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Home My WebLink AboutWTR2703638_2Rodarte Construction, Inc. Job Name: President Park Watermain Replacement Prj Diary and Cost Code Notes and Indexes / Working Conditions Print records for all Diary and/or Cost Code Note Entries between 5/28/2013 and 6/21/2013 Date Foreman Cost Code Note Index Codes 05/28/2013 Kevin Cloudy w/ Rain at times Lloyd's delivered truck & trailer load of cold mix ticket 424860 31.38 tons 10 Potholes Layout 300 ft of pipe Ground Ashpalt 100 ft on Olympia Locates Complete on Project Touma Surveyed Olympia Picked up 5/8 truck & trailer load of 5/8 to backfill potholes Steering Column broke on cat loader 05/29/2013 Kevin Cloudy w/ Rain Started to dig mainline bucket was to big missing pipe material Install Silt Fence around site Started to dig at 10 am Fixed loader steering column at 2:30 Solo load of sand delivered Pipe Delivery (valves and fittings) 80 ft of pipe 05/30/2013 Kevin 05/31/2013 Kevin Cloudy Mob out Komatsu 228 Excavator and brougnt in Cat 312 Excavator Corliss hauled out a load of dirt Mob in Conex, Sweeper, and Forks Loader broke fans not working Install Pipe 220 ft Partly Sunny Asphalt Grinder Broke Cat 312 #342 Broke- Hose Leaking Bolted Fittings 1 Hour Del Mar Sawcut- Approx 250 ft Install 130 ft of pipe Job Code: 1306 A Bolded !Vote Index Code with Asterisks Printed on: 06/24/2013 11:07.19 �.-- Page-;�---- Rodarte Construction, Inc. Job Name: President Park Watermain Replacement Prj Job Code: 1306 Diary and Cost Code Notes and Indexes / Working Conditions Print records for all Diary and/or Cost Code Note Entries between 5/28/2013 and 6/21/2013 Date Foreman Cost Code Note Index Codes 06/03/2013 Kevin Sunny 06/04/2013 Kevin Sunny 06/05/2013 Kevin Sunny 06/06/2013 Kevin Sunny 06/07/2013 Kevin Sunny Del Mar Sawcut 288 ft Hauled Truck & Trailer load out asphalt and dirt to silica Trident delivered valve box risers installed 3 clusters of valves installed 1 pig port and 7 valves Install 241 ft of pipe Dylan fixed Loader Mob in water truck Installed valve cluster Olympia and 11th Place / Olympia and 11th Street 9 valves Install 305 ft of pipe Ron delivered truck and trailer of 518 CSTC 1 Solo Load of Sand and Cold Mix Picked up 1.5 yards of concrete for thrust blocks Fittings Delivered from Trident Install 200 ft of pipe Delivered 5/8 and cold mix Broke 3/4 inch gas line unlocated 2 hrs stand by Del Mar on site sawcut 3000 ft Install 160 ft of pipe Load of Cold Mix Delivered Best Sweeping Swept Road Mob Trench Box Install 350 ft of pipe A folded Note Index Code with Asterisks Printed on: 0612412013 11:07:19 Page 2 Rodarte Construction, Inc. Job Name: President Park Watermain Replacement Prj Diary and Cost Code Notes and Indexes / Working Conditions Print records for all Diary and/or Cost Code Note Entries between 5/28/2013 and 6/21/2013 Date Foreman Cost Code Note Index Codes 06/10/2013 Kevin Sunny No Issues Moved over to NE 11th Street Install 25 ft of pipe 06/11/2013 -Kevin Partly Cloudy Hit Gas Service @ 3406 NE 11th Street -Locator did not mark (Jed has pies) crew down for 1 hour Install 320 ft of pipe 06/12/2013 Kevin Partly Cloudy Cold Mix Delivered from Lloyd's Dan delivered fittings Install 200 ft of pipe 06/13/2013 Kevin Partly Cloudy Dan delivered fittings Install 280 ft of pipe 06/14/2013 Kevin Partly Sunny Delivery from Consolidate Pipe and Fittings Installed Pig Port Billy and Julian onsite to repair cold patches Demob- Cat 312 Del Mar onsite sawcut 1050 ft Install 200 ft of pipe Job Code: 1306 06/17/2013 Kevin Sunny CAT 312 Excavator has hose replaced CAT Loader Steering Column worked on Hit gas line @ 3507 NE 11th Street line not broke slightly kinked PSE said out to tolerence and need to replace they will bill Rodarte Install 305 ft of pipe A Bolded Note Index Code with Asterisks Printed on: 0612412013 11:07:19 Page 3 Rodarte Construction, Inc. Job Name: President Parlc Watermain Replacement Prj Diary and Cost Code Notes and Indexes / Working Conditions Print records for all Diary and/or Cost Code Note Entries between 5/28/2013 and 6/21/2013 Date Foreman Cost Code Note Index Codes 06/18/2013 Kevin 06/19/2013 Kevin Partly Cloudy w/ Rain Trident delivered fittings Install 268 ft of pipe Partly Cloudy / Rain Del Mar onsite sawcut approx 1000 ft 06/20/2013 Kevin Cloudy w/ Rain Hose on Hoepac Broke Sweeper Pierce St- 5ft x 10 ft hole under asphalt and approx 3 ft of rock spent extra time hoe -packing backfill Install 340 ft of pipe 06/21 /2013 NOTE: Partly Cloudy Nobody Onsite Filters in effect. Dates >= 05/28/2013 and Dates <= 06/21/2013. All Foremen. Print: Working Conditions. Print: Daily Diary Notes. Print : Cost Coded Notes. All Note Indexes. All Cost Codes. Job Code: 1306 A Bolded Note Index Code with Asterisks Printed on: 06/24/2013 11:07:19 Page 4 DAILY INSPECTION DIARY REPORT DAY: % Vf"-s DATE: WORK PERIOD: a.m./p.m. to WEATHER: Q(l °F(AMIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: a.m./p.m. CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: CORLISS RESOURCES Quality Concrete • Washed Sand & Gravel • Crashed Rock "Great Service Since 1945 1 800 YOU POUR P.O. Box 487 • Sumner, Washington 98390 Concrete Dispatch: Phone 253 8916680 • FAX 253 891 6691 Gravel Dispatch: Phone 253 8916686 • FAX 253 8916692 rIME CUST P.O. NO. I JOB NU SOLD TO DELIVERY ADDRESS AND INSTRUCTIONS LF/DELVD IDRIVER I TRUCK ID GROSS WEIGHT LOAD NO. � TONS PRODUCT OUT I PLANTTIMEIN I I SUBTOTAL CUST. SIGN X DRVR. SIGN X WEIGHMASTER SIGN X An additional charge will be made on deliveries less than 12 yards. Loads quoted by the yard, are sold by volume, approximately 1.35 tons per yard. Any dump delays over 10 minutes will be charged at the current hourly truck rate. Not responsible for damages beyond the curb. TERMS: DUE 10TH OF MONTF FOLLOWING DATE OF PURCHASE. =INANCE CHARGE OF 1.833% PER MONTH (22%PER ANNUM) WILL BE CHARGED ON ALL PAST DUE ACCOUNTS. HBC Scale Ticket 4-11 A $35.00 SERVICE CHARGE WILL BE COLLECTED ON ALL RETURNED CHECKS. Tuesday 7 : 00 AM LLOYD ENTERPRISES, INC. PIT RUN - CRUSHED ROCK - TOPSOIL PO Box 3889 Federal Way, WA 98063 (253) 874-6692 - (253) 927-0416 Sold To: RODARTE CONSTRUCTION INC Ordered By: Dan � Phone: Delivered To: PIRESIDENTS PARK 3 Address: 1025 01ppia Ave Ne Renton /. 1f' 'N I COLD MIX ! ASPHALT WHLS 7edk1c1 Date: / 28 / 20 13 4% Fuel Surcharge 424860 Appmdn%ta Quantity: T & T - GET MIX OUT OF ICON Subtotal 3p9tiA Irf,6u fiw5: KEVIN ON SITE 253M2-2734 Tax f S Total Customer Signature: 0SQ4113 03:46 PM. jeff Customer releases and agrees to hold harmless Lloyd Enterprises, Inc. for any damages to his/her real or personal property caused by delivery of materials listed above. All materials having been dumped out of trucks is considered sold and is not warranteed to meet any particular specifications. When material is no longer acceptable it is sole responsibility of the buyer to notify seller to stop delivery. The owner of the within described premises is hereby advised that a lien may be claimed by Lloyd Enterprises, Inc. if the full amount of this invoice is not paid within 30 days. LLOYD ENTERPRISES, INC. PIT RUN - CRUSHED ROCK - TOPSOIL PO Box 3889 Federal Way, WA 98063 (253) 874-6692 - (253) 927-0416 Date: Sold To: Ordered By: Phone: Delivered To: Address: Customer Signature: Subtotal Tax Total Customer releases and agrees to hold harmless Lloyd Enterprises, Inc. for any damages to his/her real or personal property caused by delivery of materials listed above. All materials having been dumped out of trucks is considered sold and is not warranteed to meet any particular specifications. When material is no longer acceptable it is sole responsibility of the buyer to notify seller to stop delivery. The owner of the within described premises is hereby advised that a lien may be claimed by Lloyd Enterprises, Inc. if the full amount of this invoice is not paid within 30 days. CORLISS RESOURCES ijdmwA Quality Concrete • Washed Sand & Gravel • Crushed Rock "Great Service Since 1945 " C 1 800 YOU POUR in P.O. Box 487 • Sumner, Washington 98390 Concrete Dispatch: Phone 253 891 6680 • FAX 253 891 6691 Gravel Dispatch: Phone 253 8916686 • FAX 253 8916692 SOLD TO DELIVERY ADDRESS AND INSTRUCTIONS PLANT # JOB NUMBER I SELF/DELVD I DRIVER I TRUCK ID LOAD NO. I TONS PRODUCT CODE AND DESCRIPTION JOB TIME OUT PLANT TIME IN (\\7 ci(�� SUBTOTAL CUST SIGN X DRVR. SIGN X An additional charge will be made on deliveries less than 12 yards. Loads quoted by the yard. are sold by volume, approximately 1.35 tons per yard. Any dump delays over 10 minutes will be charged at the current hourly truck rate. Not responsible for damages beyond the curb. TERMS: DUE 10TH OF MONTI- FOLLOWING DATE OF PURCHASE. =INANCE CHARGE OF 1.833% PER MONTH (22%PER ANNUM) WILL BE CHARGED ON ALL PAST DUE ACCOUNTS. HBC Scale Ticket 4-11 A $35.00 SERVICE CHARGE WILL BE COLLECTED ON ALL RETURNED CHECKS. Carrier RODCON Rodarte Construction, Inc Vehicle 207 207 Customer RODCON Rodarte Construction, Inc Order Product 1100 Dry Dirt P.O. 1-397/RENTON Deliver Weighmaster JWS Ticket System Received R Ticket 1161513 5/30/2013 8-03.00AM Location: 1 Waller Rd. Gravel Pit Qty Rate Amount Product 23.63 Ton 5.50 129.97 Freight 0.00 0.00 Tax REFUSE 3.6000 4.68 Total 134.65 Pounds Tons Metric Gross 91640 45.82 41.57 Tare 44380 22.19 * 20.13 Net 47260 23.63 21.44 Predetermined Tare Today Load: 1 Qty 23.63 CUSTOMER Concrete} Injurious to eyes.Causes skin imtabon.Contains Portland Cement. Read the following warning before using: Contact with wet, unhardened concrete, mortar, cement or cement mixtures can cause skin irritation, severe chemical bums or serious eye damage. Avoid contact with eyes and skin. Wear waterproof gloves, a fully -buttoned, long -sleeve shirt, full-length trousers and tight -fitting