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DELIVERY TICKET
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SAND & GRAVEL COMPANY
400 VALLEY AVE NE, PUYALLUP, WA 983/L -151b
sH[ES/OFFICE vvvvw.M I�3Senda. ,dGravel.com
jZosl 1133-31005 CONCRETE ORDERS SAND & GRAVEL ORDERS
k25319ee-UUaet (253) 833-3700 (253) 536.9100 SHELTON OCTICIPim
s— nor% aaa_:,,aR 1,5.1 m-4116 (9531843-1787 (360)426-3344 (360)491-1111
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1..U31 VM1!m P.O. OR JOB NO.
PCAITr ICO
DECIVERP r tOKET IGO.
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6115-5
1.172
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C T DLVRD
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SLUMP
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SPECIAL INSTRUCTIONS
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JOB xDDRESS
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CITY UNITS
PROD. CODEI
DESCRIPTION
UNIT PRICE
AMOUNT
11 00 yd i
)4421r,
r144—Ela .,
►NATER 4 164n TER 4
11 00 CY
1001d
AIR ENTRAINMEW
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000
ENV I RMHl= N I AL COMPLIANCE - Hi
1..00 LD
i4v J.
HJEL yl[RCLIAROE-RFA.VY MIX
DRIVER NO.
TRUCK NO.
TERMS:
SUB TOTAL
oE.
L
RECERSE - CtSTOMER RELEASES & AGREES TO HOLD HARMLESS THE MILES CO.
q' 17
FOR ANY DAMAGE TO HIS REAL OR PERSONAL PROPERTY CAUSED By DECIVERT OF
MATERIALS LISTED ABOVE.
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ORIvER.
F.
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bIGMAJ URE
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X
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6115-5
1.172
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Load Size
'Mix Crede
m! u.ar ited Qlty MI _'I. Aijt 5r-
Load ID
11-40 c1f
0442A
Sar'
49140
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'1270 Its
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14sm tb
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373 ar
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1478 tb
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DELAr%ERY TICKET - N1 .1 li
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SAMD& GRAvECUUMPAMT
400 vACCEY AVE ISE, PUYALCUP, VVA a831Z-z5]6
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(cBa) 3aa-a100 CONCRETE ORDERS SAID a1 GRAVE[ ORDERS
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bNtGIAL INUT RUG I IUN5
Cob I OILIER ILO.
ORDER AO.
CUa I OMER PO OR .IOB ILO
PLART no
DELIVERY I ICKET NO.
[j4/1 ll201
10 00 yd
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t0 00 CY •r001L7
CY ORDERED
CY DLVRD
LOAD NO
1w o_ -j CY
5-16.- eT W-1.1
ENVIR014MENTAL COMPLIANCE - Iii
PLANT TIME OUT
JOB TIME IN JOB TIME OUT
PLANT TIME IN
FUEL_ SuriurlARGE- a iEnu Y m l x
Loticl 5iZ4 Mix Code
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Load ID
10.00 cY 0442, .
w
49152
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bNtGIAL INUT RUG I IUN5
14 lGlitirksK Li,lr r lilt a •e 1 I I U56 C1 - ISRTUEWAY/GURY
UNITS
PROD. CODE
DESCRIPTION UNIT PRICE
AMOUNT
10 00 yd
WNEA
ij-4421;
t0 00 CY •r001L7
7`cli W Ucivre
AIF'' ENTRA.>mMEme
U.i:+lt TjcFcot fluor T.ir-kec
1w o_ -j CY
D300
ENVIR014MENTAL COMPLIANCE - Iii
USeL
1 Ord LD
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FUEL_ SuriurlARGE- a iEnu Y m l x
Loticl 5iZ4 Mix Code
7DtWR ILO, I ROCK N0
SUB TOTAL
TAX CODE. EE
�� _ z RELEASE - COs 1 OILIER RECE75E5 s AGREEb 10 ROCD RARIGICEbb I RE MIICEb CO.
FOR AICT I3mMIAGE 10 RIs RMAL OR PERS'UICAC PROPERI T CAUSED IST DECIvERT OF
151RIvER. MATERIALS LISTED ABOVE
t�era-r rt•ar_ - SALES TAX
NAP I I Fl-� � SIGAATURE
X TOTAL AMOUNT
5
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7`cli W Ucivre
(I�rr.
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ID
Time Cie re
M065 1996
USeL
115i)".2cl
4 1385
lu-w W, 4; 1/ 1
Loticl 5iZ4 Mix Code
KtcLIViled
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Load ID
10.00 cY 0442, .
w
49152
""m LtwrlMon Oegirl4r!
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94crell
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e;ANDOW 2 SAND CLASS 2 1770 ib
i336+1 Ib
11.1m Ib
A aft £.W%A
79 of
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75.0 a
150 A
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lAtp PoLYSyr U19 FoU, 937 l ra
3110 ca
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Load 3*?f} lb Gem®m/01C, O+ISG
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Design 2952 gl
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217 AI To Aft 43$ of
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lb I CY