and gloves.PROLONGED CONTACT MAY CAUSE BURNS.Avoid contact with eyes and (TO BE SIGNED IF DELIVERY TO BE MADE INSIDE CURB LINE) EXCESSIVE WATER IS DETRIMENTAL
irolonged contact with skin.In case of contact with skin or eyes,flush thoroughly with water.If TO CONCRETE PERFORMANCE.
-citation persists,get medical attention.KEEP CHILDREN AWAY. Dear Customer-The size and weight of this truck could cause damage to the
>ONCRETE IS A PERISHABLE COMMODITY AND BECOMES THE PROPERTY OF THE premises and/or adjacent property if this load is placed where you desire.It is our wish
'URCHASER UPON LEAVING THE PLANT.ANY CHANGES OR CANCELLATION OF ORIGINAL to help you in every way that we can,but in order to do this we are requesting that you
NSTRUCTIONS MUST BE TELEPHONED TO THE OFFICE BEFORE LOADING STARTS. Sign this RELEASE relieving this supplier and its affiliates from any responsibility from x
VE DO NOT GUARANTEE FINISHED RESULTS OBTAINED FROM THIS LOAD OF damage that may occur to the premises and/or adjacent property,buildings,sidewalks, REQUESTOR'S NAME
>ONCRETE AS MANY IMPORTANT FACTORSAFFECTIIJG THE ULTIMATE QUALITY OF THE drive—ways,curbs,etc.,due to the delivery of this material,and that you also agree to
IOMPLETED JOB ARE OUT OF OUR CONTROL.We dent warrant that the concrete can be help the driver remove mud'from the wheels of his vehicle so that it will not litter the
ised in any particular environment or soil conditions or that the concrete is fit for any particular use. public street.Further,as additionat consideration;the undersigned agrees to indemnify
>elect on of the mix design and/or specification of the mix design parameters are solely the SA •
espons bility of the Customer,and we assume no liability therefore. and holdharmless reen driver of this track and this property which supplier and y b affiliates fbyany and FULL LOAD '/.LOAD %x, LOAD,,,
all damage to the remises and/or adjacent ro ert which ma be claimed by anyone
...-:�+- ?.6P
'LEASE NOTE:.THIS LOAD OF CONCRETE IS PRODUCED IN ACCORDANCE WITH to have arisen out of delivery of this order .."^"
>TANDARD SPECIFICATIONS FORty READY Ix'',CONCRETE ASTM. ANY DE-ICING
AATERIALS,IMPROPER FINISHING AND LACK OF CURING WI(!L CAUSE DAMAGE OR A "
1ECREASE IN STRENGTH. `•.., (GALLONS) (GALLONS) (GALLONS) (GALLONS)
IOTICE:MY SIGNATURE BELOW INDICATES THAT I HAVE READ THE HEALTH WARNING SIGNED: A ST-RESULTS'°"""""'+°`^^
*TICE AND SUPPLIER WILL NOT BE RESPONSIBLE FOR ANY DAMAGE CAUSED WHEN ..-^"P�*
IELIVERING INSIDE CURB LINE AND AGREE TO THE TERMS AND CONDITIONS ON WEIGHMASTER CERTIFICATE
LEVERSE SIDE.TIME IN EXCESS OF FREE TIME WILL BE CHARGED AT CURRENT DELAY SLUMP CONC.TEMP. AIR%
LATE.ALL C.O.D.DELIVERIES MUST BE PAID IN ADVANCE AND LOAD ACCEPTED BY THIS IS TO CERTIFY.that the following described commodity was weighed,measured
{IGNING THIS DELIVERY TICKET BEFORE POURING. or counted by a weighmaster whose signature is on this certificate,who is a recognized CYLINDERS TAKEN: ❑YES [St NO
.OAD RECEIVED BY: 1 authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of
+^� 3r^s Division 5 of the California Business and Professions Code,administered by the Division NAME OF TESTING LAB: f�
K (- (-4,--. ‘--''I-}' (F S. !? of Measurement Standards of the California Department of Food and Agriculture. ° t,,.r`�,..,,--
USTo 1 :. I-I-I A f " t---r' JUN'tp ill 1---• dUSTO#STEFf debt DELIVERY ADDRESS
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:USTOMER P.O.# SPECIAL INSTRUCTIONS
:USTOMER JOB ID#
LOAD QUANTITY ORDERED QTY CUMULATIVE QTY PRODUCT ID DESCRIPTION UNIT PRICE EXTENDED PRICE -
.1-(f f/±)+Y' 2f!f++ 'a .t ii( IDili i 01..1 1 50,4 3 61711:.I'!p.i i•-,6.i.:'
S iNli • f=3 NV 1 1_}°IIS 1 -�111I S1._,11iT.
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BATCI4TNE , LEAVE PLANT ARRIVE JOB BEGIN POUR FINISH POUR LEAVE JOB ARRIVE AT PLANT USAGE CODE SUB TOTAL
TOTAL WAIT TIME PREVIOUS TRUCK LOAD# ..SLUMP, .• TIME MAP PAGE r DUE ON JOB TAX RATE TAX
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_- + „� ORDER# PLP�NT TRUCK-# :13 DELIVERY P_fZOFES_SIONAL ,- ORDER GRAND TOTAL TOTAL
r .,_iDAT 1 .. 1 1 .. :° 1 .€,i.e.6": r t r: IW I, ;.!1-0.1:::-.1\91...1:.
)RUM REV-AT PLANT DRUM REV-START DRUM REV-FINISH DEPUTY WEIGHMASTE- „ CONTROL#
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12702427
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