eye protection when working with these materials. If you have to stand in wet concrete, use waterproof boots that are tight at the top and high enough to keep concrete from flowing into them. If fnisning concrete, vies knee pads to protect knees. After contact with any of these materials, wash off immediately with fresh, dean water. Indirect contact through clothing is as dangerous so promptly rinse these materials from dothitg. Seek immediate medical attention if you have persistent or severe discornfort.ln case of eye contact, flush with plenty of water for at least 15 minutes. Consult physician immediately. KEEP out of reach of children! User agrees to convey this waming to all persons who may use or come into contact with wet (unhardened) concrete. mortar, cement or cement mixtures. Aggregates: Prolonged inhalations of dust from a gravel product may be hazardous to your health. Measures to control fugitive dust should be taken 4140613 when handling this product. Hot Asphalt emits nuisance fumes. Avoid breathing fumes. Also, Asphaft may cause severe bums. Wear protective safety gear (big sleeves, pants and gloves). If burned, cod with water and see a physician. . r— Water added at customer's own risk. Additional water added to concrete will Property Damage Indemnification & Release z 1 reduce its strength.Buyer's agent agrees to accept responsibility for reduced strength The operator of this piece of heavy equipment in presenting this RE- Unloading & Standby Excess unloading will be due to water added above design. LEASE to you for your signature. is of the opinion that the operation of this charged at posted truck time rates. Truck standby " machinery in the manner required to perform our contract with you may time charged at posted truck time rates. Arrived at job with inch slump. possibly cause damage to the premises or property. It is our wish to help you in everyway that we can, but in order to do this, the operator is asking Limited Warranty The only liability of the seller for Added gal water at customer request. Test cylinders taken that you sign this RELEASE. In consideration of the performance of the product defect is the return of the purchase price. In no event shall the seller be liable for any direct, indirect, Other additions seller of its contract with me, I the undersigned, hereby INDEMNIFY the seller and its employees for any damage and for all claims to the premises, building, utility pipelines or cables, telephone lines, driveway or other incidental or consequential damages resulting from the use of the products or arising out of breach of any. warranty. All claims for damages or shortages must be Received appurtenances, at: made within 24 hours of dellvery.We do not assume by X /i Buyer's Ag6t recdi�Vof pr6EUc7 and approval of any added items The addition of any extra products to our mixer may void any warranty expressed or implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our mixer. and RELEASE the seller and its employees from any liability. Signature of Owner or its Agent Signature of Owner or its Agent ___.._ WGDELTKT090408 Leave Plant Arrive Job Sit Start Discharge Finish Discharge' Leave Job Site Arrive Plant Drivers' Comments — - Company/ Order No. Cust. No. Customer Job Lilo t Customer CONS1"RUCTION Delivery Instructions Load Qty Delivered Qty Gross Trk: 61960 Tr' 1 r : 42960 Customer PO/ Phase Code Delivery Address Order Qty ProductCode Tare Net 30920 31060 12960 30000 UOM Product to COLD —MIX TICKET NO. responsibility for any damage beyond the curb line. 1)40 KERSEY WAY SE AUBURN, WA 98092 353--839—� ' 101 \ I Illlll Ill�llll Iill IIII IIII, II. III fill Driver Co. Proj. No. OUTSIDE DR Data 06I05 f 13 CRUSHED ROC' Map Zone F Scale 07:31 Time: Load Size Prod. No. Description Slump Type CC Use Haul Cd. Pit/Plant Sales Tax TOTAL DUE Truck Gross Weight Tare Weight Trailer Trailer Taken by Check # DELIVERY TICKETMIL S CUSTOMER COPY SAND & GRAVEL COMPANY P.O. BOX 130 • AUBURN. WA 98071 SALES/OFFICE www.MilesSandandGravel.com (253) 833-3705 CONCRETE ORDERS SAND & GRAVEL ORDERS (253) 922-0327 (253) 833-3700 (253) 536-9100 SHELTON OLYMPIA fax (253) 833-3746 (253) 922-9116 (253) 843-1787 (360) 426-3344 (360) 491-7777 DATE CUSTOMER NO. ORDER NO. CUSTOMER P.O. OR JOB N0, PLANT NO. I DELIVERY TICKET NO. CY ORDERED CY DLVRD LOAD NO. SLUMP Gallons of Water PLANT TIME OUT JOB TIME IN JOB TIME OUT PLANT TIME IN Added By Customers Request CUSTOMER NAME SPECIAL INSTRUCTIONS JOB ADDRESS OTY UNITS PROD. CODE DESCRIPTION UNIT PRICE AMOUNT DRIVER NO. TRUCK NO. TERMS: NET 30 DAYS. INTEREST AT THE MAXIMUM ALLOWABLE RATE WILL BE SUB TOTAL CHARGED ON PAST DUE ACCOUNTS. IF COLLECTION BECOMES NECES- SARY REASONABLE ATTORNEYS FEES WILL BE ASSESSED. TAX CODE. RELEASE — CUSTOMER RELEASES & AGREES TO HOLD HARMLESS THE MILES CO. FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE. _ DRIVER, y GALLONS OF WATER ADDED SY'CUSTOMER'S REQUEST SIGNATURE SALES TAX X TOTAL AMOUNT REPRESENTATIONS -DISCLAIMERS 1. Warranty of concrete strength or other performance apply only when concrete is tested by qualified technicians in strict conformance to the provisions of ASTM; Strength test are evaluated according to the provisions of AC 318, latest revision, "Building Code Requirements for Reinforced Concrete." We will not be responsible for tests or for other expenses incurred without prior approval. 2. Supplier shall not be liable for the condition of the concrete if additional water is added. 3. Supplier shall not be liable for any damage done to shrubbery, flowers, city or private sidewalks, roadway or private property in the delivery of this material. 4. If the supplier's truck shall become immobilized due to terrain during the delivery of this material, property owner shall pay all towing charges incurred in the removal of the said truck. 5. All prices subject to change without notice. CAUTION 1. Please note that treshly mixed cement, motlar. concrete or grout may cause skin irjury. Avoid contact with s 'Ki,-.where possible & wash e>.posec; areas promp'rly with water. If anv cement mixture gets into eyes, rinse immediately & thoroughly with v^✓i.:'er ;4 gc:t prompt medical attention. _.. Keep ad cement rii,(Tures out: of rear_.!; of ci�ildren. �. Plea!;-,, kee,o concrete front f r ,ezing protect tr frorn adverse weather cordltir)ns a7 all i; ie. DUMPING TIME Free unloading time is calculated nt 3 rnin,Aes per cubic ,,arrl A "Siandby Tin-i " c lhar0� way be applied b •yon;d inis period at $75.00/hour. SHOP r ' r ; D CHARG—S 1. For deli eric s t_rnder 7 cubic vards of concrete or 10 tons of gravel, therewill be a niirirnum loan ± charge. Witness'signature - Customer Signaturr? CUSTOMER Concrete: -Injurious to eyes.Causes skin irritation.Contains Portland Cement. Read the following warning before using: Contact with wet, unhardened concrete, mortar, cement or cement mixtures can cause skin irritation, severe chemical bums or serious eye damage. Avoid contact with eyes and skin. Wear waterproof gloves, a fully -buttoned, long -sleeve shirt, full-length trousers and tight-ftng eye protection when working with these materials. If you have to stand in wet concrete, use waterproof boots that are tight at the top and high enough to keep concrete from flowing into them. If finishing concrete, wear knee pads to protect knees. After contact with any of these materials, wash off immediately with fresh, dean water. Indirect contact through clothing is as dangerous so promptly rinse these materials from clothing. Seek immediate medical attention if you have persistent or severe discomfort.ln rase of eye contact, flush with plenty of water for at least 15 minutes. Consult physician immediately. KEEP out of reach of children! User agrees to convey this warning to all persons who may use or come into contact with wet (unhardened) concrete, mortar, cement or cement mbdures. Aggregates: Prolonged inhalations of dust from a gravel product may be hazardous to your health. Measures to control fugitive dust should be taken when handling this product. Hot Asphalt emits nuisance fumes. Avoid breathing fumes. Also, Asphalt may cause severe bums. Wear protective safety gear (long sleeves, pants and gloves). If burned, cod with water and see a physician. Water added at customers own risk. Additional water added to concrete will Property Damage Indemnification & Release reduce its strength.Buyer's agent agrees to accept responsibility for reduced strength The operator of this piece of heavy equipment, in presenting this RE- Unloading & Standby Excess unloading will be due to water added above design. LEASE to you for your signature, is of the opinion that the operation of this charged at posted truck time rates. Truck standby machinery in the manner required to perform our contract with you may time charged at posted truck time rates. Arrival at job with in slump. El possibly cause damage to the premises or property. It is our wish to help you in everyway that we can, but in order to do this, the operator is asking Limited Warranty The only liability of the seller for Added gal water at customer request. Test cylinders taken that you sign this RELEASE. In consideration of the performance of the product defect is he return of the purchase price. In no event shall the seller be liable for any direct, indirect, Other additions seller of its contract with me, I the undersigned, hereby INDEMNIFY the seller and its employees for any damage and for all daims to the premises, building, utility pipelines or cables, telephone lines, driveway or other incidental h consequential damages resulting from t sing the use of the products or cout of breach of any All claims for damages or shortages must be Received �l appurtenances, at: warranty. made within 24 hours of deliver We do not assume by Buyer's Agent'receipt of prodsj.ct-3ld approval of any added items The addition of any extra products to our mixer may void any warranty expressed or implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our mixer. and RELEASE the seller and its employees from any liability. Signature of Owner or its Agent Signature of Owner or its Agent WGDELTKTO90408 Leave Plant Arrive Job Site Start Discharg Finish Discharger —Leave Job Site Arrive Plant Drivers' "{ — Comments Company/ Order No. Cust. No. Customer Job ItUOk*-iC j L ti64!