HomeMy WebLinkAboutPermit Miscellaneous 2009-3-12
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~ ' ~CE Equipment
~pecialty ,
Services
Inc.
Mike Kuenne
541-
349 W lJlo Street
Springfield, )r. 97477
(541)485-8930 Fa,: (541)393-0202
CCB# 154093 DEQ# 38314
Bill To
Oregon Water Services, Inc'
727 Wilson Street
Eugene, OR 97402
P.O. Number
Terms
Rep
MDK
Net 30
Quantity Item Code
1,000 PUMPING
I Job Location
1742 DELROSE
I Date
I 3/12/2009
--
CoM 247'1 - 001 Z-,i
Ship
,/1212009
Descriptior
TANK PUMPING FOR TJ, NK
ABANDONMENT
,
NICE GUY NO ADDrnO 'IAL CHARGE
FOR ALL THAT EXTRA ,lARD WORK
AND MUD
'.,
~.
JjJ~/o\" .'
WAY COOL'
I Total
F.O.B.
Price Each
0.265
..
p.l
Invoice
Invoice # I
9467 I
Project
Amount
265.00
$265.00
~r.n<c['!':L~aJSeS skI1 m_,CootJi" PO!l~d-:'=I-Read ~ fotv.i~ -*'9beW:uS~ ~tai ~ We(
~ , c:erre1t cr CEfT'Sl1 rrixtLres (31 cause ski'l initabcrI, severe cnemca tuns CJ se-ious ete d<rna'Je. AvOO cxrrtad 'MIh
eyes a>d sJ<i>. gbIes. . f\Jy-lluIlllred. ~ slit U1ength """'" a>d Ii;Iht-fiIlirg "to ~ v.t1en1Y<Xl<i\i ~ 1hese
rrateriasll""""""Io';.!1"l ilwe!concrele. usewalelproctboolslhat...li;lhtaltl'elDpa>dhighO'lOUJhtokeepconcrelefroolllaM~ i11DtI'em
Ili'OsI1nJconcrele. 'IIeif"",,~topmectkneesAftercmta:tv.i1t1 'injct1heserraterias. washctfi-rlre<lalelyv.i1t1[esh._walEr,1ndirectcmta:t
1lmIJhclolt'i'li.asda1geroossoprorlJlllyri1se1heserraterias froolclolt'i'li____1ioo1yoo""",,persistento-severe
_atln case ct "to cont1d, 1\S1~ ~ctwalErfa' alhlast 15 rmrtes, Con9JlphjsiBl i-rIre<IaleIy, KEEP ootct.- ct_i Use'
agrees 10 rm<ejltiswamg to" persoro "'" rroy use 0- cane i11D ""tact v.i1t1 we! (~concrele. rrota'. 0'l'lIeI1t o-O'l'lIeI1t rrixbJres,
Aaareaates: PtttlrgOO ~ of dust froo1 a grayeI pn:xllx:l may be haza'l:ku; lo ycu ~, Measures lo control fl.gilive dust sIo.id l::e talen
.ten ~ IIis ~ Hot AIM.h errils I'lJisa1re fumes, Moo breaIli1g \Ires, Also~Asph<t rroy caJSe severe btJns, W'" prctedive
sa!eIy _ (krg ........ palls "" ~""",), 11xIred. 000 ~ waIEr a>d sre . physm1.
Water added at customer's own risk. Additional water added to concrete will Property Damage Indemnification & Release
reduce its strength.Buyers agent aarees to accept responsibility for reduced strength The ~ ci !tis piece rJ heavy eqUJmrt. i1 ~ /his RE-
duetowateraddedabovedesign. LEASE to~fa"yrJJsgnallte,isctlhe~MIhe~r:JU'is
rT1id'ilefy. tI'e_reqlRdtoperfo'mourOO'tr<<:t~ yoorroy
possiJIycaJSeda-nagetltl'eprrrriseso-~,h.o.r\\ishtohelp
yooil_lhat.."". txJtilada'todoltis. tI'e"""""'.aski1g
that yoo sign Itis RElEASE, In roiOOeabo , ct ~ pefOO1la'<e ct ~
_ ct rts 00'tr<<:t ~ me. I tI'e lI'def1;igned. he'el1}' INDE~IFY tI'e
_a>drts~Itr'injda-nagea>dfa'''cBmlotl'eprrrrises.
buiklng. utifity pipeW1es .. cables. \eIeptale Oles. dri-leway 0- _
awutenances. Ii:
Arrived at job with
inch slump.
o
Added _ gal water at customer request.
Test cylinders
take"
Other additions
~
Received
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 liabiltty.
Signature of Owner or Its Agent
Signature of Owner or its Agent
_ Leav: Plan' liI"ive: Job SI'1 Start"'o:scha<g1-Finlsh Fh.rgej
Drivers'
Comments
-JWGDEL TKT09D408
Leave .JOb Site Arriv~ Plant J
.. ,
,
Order No.
Cus~ Nd.
Companyl
Customer Job
Customer pO;
Phase Code
TIC/EJ' NO.
58(.0'7746
58012
43484 OREGON WAT DtLROSE
-----l
CUSTOMER/OFFICE
2103086
Unloading & Standby Excess unloading will be
charged at posted truck time rates. Truck standby
time charged at posted truck time rates.
limited Warranty The only. liability of the seller. for
product defect is fheretum of the purchase price. In no
event shall the seller be liable for any dIrect, indirect,
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
made within 24 hours of dellvery,We do not assume
responsibility for any damage beyond the curb line.
Eugene Sand and Gra
90~20 Loburg Ruad
Eugene, OR ~7408-9467
541-485-1084
III I 11111111111111111111
1
\.
Driver
Co. Proj. No.
r<_'
TODD I':ERR
[Jato
Mop
)3/1<: 20tJ)
ES1 Zooe E
Customer
OREGON WATER SERVICE
Delivery Instructions
Delivery Address
1742 DEL~OSE AVE-BPFINGFIELD
CO'" 2.:10'1 - ,)0 'JZs.
YOLANDA LF T OFF 19TH OFF MOHAWK
",00 PSI C.DF
~NVIRONMENTAL SURCHARGE
OFF GRANDVrSTA RT OFF
Load Oly
6.50
6 50
Product Code UOM
396215 yd
487000 '!a
ProdLfct Description
Oelivered Qty
Order Qty
6.50
6.50
0.00
'"
\
ON JOB TIME: 13120
Load Size Prod. No Description
J,., c: >l9A-'" 1 "I "\1;('\
Truck Gross Welgh( Tare Weighl
,
cc
Use
Haul Cd.
Slump Type
<'liT. rn<= J,.,
TraIler Trailer Taken by
I Check #
0838
""'.
Time:
11:.:,+5 FM
Unit Price
Amount
"
Itjt/j~
PiU~ tsales Tax
"'Q TOTAL DUE
l
t
~
.