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. r _ INTERNAL USE ONLY
Ase emereie- Observations -- Comments es Results
Western Slope Concrete •
Po Box 1319 Carbondale, CO 81623
Office : 970993-3973 . Fax: 979-993-2412
Plant 001 a + - Carbondale, CO 970-963-0180
Carbondale 0242 County Rd `# 9� , d
Plant 002 ed. Dotsero - 4155 Hwy 6 , Gypsum , CO 970-524-2520
Plant 003 a..► Silt --1412 CO, RD, 311 - Silt, CO 970-963-0180
PLACEMENT- AND JOBSITE CONDITIONS - Cie all that app
Windy - Breeze -- Still 3 . Subgrade - Frozen - Wet Dry E.�cplaln Above -
5 . Access Issues `
2 . Rain - Snow — Hot • 4. Placement Concerns - Explain Above 6 . Pump Issues - Explain Above
10-1 Load 10-2 Leave Plant 108 Arrive Job Site 10-6 Start Dischar .. a 10-6 Finish Disch. 10-S Leave Job Site , 1- 0710 Arrive Plant
4/ 45.1 , ffzin5 ISrs - gel ege : git fit a<
Anna ans.„
In the event of deliverybeyond curbline this company will not assume liability for NOTE: This concrete contains correct water contents formix
Ya p y ty strength of mix
age to sidewalk, driveway or other property. The purchaser shall in no event indicated . 1 (e ';do not assume responsibility for strength test when water is
•- ept deliveries of materials not in accord with the agreement of the parties, but such added at customer's request.
materials shall be refused by the purchaser and returned to the seller with a wriften
statement of the reason for the refusal thereof. Otherwise, receipt of such materials Because the conditions of use and application of colored concrete are beyond
and the signature of the consignee or the consignee's agent shall preclude any and all our control, Casey Concrete makes no warranty of merchantability or fitness for
r. No cancellation accepted after concrete has been loaded in any particular purpose and expressly disclaims liabilityfor consequential or
claims by purchase
carrier's truck at our plant. incidental damages, `whether based on warranty or negligence.
Water added on job at customer's request Gal
'PLANT YARD TICKET# ORDER# TRUCK# LOAD- SIZE MIX DATE
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CUSTOMER# SOLD TO P.O.# P #OJECT#
1764 EWII" G TRUCEIUG COUSTRU 000005
5
DELIVERY ADDRESS IZONE# USE DRIVER
303 aO E CREEK RI V VAIL OUTSICIE , CHRIS
INSTRUCTIONS
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_ CAL TO CY EST. '!
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GAL .TO CY ES
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GAL TO CY EST. If
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GAL TO CY EST. "
1,-0 AD I CgfE 'MLATIVORDERED re
PRODUCT
PRODUCT DESCRIPTION UNIT OF UNIT uANrITY / QUANTITY CODE MEASURE PRICE
- AMOUNT
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tDQT 1. SN FLCIWT I ' .,'
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ONTACT WITH WET (UNHARDENED) CONCRETE, MORTAR, CEMENT, OR CEMENT MIXTURES CAN CAUSE SKIN IRRITATION SEVERE CHEMICAL BURNS OR
ERIOUS EYE DAMAGE. Wear waterproof gloves, a long-sleeved shirt, full-length trousers, and proper eye protection when working with these materials. If you have to stand
wet concrete, use waterproof boots that are high enough to keep concrete from flowing into them. Wash wet concrete, mortar, cement, or cement mixtures from your skin
imediately after contact. Indirect contact through clothing can be as serious as direct contact, so promptly rinse out wet concrete, mortar, cement, or cement mixtures from
tithing . 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 a
lysaician immediately. KEEP OUT OF REACH OF CHILDREN : USER AGREES TO CONVEY THIS WARNING TO ALL PERSONS WHO MAY PURCHASE, USE OR COME
I CONTACT WITH WET (UNHARDENED) CONCRETE. MORTAR, CEMENT, OR CEMENT MIXTURES.
by:
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CUSTOMER COPY
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