-55 Customer Tr' "ONSTRUC'T I C)N Delivery Instructions Load Qty Delivered Oty OrderQty Prod Gross Tare Trk: 61100 30920 Tr1r: 43000 12960 Customer PO/ Phase Code Delivery Address responsibility for any damage beyond the curb line. 340 KERSEY WAY S1 AUBURN, WA 9809-2 253-839-21.01 TICKET NO. Driver Co. Proj. No. OUTSIDE E .)or Date 06 UOM Product Descrigboln - 0" CRUSHED ROCP to WASHED BEDDING SAND Net �. 30180 FUEL CHG 30040 1 1 - C/N: Load Size Prod. No. Description Slump Type CC Use Haut Cd. Pit/Plant 11ULA Gross Weight Tare Weight Trailer Trailer Check # k1ap Zone Scale Time: Sales Tax TOTALDUE CUSTOMER Concrete: Injurious to eyes.Causes skin irritation.Contains Portland Cement. Read the following warning before using: Contact with wet, unharderxe concrete. mortar, cement or cement mixtures can cause skin irritation, severe dternical bums or serious eye damage. Avoid contact with eyes and skin. Wear waterproof gloves, a fully -buttoned, long -sleeve shirt, full-length trousers and tight -fitting eye protection when working with these materals. If you have to stand in wet concrete, use waterproof boots that are tight at the top and high enough to keep concrete from flowing into them. If finishing concrete, wear knee pads to protect knees. After contact with any of these materials, wash off immediately with fresh, dean water. Indirect contact through clothing is as dangerous so promptly rinse these materials from clothing. Seek immediate medical attention if you have persistent or severe discomfort In case of eye contact, flush with plenty of water for at least 15 minutes. Consult physician immediately. KEEP out of reach of children! User agrees to convey this warning to all persons who may use or cane into contact with wet (unhardened) concrete, mortar, cement or cement mixtures. /1 1 3 L �i L Aggregates: Prolonged inhalations of dust from a gravel product may be hazardous to your health. Measures to control fugitive dust should be taken 4 when handling this prodtct. Hot Asphalt emits nuisance fumes. Avoid breathing fumes. Also, Asphalt may cause severe bums. Wear protective safety gear (long sleeves, pants and gloves). If burned, cool with water and see a physician. Water added at customer's own risk. Additional water added to concrete will Property Damage Indemnification & Release reduce its strength.Buyer's agent agrees to accept responsibility for reduced strength The operator of this piece of heavy equipment, in presenting this RE- Unloading & Standby Excess unloading will be due to water added above design. LEASE to you for your signature, is of the opinion that the operation of this charged at posted truck time rates. Truck standby machinery in the manner required to perform our contract with you may time charged at posted truck time rates. Arrived at job with inch slump. F-1 possibly cause damage to the premises or property. It is our wish to help you in everyway that we can, but in order to do this, the operator is asking Limited Warranty The only liability of the seller for defect is the the In Added gal water at customer request. Test cylinders taken that you sign this RELEASE. In consideration of the performance of the co seller of its contract with me, I the undersigned, hereby INDEMNIFY the product return of purchase price. no event shall the seller be liable for any direct, indirect, Other additionsany damage p seller and its employees for aid a and for all claims to the remises, building, utility pipelines or cables. telephone lines, driveway or other incidental or consequential damages resulting from the use of the products or arising out of breach of any warranty. All claims for damages or shortages must be Received appurtenances, at: made within 24 hours of deliver We do not assume by X Buyer's Agent receipt of product and approval of any added items The addition of any extra products to our mixer may void any warranty expressed or implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our mixer. and RELEASE the seller and its employees from any liability. Signature of Owner or its Agent responsibility for any damage bey ond the curb line. 040 KERSEY WAY SE AUBURN, � WA 98092 {` 2'53-839—G 1 0 1 t Signature of Owner or its Agent r' _-- -- -- _ _ — --._ GDELIKT090408 . ge� I Leavejob Site Arrive Plant Leave Plant Arrive Job Sit Start Dischar I Finish Discharge Le III I `7 Drivers' Comments Company/ Order No. Cust. No, Customer Job Customer Delivery Instructions Delivered Qty Order Qty Customer PO/ Phase Cod$ TICKET NO. J Delivery Address Driver Co. Proj. No. t= Load Size Prod. No. Description Slump Type CC Use Haul Col. Pit/Plant Truck Gross Weight Tare Weight Trailer I Check # Date k1C.� WP zone Scale Time: re: Sales Tax TOTAL DUE ohm DAILY INSPECTION DIARY REPORT # DAY: DATE: 5 /Z911 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: jY�M �df (/ : c- 1G,eU ( .1 40r v1n.avn kU1-t,4,4Sy - /'C Z L 41,/o.-v,0 5,//f 0Pe%04-- C44 1-7�- 5-r,4 1 \ + g 1 4-_ C`,, ...�� P I q- c... &= Cc- / a r- V . Q 1A, / / .� ? / ✓i % / 1/ L L� /il/J^ ..r .-s / /�-� G G h S 8 F7d-Z 8" a= 6 c) i- r- CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT DAY: �1� DATE: S/ D//,3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: cv iu T /�l► c.-, �! ►,��r�,4 /Lv� .(✓c� ? .as %jam 44 s T --z Y/ T, -; A&- 7;4,s S114 " le:::l rd = r- " �z a,,04eT,-Z � Z 00 L r— CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY DAY: DATE: S /mil / 13 WORK PERIOD: WEATHER: TEMP. MAX OF MIN OF WORK ACCOMPLISHED TODAY: a.m./p.m. to PRECIPITATION: a.m./p.m. REPORT /?�1,4.r,,fJau e-- s, .5 � �: G� y��.om c � S a E IF r�/110.4 8 t7s .vim // 4-01 �7"07.4j ,shi_r �.� ��til s•�-jai .��i,.�l� �o S�% CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT DAY: DATE: G / 3 / 13 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: � � �o •u � � u t�si a �^-� F ar •-!c i —1, - / if to n t-Cw- v % - h S>/y �� B .. 1✓ .A1 -1-7 /lea / a " 41*1/ym.�i•¢ sera- �i[l ti c- a *'-- 0/ ';LA- I -A I rss CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY _ REPORT DAY: V(;S-bn:7 DATE: CG/ `%/ /,3WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: —icelop, ci �n�eiS rc�io s, .161�isw-r l t e rv% 8 8 „ 2�Z Yoo 4 9 S 9 .f G.�� 644-4S v CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY �� REPORT �� DAY: �� DATE: (p /� / 13 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: D� Cvv►ST. —M J _S 4S h . 44 -To f*,r m ,yji--b l9w, 7h , s ? 1316 c •4. t Ad�ba / Z) h on . a / V%'1 Aq- 4 ","f / " .J '\, 1 , A-, ��o.�-� -b A, L o w.A.li AN04 % r.. C.. r •, c: r ,u w Co-l-w a`6 T dtX C•a. v4-4-C A- -b /h.S 7-0, P his. /(.�', / Gv. 6y rr, f /-v. A-✓cr u PU i n G/ n E CACIAJ Tl �.� /�liy %u ✓1'hh.t o �t.� .tiP_ Mw- lb ` �1 Gg�,n 0/ Gr a L 772�q� CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY DAY: I� .,rs _ DATE: / // WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: H REPORT # G r, G CA-y- o� a� !/A'N" �/ - C r e.� 8 11 �3 6(�.�L'�/ vc eh 04 IS o eA&ej uYJ �e nt�A P 7) 33 o S' SrG-�►on � w� Pyc ho itcrri PcTl c St, ui c c� t�-t V VVN- czL. CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT 46 DAY: lll6rl zK!.z DATE: //Q // WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: e7 S i ee DAr *lip Is _ 0l�e eVw , lJ�� c/�s�� ih•s ch,� 7hr� ST�,�� 8 Ntsl zK-n c- V-- :2?0 CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY // REPORT DAY: (/ DATE:(O /l% //3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: %✓rrs , "J a f-� �� Z&,Z x Ar/dlser-rr0-•0� ___�f,,¢rz�%l►�� r ,,a-S Ste/ G / GG� � 3�iJ�o �/ G= // �' .%' It VXA- 6401e (J.e.Jv r CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY DAY: � e p DATE: )-,WORK PERIOD: WEATHER: TEMP. MAX OF MIN OF WORK ACCOMPLISHED TODAY: a.m./p.m. to PRECIPITATION: a.m./p.m. REPORT U IA4 r k � -1 C .a 5 171 r 1 4 utiar� CJ .d-D/ok STL,4 --s- LO ♦ — /Zc— � /oC - Qj�IO 1L ,0 " L .4-5T ?-y 6,e /p L4Ler� . I7 .S�sl7[� Z,C�Gegi�/y- .4 s Spl,—jr or- A/ T yJ7ihi /21/Z6' iorf�T Ty oazO.17e/ /5 wh Y r1 Z,e .2z s / 4If v � C.L �•�.� G c r A �,►_ rvi.d r� % i r, i� his ��``� / / �� / L...1 � %. 1�� bv...a, l r.l,4ri m�s / 1 ,, L; s 8 8-z>= Lei 0 ly s `,c"� &.01,0e- G�L-r- CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT # DAY: r , 10 0741 DATE: (y / /7 / 13 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: 0 h /✓�f�/fie c/G1a r Oi� /0/4//yi/.! 1,4 c'= �' XC.4-c.�s.Li., r ea-c 7 �-V A,,_1., � ► 11-s a 8 b? Z 7 G L r— CONTRACTOR SIGNATURE U !� =W, INSPEC ATUR — - - DATE: DAILY INSPECTION DIARY REPORT DAY: (-�= 6 DATE: // 8 / /.3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: %s i Zs.�--A .9 V ,,/ G f / _44` S T Try CJ .4n e, o x S�� u► e�� . QV is hr-S 1irm-.*N- \�lew, r)L 8 tq ,. T�.z 5620 4- � 1 t Ktl Z' C-,� r/,� 1tc� C0 CONTRACTOR SIGNATURE !li . drilluffim., DATE: DAILY INSPECTION DIARY REPORT DAY: DATE: (-/2k-� WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: ILC°fY� /�Z:a �ae! s '.�iL a C�7iG• •'-"i •�-Lr.� �.�� „ ,.��., cis ? s Tom. i i , . D .i ,4t4-- ti - jJ e X // , Lli,rrse-�i — e2,., // a 8 `�s L ic 9 8 " && 4efg&� 74y y CONTRACTOR SIGNATURE INSPECTOR SIGNATURE r4.A' DATE: DAILY INSPECTION DIARY REPORT DAY: �ij,��q,�DATE: / / WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: /lUdwaffll"M i CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY DAY: DATE: /Z%//3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: —1S da:c L-1,10 hl 7-2y C. Ti oy+ D \� to Y^^- = Q � r r. w i. i i CONTRACTOR SIGNATURE INSPECTOR SIGNAT REPORT -4� DATE: DAILY INSPECTION DIARY ��J� REPORT �� DAY: /U ES 7��yy DATE: // WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: O(1 LohS? 9;N .