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WP0038903
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038903
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Entry Properties
Last modified
3/22/2019 2:59:34 PM
Creation date
1/23/2019 8:39:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038903
PE
4369
STREET_NUMBER
22901
Direction
E
STREET_NAME
SKIFF
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
20519007
ENTERED_DATE
10/18/2018 12:00:00 AM
SITE_LOCATION
22901 E SKIFF RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
AMeuangkhoth
Supplemental fields
CYEAR
2018
Tags
EHD - Public
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WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity <br /> was weighed,measured,or counted by a weighmaster,whose <br /> signature is on this certificate,who is recognized authority CONCRETE PRODUCTS INC. <br /> of accuracy,as prescribed by Chapterr 7(commencing with � <br /> Section 12700;of Division of the California Business and 1900 Roosevelt Avenue Escalon CA 95320 <br /> ProfessionsCode,administered by the Division of MeasurementP > > <br /> Stand*d!�of the California department of Food and Agriculture. <br /> 209-838-1448 <br /> WEIGHMASTER SIGNATURE TICKET NO. <br /> NOTICE: MY SIGNATURE BELOW INDICATES THAT I ACCEPT THE TERMS AND CONDITIONS OF THIS DELIVERY TICKET, WAITING TIME: <br /> INCLUDING THE TERMS AND CONDITIONS ON THE REVERSE,WE MAKE DELIVERIES INSIDE CURB LINES AND ON <br /> LOTS OR PROPERTY AT CUSTOMER'S RISK ONLY AND ACCEPT NO RESPONSIBILITY WHATSOEVER FOR ANY DAMAGES $ per hr.unloading charge. <br /> RESULTING FROM SUCH DELIVERIES.CUSTOMER SHALL INDEMNIFY,HOLD HARMLESS&DEFEND P&L CONCRETE LEAVE PLANT <br /> PRODUCTS,INC.FOR,FROM&AGAINST ALL CLAIMS FOR DAMAGES OR PERSONAL INJURY.EXPENSE OF REMOVING <br /> MIRED TRUCK PAYABLE BY CUSTOMER.WE ARE NOT RESPONSIBLE FOR THE STRENGTH,SLUMP,OR QUALITY OF <br /> ANY CONCRETE TO WHICH WATER OR ANY OTHER MATERIAL HAS BEEN ADDED AT THE BUYER'S REQUEST.WE DO ARRIVE JOB <br /> NOT GUARANTEE THE COLOR OF THE CONCRETE.WE HAVE NO CONTROL OVER THE PLACING, FINISHING OR <br /> CURING OF CONCRETE AND DO NOT GUARANTEE THE FINISHED WORK IN WHICH IT IS USED,INCLUDING CRACKING. <br /> CONCRETE IS A PERISHABLE COMMODITY AND BECOMES THE PROPERTY OF THE PURCHASER UPON LEAVING THE LEAVE JOB <br /> PLANT ANY CHANGES OR CANCELLATIONS OF ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO OFFICE BEFORE <br /> LOADING STARTS.CUSTOMER IS RESPONSIBLE FOR PROVIDING A SUITABLE PLACE,ON CUSTOMER'S PROPERTY, <br /> FOR DRIVERSTO WASH CHUTES AS NECESSARY.ANY CLEANUP COST OF CUSTOMER-PROVIDED WASHOUT SITE ARRIVE PLANT <br /> OR REMOVAOF TRACKED-MUD FROM STREETS AND ROADS WILL BE BILLED TO CUSTOMER. <br /> SEE TERMS AND PONDITIONS ON REVERSE SIDE.READ FRONT AND REVERSE CAREFIULLY <br /> BY: - CUSTOMER SIGNATURE ATCU ADDED CYLINDERS TAKEN <br /> AT CUSTOMER'S REQUEST GALLONS [I YES ❑NO <br /> CUSTOMER ID P.O.NUMBER LOAD NUMBER JOB NUMBER TIME DATE TICKET <br /> SOLD TO DELIVER TO DRIVER <br /> I'I Fa RD. & B I EDERMAN RD. <br /> TERMS <br /> QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED <br /> THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE <br /> r. k14I tf41%fbVI01I 1. 01" l:ia:-1CK b'14:4ND '.-_AJJRRY yd 144 ter,'. <br /> 1. 00 .2JH IFIT 1 LOCAL- 4. 5 to 5. 75 /L X50. Of": $50. 1710 <br /> 1. 110 EF ENV I RONME W AL. FEE /L. € 15. O1;` $15. 00 <br /> TRUCK PLANT SLUMP DUE AT JOB USE OF CONCRETE <br /> WAITING TIME <br /> 1 -00 P ': r:`iND0011Z►;.3 SUB TOTAL b 787. 50 <br /> SPECIAL INSTRUCTIONS TAX $cc. `9 <br /> 4600634 SCO TOTAL $84,1.3. 49 <br /> GRAND TOTAL Ir64..?. 4`=3 <br /> TICKET NO. <br /> -1-r r_t e k D r~i s ei r I.,J s e r i7:i ..p Ticket N i_t m T i c L.e t 11) -1-i Hie <br /> 5 GARY PHTL.If-' 1993 12:27 <br /> r' <br /> Load Size Mi.x tr`uLJ Rc-tr.iT'rted 0t,y I'di. x Agcy Load TD <br /> c5,, 00 d SAND00103 1) 121.08 <br /> Material Design Qtyy Rei2ired Batched % tsar % Moisture Actual Wat <br /> SAND 1101 2850 1b 151 5 ]b 15100 lb -0.03% Lm M 10'2 q <br /> CEMENT %8.0 lb 4840.0 Ib 4810.0 lb -0.622% <br /> WATER 40.00 g 1 142.54 g 1 142.@6 g 1 -0.38% 142.00 g 1 <br /> Actual Nits Batches. l r <br /> Load Total: 21095 1b Design 0.345 Water/Cevent 0.424 A Design 200.0 1 Actual 244,4 gl To Add: 0.0 gl <br /> Slump: 7.00 in # Water in Truck: 0.01 1. 'Adjust WAter: 0.0 gg1 i Load Trim Water: 7.0 gl/ yd <br /> Actual WIC Ratio: 0.424 Actual Water: w44 gL Batched Cement: 4810 lb Allortable Wafer: 0 16 <br />
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