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WP0038455
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038455
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Entry Properties
Last modified
9/10/2018 2:51:45 PM
Creation date
9/10/2018 2:48:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038455
PE
4349
STREET_NUMBER
37222
Direction
S
STREET_NAME
BIRD
STREET_TYPE
RD
City
TRACY
Zip
95304-
APN
26508015
ENTERED_DATE
6/20/2018 12:00:00 AM
SITE_LOCATION
37222 S BIRD RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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DAfonskaia
Tags
EHD - Public
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fA L A VERAS <br />HEIDELBERGCEMENTGroup <br />Delivery Tag <br />Weighmaster Certificate <br />CUSTOMER COPY 2 <br />Calaveras Materials Inc. <br />7673 N. Ingram Avenue Av. 14 <br />Fresno, CA 93711-5838 Ty-acy Pl `tt-it V53 <br />Phone 559-277-7060 28983 S. M ,.c, Plt, t, h l -iv <br />Toll Free 800-726-5615 <br />Load Leave Plant Arrive Job Start Pour End Pour Leave Job Arrive Plant <br />Water Added on Job at Customer <br />Customer's Request Gallons Signature X <br />WEIGH MASTER CERTIFICATE: THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a weightmaster, whose <br />signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the <br />California Business and Professions Code, administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br />Plant <br />Ticket No. <br />Order No. <br />Customer No. <br />Sold To: <br />% MoisturEE Rctual Wat <br />Date <br />Delivery Address <br />1b <br />IMIb <br />10820 1b <br />Zone <br />Driver <br />CEI1#1 <br />Special Instructions <br />5170 1b <br />5145 lb <br />-0.48% <br />Project No. <br />Special Instructions <br />515 lb <br />lb <br />lb <br />Job Number <br />Truck No. <br />Load Size <br />Mix Code <br />Slump % Air <br />% Call. <br />Project Name: <br />Load <br />Cumulative <br />Ordered <br />Unit of <br />Product <br />Product <br />Unit <br />amount <br />Quantity <br />Quantity <br />Quantity <br />Measure <br />Code <br />Description <br />Price <br />0.582 T <br />.]. V) <br />d t. 00 <br />l '.J. 00 <br />y ❑ <br />r; i i VJ4J <br />Nater: 0.0 ql <br />/ Lead Trial .0.0 gl/ CYD <br />1� 47141 <br />0. 00 <br />ems. <br />CAC( IRI' <br />. C:AFtB E.lglJIREINMEr; <br />CA. 00 <br />eak <br />FUEL_ <br />UEL.. SURCHARGE_' <br />l <br />F <br />CALAVERAS MATERIALS INC. ASSUMES NO <br />CERTIFICATE OF COMPLIANCE: WE CERTIFY that the <br />RESPONSIBILITY FOR DAMAGE INCURRED IN <br />portland cement, chemical and mineral admixtures contained in <br />DELIVERING MATERIALS INSIDE THE CURB LINE. <br />the material described below are brands stated and comply with <br />specifications: <br />CALAVERAS MATERIALS INC. <br />CEMENT BRAND: <br />Sub total <br />TYPE: II MILL LOCATION: <br />Tax <br />CHEMICAL ADMIX BRAND: TYPE: <br />MANUFACTURER: <br />By ;-i7,. kd'. <br />MINERALADMIX MANUFACTURER: <br />CLASS: <br />Total <br />rnniTDni F— n n f- P% n <br />NO. J G 0 J 0 0 -4 DO NOT USE FOR TICKET NO. <br />FORM # WC (Rev. 5/06) X289327 <br />Nater-lal <br />Desi�ggn� aty <br />A <br />R�e��qwired <br />9atd7 ed <br />% liar' <br />% MoisturEE Rctual Wat <br />C0NSM <br />Ib <br />1b <br />IMIb <br />10820 1b <br />-1.00% <br />4.50% M 58 g1 <br />CEI1#1 <br />1034 lb <br />5170 1b <br />5145 lb <br />-0.48% <br />NATER111 <br />515 lb <br />lb <br />lb <br />iOTWATER <br />% # <br />lb <br />lb <br />WATER2 <br />180 % # <br />2121 lb <br />2110 lb <br />-0.51% <br />E49 gl <br />Actual <br />B#Chres:. <br />> <br />.. .. .__ . <br />�aC� <br />Load Total: 18075 lb <br />Design 0. X99 <br />g <br />iiaterfCeaent <br />0.582 T <br />Design 309.c 1 Actual 307.1 gl To Add: yl <br />later, <br />Wlutp. <br />7.00 in # Nate <br />i <br />g <br />Nater: 0.0 ql <br />/ Lead Trial .0.0 gl/ CYD <br />
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