}&L-,s te yl 3i X k e An- (2:1. . 1l r 4 Z ��2cc W r�►A-�-- one - 104'` Pl 01): CONTRACTOR SIGNATURE INSPECTOR SIGNATURE - DATE: DAILY INSPECTION DIARY REPORT 4� DAY: DATE: WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: rL 6 cD A4%, i Ca n .s T . Ca do i T/y///•7G •, ��m tsT,G s,Pi G r CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: W —w DAILY INSPECTION DIARY REPORT # DAY: %�IurS ?,—z DATE: / Z 7/ /3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: FCiD1i 9-eeo"G� �A �irN�►� Lr� �G H C % Q Cis I'l e7 Lellff1 ` — r" P r� s7,0*-/ke a he-& : or_ lex-_ �s i.¢..�� a O/v woo /-"OL ti 41 '�' &V-/ Cyj 7- "ol 4 CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: ' W DAILY INSPECTION DIARY DAY: /(i DATE: /18 /13 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: /,*,- P•J7 Qv 97---r / Z "--7 4u4-4,- Sr/u/ c c:-=F a CONTRACTOR SIGNATURE —/7 G(/ INSPECTOR SIGNATURE REPORT DATE: DAILY INSPECTION DIARY REPORT DAY: DATE: `] / / / / 3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: S L Ak �. Kd�J�/iCrrylP x s� (o CONTRACTOR SIGNATURE INSPECTOR SIGNAT= DATE: w DAILY INSPECTION DIARY REPORT # DAY: DATE: 7/Z //'z WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: G11101.4/ /lp 0-7 zD -110- / / 1 I7 S -a -2>017/ f T/ c /5� (� �7 � i,a ,zg �i& tVN/1%, I2. 1 SC/b/GLS /O L(�ts4',* — 7 - 3 - / S / )-rr l/,,- .// / pr- 4 IJ f- .UG t� w if CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY DAY: MOH A DATE: `]/ WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: REPORT I _ 1 I lI L� / ii 1 1 Z 1" Sri u i c, its 8 CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY _ REPORT 4l DAY: DATE: —7 /,3 WORK PERIOD: a.m. /p.m. to a.m. /p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: Pr Ys � Dt..�.s �.4'+.-lG liy.�..�. i-r�.4..-, �,c,✓ /'�'c ri�t� 1� ✓ �d sn utfs ;n �h S7/� 1 / " " �a.�-, eS T� c. Gt��+�r Se,, e" c s off ,life [a 1 I be -.� .., /FYIa,7,e .`tomz aog .2„n.,4% Q.-) .o.._,_L_- �-, c: S 1ZZ \'` Sr• (,i c a-,c /n CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT DAY: Wtl) DATE: 7 / /o / /3 WORK PERIOD: a.m./p.m. to WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: 177vrs — a.m./p.m. CONTRACTOR SIGNATURE INSPECTOR SIGNAT E DATE: DAY: 1- ►2. , WEATHER: DAILY INSPECTION DIARY REPORT 4� DATE:'7 // Z //I WORK PERIOD: a.m./p.m. to a.m./p.m. TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: %firs . � •� /�a*� C�,r..�s�-� µ �� / ,� lack 1-c ?h s �s h A- /S o 7 �i rt �s h G �• a-7�� CONTRACTOR SIGNATURE INSPECTOR SIGNATURE �— DATE: DAILY INSPECTION DIARY REPORT 4� DAY: DATE: ;7/ /3WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: (�o.,s►t cam kVN `-r n-,% L> a w► i s L \3 Z �ow.cs-c• c. Se.vl c fr Gv1 t— CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY _ REPORT DAY: `v<, DATE: ?//6//3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: RaclA,,k 6.-+S7 %hl.s s,06i v U I or c —ins— cj-A - ihl 04+72� Jk9 CAe-c01" O� Se" v i c c ?r4%-,s ✓-ris d_P% "re c c ch -z J I-eb FG/ 1!e K " W'd CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT DAY: w-e-b DATE: 7 // 7 //3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: F i, /.dc�rriG, h e. 1.4 v► .s vs-! t.a CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY �- REPORT # DAY: DATE: /Z3/1,3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: va co" �a n S T C a-t, C LVG-Items �D� / S a /.4/,ram 8 C /N.4 6A i tiG /?_ ��^ a/ s O�'!E Aws ,tic f-c) M4� n rt po v �� 7�� t., J > T7 fin� rd 1 tf �ov��npci 7o w%,-to% TL,. e% CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: AM- 1 *1 I 0 \ Vl- DAILY INSPECTION DIARY REPORT DAY: Wei) DATE: % / LY/a WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: eaA-t Coh ST n ..�� \�S dL1C U ♦ 1 t , ,"" , i .O c ��T.a�-ems e CJJ -. � S — v SGG ee/� % ,, CONTRACTOR SIGNATURE INSPECTOR -SIGNATURE DATE: ISSTONEWAY CONCRETE ACCOUNTING: 9125 TENTH AVENUE SOUTH SEATTLE, WA 98108 • (206) 762-2566 DELIVERY TICKET 3EATTLE (Plant #11) 3803 E. Marginal Wy S., Seattle ACCOUNTING (206) 762-2566 TUKWILA (Plant #12) 17024 W. Valley Hwy., Tukwila FAX (206) 762-2358 RENTON (Plant #14) 915 Houser Way N., Renton CEDAR SHORES (Plant #20) 21010 Cedar Grove Rd. S.E., Maple Valley SALES & A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. ORDER DESK (425) 226-1000 TICKET TIME AM LEAVE PLANT ARRIVE JOB BEGIN POUR FINISH POUR LEAVE JOB ARRIVE PLANT PM DATE CUSTOMER NO. ORDER NO. PROJECT PLANT # CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. JOB ADDRESS COLLECT ON DELIVERY (C.O.D.) ❑ CASH ❑ CHECK # ❑ CHARGE MAP ZONE CARD # EXR SPECIAL INSTRUCTIONS ❑ VISA ❑ MASTERCARD ❑ DISCOVER • ••. • • OD JOB TOTAL SLUMP SPACING ORDERED BY • TRUCK NO. DRIVER REMIT PAYMENT TO 9125 10th AVE. S. WATER ADDED ON -SITE CYLINDERS AUTHORIZED BY: SEATTLE, WA• ❑ YES 98108 TERMS ON • • gals. to full load ❑ YES REASON FOR DELAY TIME: gals. to 2/3 load ❑ YES ❑ JOB NOT READY - LACK OF HELP — ADDING WATER = WHEEL BARROW JOB ❑ ARRIVED JOB EARLY C TRAFFIC ❑ TRAIN = DRAW BRIDGE gals. to 1/3 load ❑ WAITING FOR TRUCK TO UNLOAD ❑ PUMP BLOW -BACK ❑ NONE ❑ WAITING ON PUMP ❑ WASH PUMP ❑ OTHER ADDITION OF WATER WILL REDUCE - WARNING- RELEASE — CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS STONEWAY CONCRETE, STRENGTH. WATER ADDED AT RRITATION TO A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL SKIN AND EYES OR PERSONAL PROPERTY CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE. DETAILS OF SITE CUSTOMER'S OWN RISK. SEE REVERSE (16) AGREEMENT ACCESS ON BACK (5). 6 MINUTES PER CUBIC YARD NOT RESPONSIBLE FOR COLOR CUSTOMER SIGNATURE UNLOADING TIME INCLUDED. VARIATION OR Additional unloading time charged at current hourly truck rate. SURFACE DISCOLORATION PRINT NAME DATE BATCH DATA: TICKET TOTAL REV 06/08 NBF CUSTOMER COPY TERMS, CONDITIONS AND WARNINGS 1. CREDIT. Condition precedent to, Seller's obligation to perform any and all credit terms of payment must be set forth in this Contract. In the absence of arty such creditterms, all deliveries under this Contract are 'Collect On Delivery" (C,O.D.). Purchaser agrees upon request to furnish Seiler such information as is reasonably necessery for Seller to determine Purchaser's financial condition_ Seller's obligation to perform under this Contract is subject to the condition precedent that Seller shall have thirty (30) days from receipt, of the executed Contract from Purchaser so that Seller's credit department may review and approve or disapprove any credit terms of payment specified in this Contract. 2. TERMS OF PAYMENT. Ail invoices are due for payment by the 30th day after the date of invoice. Service charges of one and one -quarter percent (1.25%) per month will be payable on all past due invoices of thirty (30) days or older. If a service charge is; assessed, It must be paid in order to maintain an open account. Purchaser shall make all payments due hereunder in lawful money of the United States and in accordance with the terms hereof. without any retention and without regard to any agreement Purchaser may have with other parties. Should legal action. be Initiated to collect this invoice, the prevailing party shall be entitled to recover reasonable attorney lees and costs, including appeals, bankruptcies. and post -judgement collection efforts. Venuolericklurlsdiotion of any suit or legal action may be had in Seattle, King County, Washington at the sole option of Seller. This agreement shall be construe and enforced in accordance with the laws of the State of Washington_ $TONEWAY CONCRETE ROUTINELY EXERCISES THEIR RIGHT TO SEND MATERIALMAN'S NOTICES ON ALL JOB& - - 3. TAXES. AR federal. state and local, taxes,'nisessmihts, fees, duties and charges levied by reason of this Proposal are in addition to prices quoted herein and shall be paid by Purchaser. 4. SCNEDi1LING. Changes or variations from original delivery request shall be conveyed through Seller's dispatch office and no other Seller's agent (including, but not limited to, drivers, quality assurance personnel or sales representatives). 5. DELIVERY CONDITIONS. All concrete deliveries will be made in concrete transit mixer trucks unless otherwise noted. Signed Purchaser has reouested Stoneway Concrete, a Division of Gary Merfino Construction Company. Inc. (Seller) to make use of a path for the delivery of materials and access to the project requiring trucks.to travel beyond the boundaries of the nearest traveled public -highway. Seller has advised that due to the size and weight of trucks, damage to the premises and/or adjacent property, or personal injury may -occur and that trucks may become damaged, disabled or stuck it Seller makes use of the path requested. Seller has further advised that it is their policy that deliveries requiring Seller's trucks travel beyond the nearest highway to obtain access to the Job site are at the risk of the Purchaser and that Seller assumes no llartility for property damage or personal injury that may result. Purchaser agree& to assume responsibility to Seller and third parties for property damage, personal injuries, truck towing and winching expensquart or d+rua�to Seller's � � ^ �;r� 9cI or shuck as a sesutt of Seiler making use oil the path requested for f"te dei®ralyof a r matbriali iih g from, resultjn� frbm, di cnnn with of the reques otsl11ern1(r'ss. Ltd deiendRep�aJ� from »thy Maims, dei)ands, losses, anrf I19bilifies to or by third ��# afft foi the belly ry of msterlafsyihether such claims may prove tb b'r true or false, groundless or fraudulent, to the full extent permitted by law and subjecli