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WP0037743
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037743
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Entry Properties
Last modified
12/27/2018 11:51:47 AM
Creation date
12/27/2018 10:33:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037743
PE
4369
STREET_NUMBER
19730
Direction
E
STREET_NAME
COYOTE CREEK
STREET_TYPE
LN
City
CLEMENTS
Zip
95227-
APN
00919026
ENTERED_DATE
12/29/2017 12:00:00 AM
SITE_LOCATION
19730 E COYOTE CREEK LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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19730 E. Coyote Creek Lane, Clement, CA. 95227 Record ID WP0037743 <br /> PHOTO#3 <br /> Recei t of the 10.3 sand/cement mix. <br /> 1*4 KN I FE RI CENTRAL DISPATCH:(800)464-6572• (209)933.6999 LEVE <br /> <^ BILLING OFFICE:(209)933-6960 <br /> AN MDU RESOURCES COMPANY P.O.BOX 66001,STOCKTON.CA 95206 RY <br /> • TAG <br /> 00 S. TONLILAC PLANT ''Y1SDI PLANT • <br /> 400 S.LINCOLN ST. MANTECA PLANT TRACY PLANT <br /> 657 E.6L PC AVE. 450 EAST WETMORE ELK GROVE PLANT <br /> STOCKTON,CA 95203 1726 WEST LINNE ROM 10260 WATERMAN ROAD AMADOR TRANSIT MOt <br /> LODI,CA 95240 MANTECA,CA 95337 <br /> SOLD TO: TRACY,CA 95376 124&0 RIDGE ROAD <br /> ELY,r,ROVE,CA 95624 BUTTER CREEK,CA 95665 <br /> 486874 SHIP TO: • <br /> A R A GROSS DRILLING 19730 E. COYOTE CREEK <br /> PO PDX 178 WOODBRIDG C/S MACKVILLE OFF LIBERTY RD , 1 <br /> 3012 WOODSON RD • <br /> • CA <br /> CLEMENTS <br /> TIME MIX NO. PrEivious Truck: <br /> 12:49 5045. 00 575661 <br /> ■, 5.00 55029 550341433 LODI <br /> 03 <br /> 07/06/18 1 5.00 <br /> 111.42-1 <br /> 1 - KNIFE RIVER AND DRIVER OF TRUCK are released from any g e QIQI 1 P <br /> responsibility of addition of colors due to variations in cement and JOB SITE CYLINDER: KNIFE RIVER 1319426 <br /> • aggregate materials or admixtures, and for damage which may be DYE$ THIS IS TO CERTIFY that the tollowi&Gd(MASTER CERTIFICATE <br /> incurred in delivering materials across the curb Or property Ilne.Claims Water weighed,measured,or counted by a weighme c-0rrimodlty was <br /> for shortage will not be allowed unless made at the time this material Gals.to full load AYES on the certificate, who is a recognizetl autA whose signature Is <br /> was delivered-ADDITIONAL WATER ADDED TO THIS CONCRETE Added prescribed by Chapter 7(commencing with Section 27p0)of ra . as <br /> WILL_ REDUCE ITS STRENGTH. ANY WATER ADDED IS AT On Job Gals.to 213 load DYES DIvi.of 0 elf oMeasia u ement Startdartlsssi theC0 a d i is er by <br /> CUSTOMER'S OWN RISK. CONCRETE IS A PERISHABLE At food and Agriculture. rme <br /> COMMODITY AND BECOMES THE PROPERTY OF THE Customer's em't <br /> PURCHASER UPON LEAVING THE PLANT. ANY CHANGES OR Request Gals.to 113 IoadDYES DEPUTY <br /> CANCELLATION OF ORIGINAL INSTRUCTIONS MUST BE • <br /> TELEPHONED TO OUR OFFICE BEFORE LOADING STARTS. AUTHORIZED BY: <br /> 0 <br /> ;RECEIVED BY: y <br /> A 5.00 Yd 504 /� <br /> 10.3 5K. SAND SL ■ <br /> i <br /> annMregOr�n'Pnluncture wnn o acseP r anY Ga Nar uae.Wrpese or aPP ca,on,nor are warranle <br /> deemed to De wnipVl the �Y Paranaer edl CortMaone.6tlyarb soltrction of the ecce a <br /> • edvrce,""'i llatlpn,retora ndaeon m su08aeUOn of Nnite glvaigarovtj gumix,unless alnenwce ackntlwl P Vae n arty <br /> •ny P•riicWa aOPlKaaon. Yar aesunrns all n6k related lu 1•db0•d o wrnirp by Knl1.River will be <br /> 0 selection of the quoted Product for <br /> 1 1 3 0 Time of Job MIn. REASON FOR DELAY TIME, <br /> • �• Standby ❑ loo nor.0, iD— I S V� V L70 Ll LI O ' <br /> 13Joe&ak. <br /> • R810 M 7(s Min. <br /> Per Min ❑ T-M Bk.D.— I A <br /> • .. . •�. `- <br /> 7 a C1 �'> . TOTAL del <br /> ( I 46 Floe(5)min per Vol.tree un1oadm9 hme 811xMyey O elo.Eisen weawo <br /> Additional unloading tlme ❑oParOed el a mINn10m 0—1[:W.MI�_ <br /> 61,60 Permin <br /> Betty Ho <br /> Environmental Health Specialist Page 3 of 3 <br />
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