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4200/4300 - Liquid Waste/Water Well Permits
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WP0036535
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Last modified
1/9/2019 11:58:10 AM
Creation date
1/9/2019 10:29:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0036535
PE
4369
STREET_NUMBER
17493
Direction
E
STREET_NAME
BRANDT
STREET_TYPE
RD
City
LODI
Zip
95240
APN
01914044
ENTERED_DATE
1/30/2017 12:00:00 AM
SITE_LOCATION
17493 E BRANDT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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tKN I FE RIVER BILLING OFFICE: (209) 933-694- DELIVERY <br /> 4 CENTRAL DISPATCH: (800) 464-6572 • (209) 933-6999 TAG � <br /> AN MDU RESOURCES COMPANY P.O. BOX 66001, STOCKTON, CA 95206 <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 /> . t <br /> t 00 Bf IX VIA w01,A)PR I D15 'L t+rt,�E S <br /> 012 WCJ(.JMSON RD <br /> [A)I <br /> TIME M X NO. ICU.YDS.THIS LOAi YARDS ORDERED- ORDER# DRIVERri-RUCK PLANT PLANT# <br /> DATE NO.OF • <br /> KNIFE RIVER AND DRIVER OF TRUCK are released from any JOB SITE CYLINDER: ❑YES 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 deliveringmaterials across the curb or roe line.Claims Water Gals.to full load OYES on the certificate, who is a recognized authority of accuracy, as <br /> property rtY 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 Job Gals.to 2/3 load❑YES 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's DEPUTY <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 /> 20IM111111111101 Zvi <br /> 111 MOM: <br /> X -OWN •• • <br /> RECEIVED BY: 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 cf the quoted product for <br /> _My particular application' •);✓A.7 L C.��'•.►9L. <br /> REV.COUNT LEAVE PLANT ARRIVE JOB Time of Job Min. ••r REASON FOR DELAY TIME: AX <br /> ❑ Job Not Ready _ <br /> Standby Min. El Job Broke Down TOT01 <br /> COUNTSTART • • POUR Rate of X$ Per Min. ElTruck Broke Down <br /> ❑ Adding Water <br /> =$ ❑ Arrived Job Early <br /> • •_ LEAVE •_ ARRIVE PLANT <br /> El slow Placing MethoTIME d <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 />
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