to the limitations below. Purchasers duty to indemnify Seller for liability for damages arising out of bodily injury to persons or damage to property caused by or resulting from the concurrent negligence of (a) Stoneway Concrete, a Division of Gary Martino Construction Company, Inc. or its agents and employees, and (b) the Purchaser shall apply only to. the extent of the negligence of the Purchaser or its agents and employees. For the purpose of the Purchaser's indemnification obligation only, the Purchaser specifically and expressly waives any immunity that may be granted it under the Washington State industrial insurance Act. Title 51 RCW. This waiver does not permit a direct action by the Purchaser's employees against the Purchaser. Further, the indemnification obligation under this Agreement shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable to or for any third party under worker's compensation acts, disability benefit acts, or their employee benefit acts. This promise of indemnity specifically applies in the case of Injuries to the undersigned's own employees, The undersigned's duty to defend, indemnify and hold Seller harmless shall include, as to all claims, demands, losses, and liability to which it applies, Seller's personnel rotated costs, reasonable attorney's fees, court costs, and all other claim -related expenses, including attorney's fees and other costs Incurred by Seller to enforce and establish its right under this Agreement, Upon Seller's tender of defense under this Agreement, the Purchaser agrees to appoint counsel of Seller's choice to defend against third party claim(s). Such counsel will be at the sole expense of the Purchaser. Seller is not responsible for means and methods of placement of ready mixed concrete or aggregate products on a project. 6. WASH OUT AREA. It will be the Purchaser's responsibility to provide a suitable area for trucks to rinse and clean before leaving the job site. An additional charge will be made per load if a wash out area is not provided. 7. PUMP HOLDS AND 111 i? BAC i�eN liiditno responsibility or obligation of communication to Purchaser when Pump Company holds or releases orders. Service to Purchaser will be�t 9 to f noting Purchaser may not receive original rate of pour requested. It is the responsibility of Pump Company to notify Purchaser of all holds and relelillea wK up,mr btowback, will be borne by the Purchaser. An additional charge, at uafier's discretion, will be Vited 8. POINT OF ACC N,fyye(t�; t t �Yilgtq(of accept responsibility for physical changes of the concrete caused by job delays, delivery syf Fit j t nk of tat tt e r 9, READY MIX CO�QbqpqTE$1 {iaili.. tyttch- o fuidf%lp concrete strength testing for acceptance, shall be In accordance with ASTM. USC and ACtan wit wpMV16"d, ' frr6 days of the performance of said tests. 10. NOTIFICATION u QfrCRLTE _ '6 olaseragrees to notify Seller In writing within twenty-four (24) hours of deficient concrete compro NOW to At ss�fli to Seller for further Inspection and testing. 11. ADDITION 8F WA b1OA FOfEi�NA1'E If water art o qn maternal i� a►ddad to the ccncrei® by or at the request of the Purchaser, its employees, agents, contractors or subcontractors, Purchaser ac!: (Ire Coflerdts a3 delivered and wolves all right to reject, revoke acceptance or Assert any claim for breach of any warranty and Seller is fiot responsible for strength dr properties of the concrete. 12. WARRANTY. 'Se'ilsr warrants that the compressive strength of ready mfxetlolroncr>ste test specimens tested for acceptance in accordance with ASTM will meet the design strength for the mix design said underthis Contract, Seller warrants the aggregate material sold under this Contract meets the description and specifications for the same set forth in this Contract. No other warranties, express far, implied, are made,Wlth respect to such construction materials, whether they be warranties of fitness or warransl( s of mercitarttabftRy.-Purchasel S exclusive ri6li rloc breach of this.warrainty shall be to require Seiler, at Seller's option, to refund the purchase prlW, to repair said material, or to provide Purchaster with a conforming replaceilherKtOr fishy non-confo`Rning mafortele. No oonsequentlat damages may be claimed by Purchaser against Seller in connection with any breach of this Agreement or broach of warranty herald,_ THE'PRIECEEDING WARRANTY IS IN LIEU OF AND SELLER HEREBY EXPRESSLY DISCLAIMS ALL IMPLIED WARRANTiES OFMERCHANTAHILITY AND OF FITNESS'FOR ANY PAhTl0QL0.R PURPOSE. 13, LIMITATION ONIIQAMAGES. Seller assumes no responsibility for, and shall hot be liable to, Purchaser for any consequential damages incurredby Purchaser In connection with this Contract, including without limitation, Purchaser's lost profits, Purchaser's good will, and any Injury to perton or property proximately resulting trout any breach by Seller or breach of yydCranty by Seller. 14. CLAIMS AND BACK CHARGES. Purchaser's exclusive procedure for commencingclaims under this Contract against Seller for any reason, Including breach of contract or breach of warrantyi ,shall be as follows: -Notice of claims against Sailor for any reason, ncluding but not limited to; breach of contractorwarranty, must be given to Seller in Writing within three (3) working days offer discovery or whefi discovery shbufd have been made. The written claim shall include the reason(s) and grounds for the clalrri and the dollar amount or relief sought. FAILURE OF PURCHASER TO GIVE SUCH NOTICE WITHIN THREE (3) WORKING DAYS SHALL CONSTITUTE A WAIVER BY PURCHASER OF ITS RIGHT TO LATER MAKE ANY SUCH CLAIM. if a dispute arises and Cannot be resolved; the parties involved agree to binding arbitration through non -legal personnel. 15. TITLE AND RISE[ OF LOSS. Unless otherwise expressly stated herein, title to the materials sold hereunder shall remain with Seller until Seller has received full payment for the same.. Risk of joss oif the materials sold under this Contract shall pass to the Purchaser upon delivery of the same, at the place of delivery designated herein. Thereafter, in addition to assuming all risk of loss; Purchaser shall be responsibierfor compliance with all governmental regulations and ordinances with regard to storage or placement of the same and shall indemnify,and hold Seller harmless against all claims for personal injuries, ,including death. and property damage arising from the storage, use or handling of said materials. 16. CONCRETE WARNINGS. Injurious to eyes. Causes skin Irritation, Avoid contact with eyes and skin. Wear waterproof gloves. a fully buttoned long-sleeved shirt, full-length trousers, and tight fitting eye'protiection when working with these materials. if you have to stand in wet concrete, use waterproof boots that are tight at tops and high enough to keep concrete from flowing into them. If you are finishing concrete, wear kneepads to protect knees. FIRST AID: If dust Is inhaled. remove to fresh air, Get Medical attention if Irritation persiaW Wash wet eonc(St:B.iMoriiar; cement, or cement admixtures from your skin with fresh; dean water Immediately after contact. Indirect contact through clothing can be as serious as direct contact, so promptly rinse wet concrete, mortar, cement or cement mixtures from clothing. Seek Immediate medical attentionit you have persistent or severe discomfort. Avoid breathing dust from cutting or grinding hardened concrete. When exposed to concrete dust above recommended limits (see MSOS), wear suitable NIOSH/MSHA-approved respirator. In case of eye contact, Flush with plenty of water for at least 15 minutes. Consult a physician immediately. KEEP OUT OF REACH OF CHILDREN, USER AGREES TO CONVEY THIS WARNING TO ALL PERSONS WHO MAY USE OR COME INTO CONTACT WITH WET (UNHARDENED) CONCRETE, MORTAR. CEMENT OR OF -MEW MfXTURES. STONEWAY CONCRETE ACCOUNTING: 9125 TENTH AVENUE SOUTH SEATTLE, WA 98108 • (206) 762-2566 SEATTLE (Plant #11) 3803 E. Marginal Wy S., Seattle TUKWILA (Plant #12) 17024 W. Valley Hwy., Tukwila RENTON (Plant #14) 915 Houser Way N., Renton CEDAR SHORES (Plant #20) 21010 Cedar Grove Rd. S.E., Maple Valley A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. ELIVE ACCOUNTING (206) 762-2566 FAX (206) 762-2358 SALES & ORDER DESK (425) 226-1000 TICKET TIME AM LEAVE PLANT ARRIVE JOB BEGIN POUR FINISH POUR LEAVE JOB ARRIVE PLANT PM DATE CUSTOMER NO. ORDER NO. PROJECT PLANT # CUSTOMER NAME CUSTOMER P.O. JOB NO. DELIVERY TICKET NO. TJ- i'i)N!"TPIffJTION INC - - JOB ADDRESS ON DELIVERY (C.O.D.) R M PICK UP ATHOUSER PLANTCOLLECT []CASH ❑ CHECK # ❑ CHARGE MAP ZONE RENTON CARD # EXP. � SPECIAL INSTRUCTIONS Ci)14 l AIDE:. D I REGT DUMP ❑ VISA ElMASTERCARD -1 DISCOVER ® ..DESCRIPTION 30075 ENV I RONMENTAL SUI'{Ci4RG JOB TOTAL SLUMP SPACING ORDERED BY TRUCK NO. DRIVER • WATER ADDED ON -SITE CYLINDERS AUTHORIZED BY: ❑ YES � gals. to full load ❑ YES REASON FOR DELAY TIME: gals. t0 2/3 load ❑ YES -JOB NOT READY ❑ LACK OF HELP _ ADDING WATER ❑ WHEEL BARROW JOB ARRIVED JOB EARLY ❑ TRAFFIC TRAIN — DRAW BRIDGE gals. to 1 /3 load ❑ WAITING FOR TRUCK TO UNLOAD El PUMP BLOW -BACK El NONE El WAITING ON PUMP ❑ WASH PUMP ❑ OTHER ADDITION OF WATER WILL REDUCE - WARNING - RELEASE — CUSTOMER RELEASES AND AGREES TO HOLD HARMLESS STONEWAY CONCRETE, IRRITATION TO A DIVISION OF GARY MERLINO CONSTRUCTION COMPANY, INC. FOR ANY DAMAGE TO HIS REAL STRENGTH. WATER ADDED AT SKIN AND EYES OR PERSONAL PROPERTY CAUSED BY DELIVERY OF MATERIALS LISTED ABOVE. DETAILS OF SITE CUSTOMER'S OWN RISK. SEE REVERSE (16) AGREEMENT ACCESS ON BACK (5). 6 MINUTES PER CUBIC YARD NOT RESPONSIBLE FOR COLOR CUSTOMER SIGNATURE UNLOADING TIME INCLUDED. VARIATION OR Additional unloading time charged at current hourly truck rate. SURFACE DISCOLORATION PRINT NAME DATE BATCH DATA: Material Description Desiggn (lty CONC%M Required batched % Var t4,:.isture Actuai.Iat ec Grav ' 7144 ` a4364 142,"s 1 b 144 1 D 1440 11 h 1% 3399% M, 8ft M I g 1 �4I-II >t t #!a9 11 1 b 1 '�0 Ib 1 lb t4 WATER WATER 1 EW I 107 lb 1i5 lb -2,14% 13 1 I.