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CUSTOMER <br />Concrete: Injuries to eyes.Causes skin irdtadon.Contairis Portend Cement Read the following warning before using: Contact with wet, <br />unhardened concrete, mi cement or cement mixtures can cam skin irritation, severe chemical burns or serious eye damage. Avoid contact with <br />eyes and skin. Wear waterproof gloves, a filly- buttoned, long-sleeve shkt full-length trousers and tight-filling eye protection when working with these <br />materials. If you have to stand in wet concrete, use waterproof boots that are light at the top and high enough to keep concrete from flowing into them. <br />If finishing concrete, wear lm a pads to prated knees. After oontactwth any offiese materials, wash limmediatelywrth flesh, dean water. Indirect contact <br />through clothing is as dangerous so promptly rinse these materials from clothing. Seek immediate medical attention if you have persistent or severe <br />dswrifortIn case of M contact, flush with plenty of water for at least 15 minutes. Consult physician immecilately. KEEP out of reach of childreir! User <br />agrees to Garvey this waning to all persons who may use or cbrrue irrio contact with wet (untuadened) concrete, niorfar, oerriemt or cement mixtures. <br />Aggregates: Probrged inhalators of dust from a gravel product may be hazardous to your health. Measures i conbol fugitive dust should betaken <br />when handling its product Hot Asahalt errmis nuisaice fumes. Avid breathing frares. Also, Asph�t may cause severe bums. Wear protective <br />safety gear (larg sleeves, partls and gives). If homed, Dock with vvoler and see a physican. <br />Water added at customers own risk Additional water added to concrete will Property Damage Indemnification & Release <br />reduce its strength.Buyers agent agrees to accept responsibility for reduced strength The operator of this piece of heavy equiprnent, in presenting this RE- <br />due to water added above design. LEASE to you for your signature, is of the (onion that the operation of this <br />machi in the manner required to perform our contact with you may <br />Arrived at job with — inch slump. po*ly cam damage to the prernises or property. it is our wish to help <br />F-1 you in everyway that we can, but in order to do this, the operator is asking <br />Added — gal water at customer request. Test cylinders that you sign this RELEASE. In consideration of the performance of the <br />taken seller of its contract with me, I the undersigned, hereby INDEMNIFY the <br />Other additions seller and its employees for any damage and for all claims to the premises, <br />building, utility pipelines or cables, telephone lines, driveway or other <br />Received appurtenances, at <br />by X <br />Buyer's Agent receipt of product and approval of any added items. <br />The addition of any extra products to our mixer may void any warranty <br />expressed or implied by the seller. The seller accepts no liability for any <br />personal injury incurred by you while adding additional products to our <br />mixer. <br />Signature of Owner or its Agent <br />Leave Plant I Arrive Job Sit I Start Discharg Finish i <br />Drivers' <br />Comments <br />and RELEASE the seller and its employees from <br />any liability. <br />Signature of Owner or its Agent <br />Leave Job Site Arrive Plant <br />Company/ Customer PO/ <br />Order No. Cust. No. Customer Job Phase Code <br />58o()9 47000 CITY OF EUGRYAN <br />Customer Delivery Address <br />- CITY OF - EUGENE 1. 5TH en QUAKER I <br />Deliv9!Y Instructions <br />LFT OFF 18TH OFF BAILY HILL <br />TICKET NO. <br />58021436 <br />Unloading & Standby Excess unloading will be <br />charged at posted truck time rates. Truck standby <br />time charged at posted truck time rates. , <br />Limited Warranty The only liability of the seller for <br />product defect is the return of the purchase price. In no <br />event shall the seller be liable for any direct , indirect <br />incidental or consequential damages restriking from <br />the use of the products or arising out of breach of any <br />warranty. All claims for damages or shortages must be <br />made within 24 hours of delivery.We do not assume <br />responsibility for any damage beyond the curb line. <br />���) __ <br />ell <br />Scale <br />Time: 7 -. 52 AM <br />Load Qty Delivered Qty OrderQty ProductCode UOM Product Description �— unavince Amount <br />5.50 5.50 5.50 32336 yd ODOT 3300 PSI 3/4 <br />5.50 ( 487000 ea ENVIRONMENTAL SURCHARGE <br />1 41 335-- 4, 50 9-( <br />ON JOB TIME: 8l:30 <br />Load Size Prod. No. Description Slump Type cc Use Haul Cd. Pit/Plant Sales Tax <br />5.50 SR -9229-65 ODOT f;200 PST - 4 4 1 DEWAI K !=,g TOTAL DUE <br />Truck Gross Weight Tare Weight <br />Trailer <br />Trailer <br />iaKen Dy <br />Check # <br />I <br />OE368 <br />- <br />- <br />m 7 Mer <br />r <br />on cm. n.? -re nqr <br />n <br />material <br />Desi , <br />Required <br />Batched <br />% Vas <br />X moisture <br />Actual <br />Wat Trim <br />3MR350 <br />1195 1 <br />9462 <br />lb <br />9480 lb <br />0.19% <br />1.50% K <br />17 <br />91 <br />CSAND350 <br />1418 1b <br />8222 <br />lb <br />8240 lb <br />0821% <br />5.43% A <br />ri <br />gl <br />AGI-11 <br />440 lb <br />2420 <br />lb <br />2415 lb <br />-0 21% <br />199ASH-C <br />77 lb <br />424 <br />lb <br />425 lb <br />0135% <br />WATER - K <br />31.2 gl <br />93.1 <br />gl <br />70.0 gl <br />-3.33% <br />90.0 <br />gl -2.0 gl <br />POZZ <br />25." a-, <br />142.45 <br />oz <br />142.00 of <br />-0 32% <br />NBAE90 <br />1.80 0z <br />9.90 <br />oz <br />10.0 oz <br />1,01% <br />Actual <br />Nut Batches: I <br />Design <br />0.504 Water/Cement <br />0.504 <br />T <br />1 157.6 gl To <br />Add: 14.0 gl <br />Slump 4.00 in t <br />