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SR0074747
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0074747
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Entry Properties
Last modified
10/3/2023 3:09:02 PM
Creation date
12/1/2017 6:30:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0074747
PE
4380
STREET_NUMBER
21060
Direction
N
STREET_NAME
RAY
STREET_TYPE
RD
City
LODI
Zip
95242
APN
01302075
ENTERED_DATE
4/28/2016 12:00:00 AM
SITE_LOCATION
21060 N RAY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
FilePath
\MIGRATIONS\R\RAY\21060\SR0074747.PDF
QuestysFileName
SR0074747
QuestysRecordID
3378521
QuestysRecordType
12
Tags
EHD - Public
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BILLING OFFICE: (209) 933-6980 IDE IVFRY <br /> KNIFE ftlVEft CENTRAL DISPATCH: (800) 464-6572 • (209) 933-6999 _ 4-9847 <br /> AN MDU RESOURCES COMPANY P.O. BOX 66001, STOCKTON, CA 95206 <br /> l <br /> A <br /> • <br /> STOCKTON PLANT LODI PLANT MANTECA PLANT TRACY PLANT ELK GROVE PLANT AMADOR TRANSIT MIX <br /> 400 S.LINCOLN ST. 851 E.LODI AVE. 450 EAST WETMORE 1728 WEST LINNE ROAD 10260 WATERMAN ROAD 12480 RIDGE ROAD <br /> STOCKTON,CA 95203 LODI,CA 95240 MANTECA,CA 95337 TRACY,CA 95376 ELK GROVE,CA 95624 SUTTER CREEK,CA 95685 <br /> SOLD TO: SHIP TO: <br /> TIME MIX NO. YARDS ORDERED OIRDER# DRIVER/TRUCK PLANT PLANT# <br /> OF • . YARDS <br /> KNIFE RIVER AND DRIVER OF TRUCK are released from any JOB SITE CYLINDER: OYES KNIFE RIVER WEIGHMASTER CERTIFICATE <br /> responsibility of addition of colors due to variations in cement and THIS IS TO CERTIFY that the following described commodity was <br /> aggregate materials or admixtures, and for damage which may be weighed, measured, or counted by a weighmaster,whose signature is <br /> incurred in delivering materials across the curb or property line.Claims Water Gals.to full load EYES on the certificate, who is a recognized authority of accuracy, as <br /> prescribed by Chapter 7(commencing with Section 12700)of Division 5 <br /> for shortage will not be allowed unless made at the time this material Added of the California Business and Professions Code, administered by the <br /> was delivered. ADDITIONAL WATER ADDED TO THIS CONCRETE On JobGals.to 2/3 IoadOYES Division of Measurement Standards of the California Department of <br /> WILL REDUCE ITS STRENGTH. ANY WATER ADDED IS AT At Food and Agriculture. <br /> CUSTOMER'S OWN RISK, CONCRETE IS A PERISHABLE Customer'sDEPUTY <br /> COMMODITY AND BECOMES THE PROPERTY OF THE Request Gals.to 1/3 load OYES <br /> PURCHASER UPON LEAVING THE PLANT. ANY CHANGES OR <br /> CANCELLATION OF ORIGINAL INSTRUCTIONS MUST BE AUTHORIZED BY: <br /> TELEPHONED TO OUR OFFICE BEFORE LOADING STARTS. <br /> RECEIVED BY: X X . • . • • <br /> "The mixes quoted are not warranted to be acceptable for any particular use,purpose or application,nor are they warranted to be acceptable for use in any particular <br /> environment or In conjuncture with any particular soil conditions. Buyer's selection of the quoted mix,unless otherwise acknowledged in writing by Knife River will be <br /> deemed to be without the advice,consultation,recommendation or suggestion of Knife River and Buyer assumes all risk related to the selection of the quoted product for <br /> en articular application." <br /> REV.COUNT LEAVE PLANT •= REASON FOR DELAY TIME: <br /> Time of Job Min. <br /> ❑ Job Not Ready <br /> - Standby Min. ❑ Job Broke Down - <br /> REV.COUNT START -• • • Rate of X$ El Truck Broke Down <br /> Per Min. <br /> ❑ Adding Water <br /> _$ ❑ Arrived Job Early <br /> TIME ON •: LEAVE JOB ARRIVE PLANT ❑ Slow Placing Method <br /> Five(5)min.per yd.free unloading time allowed. ❑ Other(Explain) <br /> Additional unloading time charged at a minimum •� � � � <br /> $1.50 per min. <br /> 649647 <br /> I i t:.:) I.: IJ rw.. 1 <br /> SITE COPY <br />
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