� g 11-0 'WATER 2 5a 11 1 107 l b H 10 I b 2. 52'r 13 l I'm Actual Num Batches: 1 Load Total: 4115 lb Design W!C: 0.532 Water/Cement: 0.500 T Design Water: 30.0 ql Actual Water: 27.6 gl To Add: Trio Water:-20.101 lbi CY TICKET TOTAL REV 06/08 NBF CUSTOMER COPY TERMS, CONDITIONS AND WARNINGS 1. CREDIT. Condition precedent to Seller's obligation to perform any and all credit terms of payment must be set forth in this Contract. In the absence of any such credit terms, all deliveries under this Contract are "Collect On Delivery" (C.O.D.). Purchaser agrees upon request to furnish Seller such information as is reasonably necessary for Seller to determine Purchaser's financial condition. Seller's obligation to perform under this Contract is subject to the condition precedent that Seller shall have thirty (30) days from receipt of the executed Contract from Purchaser so that Seller's credit dopartment may review and approve or disapprove any credit terms of payment specified in this Contract, 2. TERMS OF PAYMENT. All invoices are due for payment by the 30th day after the date of invoice. Service charges of one and one -quarter percent (1.250/r)) per month will be payable on all past due invoices of thirty (30) days or older. If a service charge is assessed, it must be paid in order to maintain an open account. Purchaser shall make all payments due hereunder in lawful money of the United States and in accordance with the terms hereof, without any retention and without regard to any agreement Purchaser may have with other parties. Should legal action be initiated to collect this invoice, the prevailing party shall be entitled to recover reasonable attorney fees and costs, including appeals, bankruptcies, and post -judgement collection efforts. Venue and jurisdiction of any suit or legal action may be had in Seattle, King County, Washington at the sole option of Seller. This agreement shall be construed and enforced in accordance with the laws of the State of Washington. STONEWAY CONCRETE ROUTINELY EXERCISES '1HEIH RIGHT TO SEND MATERIALMAN'S NOTICES ON ALL JOBS. 3. TAXES. All federal, state and local taxes, assessments, fees, duties and charges levied by reason of this Proposal are in addition W prices quoted herein and shall be paid by Purchaser. 4. SCHEDULING. Changes or variations from original delivery request shall be conveyed through Seller's dispatch office and no other Seller's agent !including, but not limited to, drivers, quality assurance personnel or sales representatives). 5. DELIVERY CONDITIONS. All concrete deliveries will be made in concrete transit mixer trucks unless otherwise noted. Signed Purch3sei has requested 3tonsway Concrete, a Division of Gary Merlino Construction Company. Inc. (Sellerj to make use of a path for the delivery of materials and access to the project requiring truci s to travel beyond the boundaries of the nearest traveled public highway. Seller has advised that due to the size and v✓eight of trucks, damage to the premises andior adjacent property, or personal injury may occur and that trucks may become damaged, disabled or stuck if Seiler makes use of the path requested. Seller has further advised that it is tf reii policy thatdeliveries requiring Seller's trucks travel beyond the nearest highway to obtain access to the job site are at the risk of the Purchaser and that Seller assumes no Iiab!hty for property damage or personal injury that may result, Purchaser agrees to assume responsibility to Seller and third parties for property damage, personal injuries, truck towing and winching expenses, and/or damage to Seller's trucks should the trucks become damaged, disabled or stuck as a result of Seller making use of the path requested or for the delivery of materials and access to the project site. Purchaser also agrees to indemnify, hold harmless.. and defend Seller from any claims, demands, losses, and liabilities to or by thin parties arising from. resulting from, or connected with the use of the requested path for the delivery of materials whether such claims may prove to be true or false, groundless or fraudulent, to the full extent permitted by law and subject to the limitations below. Purchaser's duty to indemnify Seller for liability for damages arising out of bcdly injury to persons or damage to property caused by or resulting from the concurrent negligence of (a) Stoneway Concrete. a Division of Gary Merhno Constrr!,:t on Co rpany, Inc. or its agents and employees, and (b) the Purchaser shall apply only to the extent of the negligence of the Purchaser or its agents and employees. For the purpose of the Purchaser's indemnification obligation only, the Purchaser specifically and expressly waives any immunity that may be granted it under the Washington State industrial insurance: Act, Title 51 RCW. This waiver does not permit a direct action by the Purchaser's employees against the Purchaser. Further, the indemnification obligation under this Agreement shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable to or for any third party under worker's compensation acts, disability benefit acts, or their employee benefit acts. This promise of indemnity specifically applies in the case of injuries to the undersigned's own employees. The .mdersigned's duty to defend, indemnify and hold Seller harmless shall include, as to all claims, demands, losses, and liability to which it applies, Seller's personrnE! related costs, reasonable attorney's fees, court costs, and all other claim -related expenses, including attorney's fees and other costs incurred by Seller to enforce and establish its right under this Agreement. Upon Seller's tender of defense under this Agreement, the Purchaser agrees to appoint counsel of Seller's choice to defend against Ihird party claim(s). Such counsel will be at the sole expense of the Purchaser. Seller is not responsible for means and methods of placement of ready mixed concrete or aggregate products on a proiec't. 6. WASH OUT AREA. It will be the Purchaser's responsibility to provide a suitable area for t, ucks to rinse and clean before leaving the job site. An additional charge will be made per load if a wash out area is not provided. 7. PUMP HOLDS AND BLOWBACK, Seller holds no responsibility or obligation of communication to Purchaser when Pump Company holds or releases orders. Service to Purchaser will be done to the best of Seller's ability, noting Purchaser may not receive original rate of pour requested. It is the responsibility of Pump Company to notify Purchaser of all holds and releases in service. Standby charges incurred during Pump Company clean up, or blowback, will be borne by the Purchaser. An additional charge. at Seller's discretion, will be added for returned concrete due to clean up process. & POINT OF ACCEPTANCE. The Buyer's point of acceptance is at the truck chute. Seller will not accept responsibility for physical changes of the �oncietu caused by job delays, delivery systems, placing equipment, or circumstances beyond our control. 9. READY MIX CONCRETE TESTING. Purchaser agrees that all ready mix concrete testing, including concrete strength testing for acceptance, shall be in a: c ordance with ASTM. UBC and ACI and that Seller will be provided with a copy of all test results within three (3) working days of the performance of said tests. 10. NOTIFICATION OF DEFICIENT,CONCRETE COMPRESSIVE STRENGTH TEST RESULTS. Purchaser agrees to notify Seller in writing within twenty-four (24i hours of deficient concrete compressive strength test results, to retain test specimens, and to make therm available to Seller for further inspection and testing. 11, ADDITION OF WATER AND/OR FOREIGN MATERIAL. If water and/or foreign material is added to the concrete by or at the request of the Purchaser, its employees, agents. contractors or subcontractors, Purchaser accepts the concrete as delivered and waives all right to reject, revoke acceptance or assert any claim for breach of any warranty and Seller is not responsible for strength or properties of the concrete. 12, WARRANTY. Seller warrants that the compressive strength of ready mixed concrete test specimens tested for acceptance in accordance with ASTM will meet the design strength for the mix design sold under this Contract. Seller warrants the aggregate material sold under this Contract meets the description and specifications for the same set forth in this Contract. No other warranties, express or implied. are made with respect to such construction materials, whether they be warranties of fitness or warranti s of merchantability. Purchaser's exclusive remedy for breach of this warranty,shall be to require Seller. at Seller's option, to refund the purchase price, to repair said material. or to provide Purchaser with a conforming replacement for any non -conforming materials, No consequential carriages may be claimed by Purchaser against Seiler in connection with any breach of this Agreement or breach of warranty herein. THE PRECEEDING WARRANTY IS IN LIEU OF AND SELLER HEREBY EXPRESSLY DISCLAIMS ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND OF FITNESS FOR ANY PARTICULAR PURPOSE. 13. LIMITATION ON DAMAGES. Seller assumes no responsibility for', and shall not be liable to, Purchaser for any consequential damages incurred by Purchaser in connection with this Contract. including without limitation, Purchaser's lost profits, Purchaser's good will, and any injury to person or property proximately resulting from any breach by Seller or breach of warranty by Seiler. 