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MAP LOCATE J 1 <br />Y. <br />LEAVE PLANT r <br />'ARRIVE JOB <br />t . , <br />Corvallis <br />0 Albany (541) 928-2547 171 lis (541 752-: 3428 <br />Di -(541) 258-7123 <br />[A Di ) <br />El St:Helens,(503).397-01 11 <br />�S�a� ton (503) 769- 646 5 !mn <br />KN I FE R1 VIM. <br />Angeh,Quar�y �503_),286-1222 -D Eugene (541) §89-660(y <br />- <br />EI Central Dispatch <br />-.F] Salem (503� 390 -6955 <br />�.� Ll <br />3 -5577 <br />❑ Brownsville (541) 747 El Gresham (503) 666 <br />-1 21 <br />103),9441 -3550 <br />d Sherw&oq (503)- 692 8242 <br />-.' <br />AN MDU RESOUI CES COMPANY <br />171 Coffin Butte (541) 745-7572 ❑ Handrock (541) 745-7572 <br />Reichhold (503) 366-5900 <br />❑ Sorinofield (541) 747-1213 <br />' CUSTOMER ACCOUNT # 31876 CODE', <br />MAP LOCATE J 1 <br />BATCH TIME <br />LEAVE PLANT r <br />'ARRIVE JOB <br />BEGIN POUR <br />, FINISH POUR <br />LEAVE JOB - <br />ARRIVE PLANT. -''•:: "„ <br />1 <br />Y , <br />r <br />WATER ADDED ED AT. <br />TEST CYL.: <br />6 MINUTES PER YARD <br />' CUSTOMER ACCOUNT # 31876 CODE', <br />CUSTOMER'S�RtQUESt_ <br />TAKEN <br />FREE UNLOADING, <br />'JO BID # <br />" <br />gals. t9 fu load <br />❑ YES <br />TIME ALLOWED ON <br />'FULL <br />LOADS. <br />Additional unloading <br />SOLD TO F-6GENE CTTY OF. <br />7., 11 " <br />gals. t /3,load <br />q� 2 <br />❑ YES <br />time charged at current <br />1 1 AND JEFFERsbN <br />1 7 r UGENE <br />' 1 /3 load <br />gals <br />[A YES <br />houflytFuck rate' <br />Y. <br />DELIVERY <br />POINT <br />A <br />ADDITIONAL WATER <br />REASON FOR,DELAY.TIME: <br />ADDED TOTHIS <br />[T JOB NOT READY.' <br />DATE P.O. # <br />04121 11, <br />- CONCRETE WILL 13EDUCE <br />El LACKOFHELP <br />TIM PLANT PIT <br />STRENGT ANY <br />El WHEEL BARROW JOB <br />DRIVER ROGER " BOGGS <br />WATER ADDED IS <br />AT CU STOMER'S <br />❑ WAITING FOR TRU6KTO UNLOAD <br />GROSS : TRUCKL#4034068e TRLR # <br />OWN RISK. <br />ET ADDING WATER <br />: <br />. WEIGHMASTER FRANK RAEBUR <br />[1ARRIVEDJOB EARLY <br />❑ OTHEFi <br />NET M (51 m, Pill cioi-' i nhw) <br />WATER REQUESTED BY: <br />SPECIAL INSTRUCTIONS: <br />MATERIAL. MIX DESIGN, SSD MOISTURE IDESIRED AMOUNT 'o.'ACTUAL AMOUNT SSD CORRECTED AMOUNT <br />CORRECTION <br />' <br />QM 5 <br />M <br />16T ­tbN" <br />t- <br />9 <br />td­ <br />WATER GAL.ND. <br />r .z <br />" <br />r <br />WAT <br />CEMENT. <br />RATIO <br />SCHEDULED ON JOB 13:27 <br />QUANT'IT Y ORDERED 5 .1 <br />MAXIMUM <br />ADD <br />PREVLIQUS TRUCK. <br />WATER GALS: <br />I I nnn TY0117 nizinlizIP 4 A 1 i <br />.. PRODUCT # <br />PRODUCT DESCRIPTION <br />QUANTITY <br />UNITS, <br />UNIT:.PRICE <br />AMOUNT,. <br />24CdL`3W1ZlH0 <br />CONTROLLED ..DENSITY-iFILL (CDF-20)" <br />10.75. <br />TERMS: NET -CASH SALES PAYABEEEOPUPON iPlid!(UP OR DELIVERY. CHARGE SALES <br />DUE AND PAYABLE BY THE.1 STH OF MONTH FOLLOWING PURCHASE. A service charge <br />of 1 per month, or a minimum of $1.00, will be made on th balance at <br />TOTAL <br />end �f the following month's billing cycle. This is an ANNUAL PERCENTAGE RATE OF <br />the 1� <br />. i� h. - f­ ��11 h­ ­� ­­ ;�l <br />/ lho .. <br />37065 - ".. <br />TICKE # 5A <br />..................................... <br />furnished on this job according to OREGON REVISED STATUTE 87.021 . .. . . RECEIVED <br />Important: I acknowledge receipt of a copy of Knife River's Ready Mix,concrete product label, and I understand and take <br />responsibility for the warning in the product label regarding working with Portland Cement concrete. <br />Administrative Group (541) 928-6491 -:32260 Old Hwy 34, Tangent, F <br />'(�CE3# 21 01 ALSO SERVING YOU AT Harrisburg Prestress (541) 995-6321'-. Tangent 6r <br />FORM 30 Revised 3/10, <br />374905 <br />t <br />Initials of Acknowledger <br />97389 <br />x'(541) -6491 <br />