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WP0037031
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037031
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Entry Properties
Last modified
1/9/2019 12:14:06 PM
Creation date
1/9/2019 10:31:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037031
PE
4378
STREET_NUMBER
25200
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
02104114
ENTERED_DATE
8/7/2017 12:00:00 AM
SITE_LOCATION
25200 N JACK TONE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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DAfonskaia
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EHD - Public
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-6980 <br /> NIFE RIVER BILLING OFFICE: CH: ( 0) 464- ) DELIVERY {{ 1 <br /> CENTRAL DISPATCH: 800 464-6572 • 209 933-6999 `J 1 <br /> AN MDU RESOURCES COMPANY P.O. BOX 66001, STOCKTON, CA 95206 <br /> 1 � <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 /> r: •r-: i,i Ei,, t 1-.i.:i'�. i t .! Il':-"�f l�r-` J� �,} �� <br /> MIX NO. ICU.YDS.THIS LOADI YARDS ORDERED I ORDER# I DRIVER/TRUCK PLANT PLANT# <br /> DATE NO.OF LOADS YARDS DEL. BATCH# SLUMP <br /> KNIFE RIVER AND DRIVER OF TRUCK are released from any JOB SITE CYLINDER DYES 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❑YES on the certificate, who is a recognized authority of accuracy, as <br /> for shortage will not be allowed unless made at the time this material Added prescribed by Chapter 7(commencing with Section 12700)of Division 5 <br /> 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'sDEPUTY <br /> COMMODITY AND BECOMES THE PROPERTY OF THE Request Gals.to 1/3 load DYES <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 /> any particular application." <br /> COUNT •= REASON FOR DELAY TIME: <br /> Time of Job Min. <br /> ❑ Job Not Ready <br /> Standby Min. ❑ Job Broke Down <br /> COUNTPOUR STOP POUR <br /> Rate of X$ Per Min. E] Truck Broke Down <br /> ❑ Adding Water <br /> $ ❑ Arrived Job Early <br /> TIME ON •- LEAVE •- ARRIVE PLANT El Slow Placing Method <br /> Five(5)min.per yd.free unloading time allowed. El Other(Explain) <br /> Additional unloading time charged at a minimum <br /> $1.50 per min. <br /> 66603 . <br /> :, •, .;.`.,'t.yt•, l j; rt P f.�.t :::{.t L a.�..F,e_rl, i"It.uri I .i�..1 asE; s.1,i i :i till-c� i�,a'{:c.�• <br /> kc (:1't.: <br /> N:rif t Y r::� I Jti f'4 IJ 6 )`;)wA <br /> 1)e iyylt.kt y NVtaiv*d liatrbed % Val.. i0'.. <br /> `3tA 11t 4840 1 b 4&30 lb -0.41" <br /> I9) lb '"Joao ib low) 1b u.•�fiY " ' 4."�t;� N r.41 0 <br /> 73.E 91 a ,1 0.1 2*A.0 g1 -0.03% W.0: g1 <br /> i1L-tul Nue valuhes: 1 <br /> &A ,,F A-1143 lb bosign 0.634 W81;er/CeA14sYrt 0.636 - f Waigrl 368.0gl kt�ual 302.7 q1 To Add.- r~5, l L-i <br /> r rt T':t.>n iw #. Wager in. Trud.: 0,0 g1 Adjus# t4ta-. 0,0 q1 ! I oil Tri�I b ter.-1-10 91/ CYD <br /> SITE COPY <br />
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