14. CLAIMS AND BACK CHARGES. Purchaser's exclusive procedure for commencing claims under this Contract against Seller for any reason, including breach of contract or breach of warranty, shall be as follows: Notice of claims against Seller for any reason, including but not limited to, breach of contract or warranty, must be given to Seller in writing within three (3) working days after discovery or when discovery should have been made. The written claim shall include the reason(s) and grounds for the claim and the dollar amount or relief sought. FAILURE OF PURCHASER TO GIVE SUCH NOTICE WITHIN THREE (3) WORKING DAYS SHALL CONSTITUTE A WAIVER BY PURCHASER OF ITS RIGHT TO LATER MAKE ANY SUCH CLAIM. If a dispute arises and cannot be resolved. the: parties involved agree to binding arbitration through non -legal oersunnel. 15. TITLE AND RISK OF LOSS. Unless otherwise expressly stated herein, title to the materials sold hereunder shall remain with Seller until Seller has received full payment for the same. Risk of loss of the materials sold under this Contract shall pass to the Purchaser upon delivery of the same. at the place of delivery designated herein. Thereafter, in addition to assuming all risk of loss. Purchaser shall be responsible for compliance with all governmental regulations and ordinances with regard to storage or placement of [he same and shall indemnify and hold Seller harmless against all claims for personal injuries, including death, and property damage arising from the storage, use or handling of said materials. 16. CONCRETE WARNINGS. iniurious to eyes. Causes skin irritation. Avoid contact with eyes and skin. Wear waterproof gloves. a fully buttoned long-sleeved shirt, full-length trousers, and tight fitting eye protection when working with these materials. If you have to stand in wet concrete. use waterproof boots that are tight at tops and high enough to keep concrete from flowing into them. If you are finishing concrete, wear kneepads to protect knees. FIRST AID: If dust is inhaled. remove, to fresh air. Get medical attention it irritation persists. Wash wet concrete, mortar, cement, or cement admixtures from your skin with fresh, clean water immediately after contact. Indirect contact through clothing can be as serious as direct contact. so promptly rinse wet concrete, mortar• cement or cement mixtures from clothing. Seek immediate medical attention If you have persistent or severe discomfort. Avoid breathing dust from cutting or grinding hardened concrete. When exposed to concrete dust above recommended limits (see MSDS), wear suitable NIOSH/MSHA-approved respirator, in case of eye contact, flush with plenty of water for at least 15 minutes. Consult a physician immediately. KEEP OUT OF REACH OF CHILDREN, USER AGREES TO CONVEY THIS WARNING TO ALL PERSONS WHO MAY USE OR COME INTO CONTACT WITH WET (UNHARDENED) CONCRETE MORTAR. CEMENT OR CEMENT MIXTURES. DAILY INSPECTION DIARY REPORT �E DAY: DATE: % WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY DAY: a%.--> DATE: 7 3 WORK PERIOD: a.m./p.m. to WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: a.m./p.m. REPORT �� '/ � sf (.- - �;.� � . / (' 1.171, ate%;�. /'INcv/� '' ��e 71 jol. fed /1-ch""Y — CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT DAY: lzy/S DATE: 6 // / 13 WORK PERIOD: a.m./p.m. to WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: a.m./p.m. CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: t ASTAmTest Laboratories o o 13600 NE 126th PL STE C, Kirkland, WA 98034 425-885-1664 www.amtestlab.com Iv ( BPS rDe'J—s PA4 COLIFORM BACTERIA ANALYSIS Date Sample Collected Time Sample County: 0810212013 Collected ® AM Month Day Year 10:10 ❑ PM KING Type of Water System (check only one box) 10 Group A Pubic ❑ Private Household ❑ Group B Public ❑ Other. Group A and Group B Systems Provide from Water Facilities Inventory (WFI): IN 71850L System Name: CITY OF RENTON Contact Person: ABDOUL GAFOUR Day Phone: 425 430 7210 Cell Phone: Eve. Phone: FAX: Send results to: (Print full name, address and zip code) UTILITY ENGINEERING ABDOULGAFOUR 1055 S GRADY WAY RENTON, WA, 98057 SAMPLE INFORMATION Sample collected name . M.WETHERBEE Specific location where sample collected: 11TH PL & MONROE Special Instructions or Comments: SAMPLE 4 OF 6 Type of Sample (must check only one box of #1 through #4 listed below) 1. ❑ Routine Distribution Sample 2. ❑ Repeat Sample (after unsat routine) ❑ Distribution System Chlorinated: ❑ Yes ❑ No ❑ Source Groundwater Rule (GWR) Chlorine Residual: Total— Free (Population of 1,000 or less) 3. Raw Water Source Sample ❑ E. coli - GWR source sample Unsatisfactory routine lab number. ❑ Fecal - Surface, GWI, some springs ❑ Other -- -- Unsatisfactory routine collect date: Chlorinated: Yes No Pubic System must pruvideSourceNumber fmmiMn Chlorine Resid: Total Free 4. ® Sample Collected for Information Only ® Construction ❑ Repairs ❑ Private Residence ❑ Other LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY ❑Unsatisfactory ®Satisfactory Total Coliform Present and ❑ E. coli present ❑ E. soli absent ❑ Fecal colifonm present ❑ Fecal colifomt absent ❑ Replacement Sample Required Sample not tested because Test unsuitable because: ❑ Sample too old (>30 hours) ❑ TNTC ❑ Improper Container ❑ Turbid Culture ❑ ❑ Bacterial Density Results: Plate Count I mi. E.coli /100 MI. Total Coliform < 1 1100 mi. Fecal Colifonn < 1 1100 mi. Method Code: Date Received: MICR- 2810 8/ 2l2013 Date Analyzed: 8/ 2/2013,16:00 Date Reported: 8/ 3/13 06603383 Lab Use Only: Sample Number (DOH number plus five diplts) 0011 Form #33W19 (revised BIOS) TT AmTest Laboratories a o w TEST 4 13600 NE 126th PL STE C, Kirkland, WA 98034 425.885-1664 www.amtestiab.com Pt es pA4�.k COLIFORM BACTERIA ANALYSIS Date Sample Collected Time Sample County: 08/02/2013 Collected 0 AM Month Day Year 10.20 ❑ PM KING Type of Water System (check only one box) ® Group A Public ❑ Private Household ❑ Group B Public ❑ Other. Group A and Group B Systems Provide from Water Facilities Inventory (WFI). IN 71850L SystamName: CITY OF RENTON Contact Person: ABDOUL GAFOUR Day Phone: 425 430 7210 Cell Phone: Eve. Phone: FAX: Send rosults to: (Print full name, address and zip code) UTILITY ENGINEERING ABDOULGAFOUR 1055 S GRADY WAY RENTON, WA, 98057 SAMPLE INFORMATION Sample collected b (name . M.WETHERBEE Specific location where sample collected: 11TH CT & PIERCE Special Instructions or Comments: SAMPLE 3 OF 6 Type of Sample (must check only one box of #1 through #4 listed below) 1. ❑ Routine Distribution Sample 2. ❑ Repeat Sample (after unsat routine) ❑ Distribution System Chlorinated: ❑ Yes ❑ No ❑ Source Groundwater Rule (GWR) Chlorine Residual: Total Free (Population of 1,000 or less) 3. Raw Water Source Sample ❑ E. coli - GWR source sample Unsatisfactory routine lab number. ❑ Fecal - Surface, GWI, some springs ❑ Other -------- Unsatisfactory routine collect date: Chlorinated: Yes No Public systernsmWprwbeSaimNumber firm (wFq Chlorine Resid: Total Free 4. ® Sample Collected for Information Only ® Construction ❑ Repairs ❑ Private Residence ❑ Other LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY ❑ Unsatisfactory 0 Satisfactory Total Coliform Present and ❑ E. soli present ❑ E. soli absent ❑ Fecal coliforn present ❑ Fecal cd%rm absent ❑ Replacement Sample Required Sample not tested because Test unsuitable because: ❑ Sample too old (>30 hours) ❑ TNTC ❑ Improper Container ❑ Turbid Culture ❑ ❑ Bacterial Density Results: Plate Count / frill. E.coli 1100 mL Total Coliform < 1 1100 ml. Fecal Colrfonn < 1 1100 ml. Method Code: Date Received: MICR- 2810 8/ 2/2013 Date Analyzed: 6/ 212013, *00 Date Reported: S/ 3/13 06603382 Lab Use Only: S=* Number (DOH number plus rive d ft) 001-1 Form #331319 (wised 8105) AmTest Laboratories row^. o 13600 NE 126th PL STE C, Kirkland, WA 98034 425-885-1664 www.amtestlab.com COLIFORM BACTERIA ANALYSIS Date Sample Collected Time Sample County: 08/02/2013 Collected EZ AM Month Day Year 10:05 ❑ PM KING Type of Water System (check only one box) ® Group A Pubic ❑ Private Household ❑ Group B Pubic ❑ Other. Group A and Group B Systems Provide from Water Facilities Inventory (WFI): IN 71850L syslannName' CITY OF RENTON Contact Person: ABDOUL GAFOUR Day Phone: 425 430 7210 Cell Phone: Eve. Phone: FAX: Send results to: (Print full name, address and zip code) UTILITY ENGINEERING ABDOULGAFOUR 1055 S GRADY WAY RENTON, WA, 98057 SAMPLE INFORMATION le collected name. M.WETHERBEE Specific location where sample collected: 11TH ST & PIERCE AVE gpwW InWuct ons or Comments: SAMPLE I OF 6 Type of Sample (must check only one box of #1 through #4 listed below) 1. ❑ Routine Distribution Sample 2. ❑ Repeat Sample (after unsat. routine) ❑ Distribution System Chlorinated: ❑ Yes ❑ No ❑ Source Groundwater Rule (GWR) Chlorine Residual: Total Free_ (Population of 1,000 or less) 3. Raw Water Source Sample ❑ E. soli - GWR source sample Unsatisfactory routine lab number. ❑ Fecal - Surface, GWI, some springs ❑ Other — -- Unsatisfactory routine collect date: LS1-1-1 Chlorinated: Yes No R/A`SyffW"`"W µwilw* M9 Chlorine Resid: Total Free 4. ® Sample Collected for Information Only 0Construction ❑ Repairs ❑ Prvate Residence ❑ Other LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY ❑ Unsatisfactory ® Satisfactory Total Coliform Present and ❑ E. soli present ❑ E. coli absent ❑ Fecal coliform present ❑ Fecal colifonn absent ❑ Replacement Sample Required Sample not tested because Test unsuitable because: ❑ Sample too old (>30 hours) ❑ TNTC ❑ Improper Container ❑ Turbid Cufture ❑ ❑ Bacterial Density Results: Plate Count 1 mi. E.coli 1100 mi. Total Colifolm < 1 1100 m1. Fecal Col'rform < 1 1100 mi. Method Code: Date Received: MICR- 2810 8J 212013 Date Analyzed: 8/ 2/2013,16:00 Date Reported: 813113 M603381 Lab Use Only: Sample Number (DOH number pies five ddjis) DOH Form 9331319 (revised