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SR0076713
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4200/4300 - Liquid Waste/Water Well Permits
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SR0076713
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Last modified
6/22/2018 2:50:54 PM
Creation date
6/22/2018 2:50:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
SR0076713
PE
4366
FACILITY_NAME
INIQUEZ, JAVIER
STREET_NUMBER
2433
Direction
N
STREET_NAME
BEYER
STREET_TYPE
LN
City
STOCKTON
Zip
95215
APN
10102208
ENTERED_DATE
6/22/2018
SITE_LOCATION
2433 N BEYER LN
RECEIVED_DATE
2/1/2017
P_LOCATION
99
P_DISTRICT
004
Tags
EHD - Public
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' VEIGHMASTER CERTIFICATE <br />THIS IS TO CERJIFY that the following described commodity <br />was weighed, measured, or counted by a weighmaster, whose <br />signature is on this certificate, who is a recognized authority CONCRETE PRODUCTS INC. <br />of accuracy, as prescribed by Chapter 7 (commencing with <br />Section )27,00),of Qivision 5 of the California Business and 1900 Roosevelt Avenue, Escalon, CA 95320 <br />Professions Code, administered by the Division of MeasurementP p <br />Standards of the California department of Food and Agriculture. 209-838-1448 <br />I MA Miami rel .. j <br />INVOICE NO. <br />NOTICE: My signature below indicates that I accept the terms and conditions of this delivery ticket includin the terms and <br />WAITING TIME: <br />conditions on the reverse. We make deliveries inside curb lines and on lots or property at customer's risk only and accept <br />no responsibility whatsoever for any damages resulting from such deliveries. Customer shall indemnify, hold harmless & <br />$ per hr. unloading charge. <br />defend P & L Concrete Products, Inc. for, from & against all claims for damages or personal injury. Expense of removing <br />LEAVE PLANT <br />mired truck payable by Customer. We are not responsible for the strength, slump , or quality of any concrete to which water <br />or any other material has been added at the buyer's request. <br />ARRIVE JOB <br />WE DO NOT GUARANTEE THE COLOR OF THE CONCRETE. We have no control over the placing, finishing or curing <br />of concrete and do not guarantee the finished work in which it is used, including cracking. Concrete is a perishable commodity <br />and becomes the property of the Purchaser upon leaving the plant any changes or cancellations of original instructions <br />must be telephoned to office before loading starts. Customer is responsible for providing a suitable place, on Customer's <br />LEAVE JOB <br />property, for drivers to wash chutes as necessary. Any cleanup cost of customer -provided washout site or removal of tracked - <br />mud from streets and roads will be billed to Customer. <br />ARRIVE PLANT <br />SEE TERMS AND CONDITIONS ON REVERSE SIDE. READ FRONT AND REVERSE CAREFULLY <br />WATER ADDED <br />BY: CUSTOMER SIGNATURE ATCUST <br />AT CUSTOMER'S REQUEST <br />CYLINDERS TAKEN <br />GALLONS El YES ❑ NO <br />CUSTOMER ID <br />P.O. NUMBER <br />LOAD NUMBER <br />JOB NUMBER <br />TIME <br />DATE <br />TICKET <br />SOLD TO <br />DELIVER TO <br />DRIVER <br />TERMS <br />QUANTITY <br />QUANTITY <br />PRODUCT PRODUCT <br />UNIT OF <br />UNIT <br />EXTENDED <br />THIS LOAD <br />DELIVERED <br />CODE DESCRIPTION <br />MEASURE <br />PRICE <br />PRICE <br />TRUCK <br />PLANT <br />SLUMP <br />DUE AT JOB USE OF CONCRETE <br />WAITING TIME <br />I <br />ii! <br />SUB TOTAL <br />TAX <br />SPECIAL INSTRUCTIONS <br />TOTAL <br />GRAND TOTAL <br />INVOICE NO. <br />
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