W6) p%e& IDe'v'k PA-4--L A AmTest Laboratories T 13600 NE 126th PL STE C, Kirkland, WA 98034 425-885-1664 www.amtestlab.com COLIFORM BACTERIA ANALYSIS Date Sample Collected Time Sample County: 08/02/2013 Collected 0 AM Month Day Year 10.15 ❑ PM KING Type of Water System (check only one box) EZ Group A Pubic ❑ Private Household ❑ Group B Pubic ❑ Other. Group A and Group B Systems Provide from Water Facilities Inventory (WFI): IN 71850L System Name: CITY OF RENTON Contact Person: ABDOUL GAFOUR Day Phone: 425 430 7210 Cell Phone: Eve. Phone: FAX: Send results to: (Print full name, address and zip code) UTILITY ENGINEERING ABDOULGAFOUR 1055 S GRADY WAY RENTON, WA, 98057 SAMPLE INFORMATION Sample collected b (name : M.WETHERBEE Specific location where sample collected: 11TH ST & MONROE Special Instructions or Comments: SAMPLE 2 OF 6 Type of Sample (must check only one box of #i through 94 listed below) 1. ❑ Routine Distribution Sample 2. ❑ Repeat Sample (after unsat. routine) ❑ Distribution System Chlorinated: ❑ Yes ❑ No ❑ Source Groundwater Rule (GWR) Chlorine Residual: Total Free— (Population of 1,000 or less) 3. Raw Water Source Sample ❑ E. soli - GWR source sample Unsatisfactory routine lab number. ❑ Fecal - Surface, GWI, some springs ❑ Other -------- Unsatisfactory routine collect date: Chlorinated: Yes No PiMcSystem must KoMeSource Number tom(wfl) Chlorine Resid: Total Free 4. ® Sample Collected for Information Only ® Construction ❑ Repairs ❑ Private Residence ❑ Other LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY ❑ Unsatisfactory 2 Satisfactory Total Coliform Present and ❑ E. coli present ❑ E. soli absent ❑ Fecal coliform present ❑ Fecal coliform absent ❑ Replacement Sample Required Sample not tested because Test unsuitable because: ❑ Sample too old (>30 hours) ❑ TNTC ❑ Improper Container ❑ Turbid Culture Bacterial Density Results: Plate Count 1 ml. E.coli 1100 mi. Total Coliform < 1 /100 mi. Fecal Coliform < 1 1100 nil. Method Code: Date Received: MICR- 2810 8/ 212013 Date Analyzed: 8/2I2013,16:00 Date Reported: 8/ 3/13 066033TB Lab Use Only: Senile Number (DOH number plus flue dpSs) 00H Farm g31319 (revised 8M) P res to" P.l*�* T AmTest Laboratories e 13600 NE 126th PL STE C, Kirkland. WA 98034 425-885-1664 www.amtestlab.com PreS rbe.".1.S Nv-k COLIFORM BACTERIA ANALYSIS Date Sample Collected Time Sample County: 08/02/2013 Collected HAM Month Day Year 10:00 ❑ PM KING Type of Water System (check only, one box) ® Group A Public ❑ Private Household ❑ Group B Public ❑ Other: Group A and Group B Systems Provide from Water Facilities. Inventory (WFl� IN 71850L Syshun Nane: CITY OF RENTON Contact Person: ABDOUL GAFOUR Day Phone: 425 430 7210 Cell Phone: Eve. Phone: FAX: Send results to: (Print full name, address and zip code) UTILITY ENGINEERING ABDOULGAFOUR 1055 S GRADY WAY RENTON, WA, 98057 SAMPLE INFORMATION Sample collected (name): M.WETHERBEE Specific location where sample collected: 12TH & OLYMPIA Special Instructions or Comments: SAMPLE 6 OF 6 Type of Sample (must check only one box of #1 through #4 listed below) 1. ❑ Routine Distribution Sample 2. ❑ Repeat Sample (after unsat. routine) ❑ Distribution System Chlorinated: ❑ Yes ❑ No ❑ Source Groundwater Rule (GWR) Chorine Residual: Total Free (Population of 1,000 or less) 3. Raw Water Source Sample ❑ E. soli - GWR source sample Unsatisfactory routine lab number. ❑ Fecal - Surface, GWI, some springs ❑ Other ------- Unsatisfactory routine collect date: Chlorinated: Yes No Pubic Systems must provide Source Number from (WFQ Chlorine Resid: Total Free 4. ® Sample Collected for Information Only H Construction ❑ Repairs ❑ Private Residence ❑ Other LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY ❑ Unsatisfactory H Satisfactory Total Coliform Present and ❑ E. soli present ❑ E. coli absent ❑ Fecal coliform present ❑ Fecal coliform absent 17 Replacement Sample Required Sample not tested because Test unsuitable because: ❑ Sample too old (>30 hours) ❑ TNTC ❑ Improper Container ❑ Turbid Culture ❑ ❑ Bacterial Density Results: Plate Count I ml. E.coli 1100 mi. Total Coliform < 1 I100 mi. Fecal Coiiform < 1 1100 ml. Method Code: Date Received: MICR- 2810 8/ 2/2013 Date Analyzed: 812/2013,16:00 Date Reported: 8d 3/13 OW3379 Lab Use Only: Sample Number (DOH mxrber plus Ne d&) 00H Form 0331319(redsed 05) Ajvffm AmTest Laboratories 13600 NE 126th PL STE G Kirkland, WA 98034 425-885-1664 www.amtestlab.com NrS Ibc -v-Ts Pik COLIFORM BACTERIA ANALYSIS Date Sample Collected Time Sample Cc nry: 08/02/2013 collected HAM Month Day Year 10:25 ❑ PM KING Type of Water System (check only one box) H Group A Public ❑ Private Household ❑ Group B Public ❑ Other. Group A and Group B Systems Provide from Water Facilities Inventory (WAY. IN 71850L systam Name: CITY OF RENTON Contact Person: ABDOUL GAFOUR Day Phone: 425 430 7210 Cell Phone: Eve. Phone: FAX: Send results to: (Print full name, address and zip code) UTILITY ENGINEERING ABDOULGAFOUR 1055 S GRADY WAY RENTON, WA, 95057 SAMPLE INFORMATION Sample collected (name): M.WETHERBEE Specific location where sample collected: 10TH PL & MONROE Special Irk or Comments: SAMPLE 5 OF 6 Type of Sample (must check only one box of #1 through #4 listed below) 2. ❑ Repeat Sample (after unsat. routine) 1. ❑ Routine Distribution Sample ❑ Distribution System Chlorinated: ❑ Yes ❑ No ❑ Source Groundwater Rule (GWR) Chlorine Residual: Total Free (Population of 1,000 or less) 3. Raw Water Source Sample ❑ E. soli - GWR source sample Unsatisfactory routine lab number. ❑ Fecal - Surface, GWI, some springs ❑ Other ------- Unsatisfac:tory routine collect date: L_S_I 1 / / Chlorinated: Yes No PdAc Sysren° must p vAde Source Number bm (wFq Chlorine Resid: Total Free 4. ® Sample Collected for Information Only ® Construction ❑ Repairs ❑ Private Residence ❑ Other LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY ❑ Unsatisfactory H Satisfactory Total Coliform Present and ❑ E. coli present ❑ E. soli absent ❑ Fecal collonn present ❑ Fecal colifoml absent ❑ Replacement Sample Required Sample not tested because Test unsuitable because: ❑ Sample too old (>30 hours) ❑ TNTC ❑ Improper Container ❑ Turbid Culture ❑ ❑ Bacterial Density Results: Plate Count I ml. E.coli M00 mi. Total Coliform < 1 1100 ml. Fecal Coliforrn < 1 /100 ml. Method Code: Date Received: MICR- 2810 8/ 2/2013 Date Analyzed: 8/ 212013,16:00 Date Reported: 8131113 06603380 Lab Use Only: Sem* Number (DOH number plus five dots) DOH Faun #331319 (revised 8M) DAILY INSPECTION DIARY DAY: T \pv►DATE: 6 / S / 13 WORK PERIOD: a.m./p.m. to WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: a.m./p.m. REPORT # R-eC,%*2k.,,eD R-es j Iks vcn-o,% .4�. Tc-s7 in n Pouf �,9.rwo Les - A- 414D PMv s ie,-c Scfn-&act 1,eb Cc.l !) marrow .4-�� C° :! 1.v.. i �✓�� CONTRACTOR SIGNATURE 23 6(/ INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY _ REPORT 4� DAY: 1�LS DATE: 8/ / �3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: (o co" Co n-s T . -ram� �- On S. �/►L - ?wo C.T %CIS c LO/nh //S A r A -5A / /K S? P /LC /o�''dD C T- / o S ?�4+tom i /.4-t� c -y h r! ,r-� 11-2A / •-a l r rm V I.OHh ,• the nS Te A / w O 8 8 � � -bz lNr-A� Nn.a � •, 3 fo L I= CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: N,E to-r=` e► orymp"4 9r 7M F, a Mm-. la 4rm I.I �1 AfE Ibi!� P1 g OLVmpja F. a ml I EX. 4" & 6" Cl ?E HYDRANT N.E.10TH PL. FINAL DETAIL =-{ T NE 10 T H PL = ;.,� ,e^. T OLYMPi:A AVE NORTH i REMOVE TEMPORARY BLOW OFF AND CUT -IN CROSS. CONNECT TD EXISTING 6" Cl. INSTALL: 1 - 8 x8" CROSS (FLxFL) 4 - 8" GV (FLXMJ) 4 _ 8" SPOOL - 3 _ 8" SLEEVE - 8 x6" REDUCER (MJXMJ) _ 6" SPOOL _ 6" TRANSITION COUPLING CONNECTION DETAIL \ EX. 8" SS X � 5-r►n�j L! �/L DAILY INSPECTION DIARY REPORT DAY: `�Jc 7 DATE: 8 / 7 /f3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: 1,t l / `�fY.✓� O Sxle— 517 Re rD.K—� is si, ►�, 4,1 e rv,**- c� �{ ('o Anne cl.� �L--Eavy�� •�Ar- I24.,—gleka,.� 8 ��JS (lei M-4- "2 '7 t t= CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: NE ion` C.T a of wiPia Nol 4 �4 8- (P— 13 s OL •, i �s DAILY INSPECTION DIARY DAY: / jLiS DATE: 8 /8 //3 WORK PERIOD: a.m./p.m. to WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: a.m./p.m. REPORT �t �DY1 +&S Ti L / i Sr/!// G c, s - �G �,�,Ly.St /✓ k !i! O c-le-� Go -7 �jui' ?J/cam -7Z6- Z 88 - 7OS-6 CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: CONNI'C I rO EX. 8" AC WA If R MAIN. EXACT DEPTH UNKNOWN. POTHOLE IN ADVANCY 110 ESTABLISH LINE AND GRA01.1 INSTALL: N.E. 12TH ST WxN" FEE (FLxFL) W/ CONC. INRUST BLOCK J - B` GV (FLxM✓) CLOSE VALVE AND REMO VE J _ 8 ` SPOOL EX. VALVE BOX. PLUG AND 2 - B" 1RANS! TION COUPLING BLOCK EX. 8" GV. - 8" Sl.EEw, �s I —,— -�,a W Z Q Lij Q CL CID J C) :CTION DETAI OLYMPIA AVE NE 0' FINAL CONNECTION DETAIL U DAILY INSPECTION DIARY REPORT DAY: DATE: 61/21/3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: Loe4..cJ& 4::�o -7s- (7, Li. e /�. 1.6-29 ev.r CONTRACTOR SIGNATURE -4g&=* S��lL ��_ -7?7%34 INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT # DAY: DATE: 8 /13/13 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT DAY: DATE: 8 /� / l3 WORK PERIOD: a.m./p.m. to a.m./p.m. WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: ro Ayr L"o K,�t'.ec_I�d',i �1i� / h S-�•¢-//�1J r pia. r� �r� !e CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: DAILY INSPECTION DIARY REPORT 41 DAY: , h^��p�„ DATE: 12(6/12WORK PERIOD: a.m./p.m. to a.m./p.m. —7— WEATHER: TEMP. MAX OF MIN OF PRECIPITATION: WORK ACCOMPLISHED TODAY: Y, F, - 2 7-za .0 j-VA JOK t� �c c .a.� d �'.s o��• o is , S �..s r e r ♦�y� �-, n vtrX- 7no /,7 yI C, h CONTRACTOR SIGNATURE INSPECTOR SIGNATURE DATE: (I . q A-70A� lot,, Ar fAS lie vi T $t` �-J, jv\ j UCJ VA- 9 1, -k- Z ` y 11 ->I c,v,&L < 114 3 1101AP t t % 9" rLxO-j VaIv.,- f 1� Af r --- -et Gross --- 5 h6-k t�ufpa r?�1s