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WP0038640
EnvironmentalHealth
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FOREST LAKE
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038640
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Entry Properties
Last modified
4/11/2019 9:31:24 AM
Creation date
4/11/2019 9:29:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038640
PE
4366
STREET_NUMBER
2820
Direction
W
STREET_NAME
FOREST LAKE
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00306031
ENTERED_DATE
8/9/2018 12:00:00 AM
SITE_LOCATION
2820 W FOREST LAKE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
AMeuangkhoth
Supplemental fields
CYEAR
2018
Tags
EHD - Public
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lVEft BILLING OFFICE: (209) 933-6980 <br /> KNIFE ftLIVERY 3,85 4 7 2 <br /> CENTRAL DISPATCH: (800) 464-6572 • (209) 933-6999 DE <br /> AN MDU RESOURCES COMPANY P.O. BOX 66001, STOCKTON, CA 95206 TAG � L <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 /> TIME MIX NO. ICU.YDS.THIS LOADI YARDS ORDERED I ORDEFI# DRIVER/TRUCK PLANT- PLANT# <br /> DATE NO.OF LOADS YARDS DEL. BATCH# SLUMP TICKET NUMBER <br /> KNIFE RIVER AND DRIVER OF TRUCK are released from any JOB SITE CYLINDER: YE 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 beweighed, 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❑YE on the certificate, who is a recognized authority of accuracy, as <br /> 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 EIYEE 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❑YE <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 /> e mixes quoted-are not warranted o be acceptable Tor-anyparticulair use,purpose or application,nor are Tney warranted o be acceptable Totuse y 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 /> •; Time of Job Min. REASON FOR DELAY TIME: <br /> ❑ Job Not Ready <br /> Standby Min. ❑ Job Broke Down <br /> COUNT STOP POUR <br /> 1:1 Truck Broke Down <br /> Rate of X$ Per Min. <br /> ❑ Adding Water <br /> _$ ❑ MWd Job Early <br /> ❑ slow Placing Method <br /> TIME ON •' LEAVE JOB ARRIVE PLANT Five(5)min.per yd.free unloading time allowed. <br /> Additional unloading time charged at a minimum ❑ other(Explain) <br /> $1.50 per min. <br /> 688472 <br /> i r.,t_t ra k U t-a v C,r- U::>e,r, 1.)3. 7,Fr I i.C i;:E.,t. 1'4 I..t it, 1 l t k tn.t: l x) l'3.fit ;,k <br /> 5503415.338 5''5 0 i08 21 'H <br /> 1._o«aC.1 S:LMe Mi;� Cock Rk:t,-11r,riH(:l (rt ;J )j1i;( i1r1t. i VA)a d T1'i <br /> 7, 00 CYIl5 504 <br /> Naltev ial Desiop Qty AeOred Batched Oar % Moisture ktual War <br /> SAND 1936 Ih 142,2 ib t4280 Ib 0.06% 5.311' A 720 lb <br /> TYPEII-V 558.0 Ib 6776.0 1b 6;75.0 1b -@A1% <br /> WATER 3501.b 1605 lb M10 lb d,31x 1609 It, <br /> iIc'ual Nue Batches: s M�fi�laJ i 4:049:i2 ` <br /> Coad Total: 2'265.5 It llesign 0..R WateriCe�lent 0.362 T Design 2454). Ib Fl t1.i.:i 3c1.s ib <br /> la Mtid: 1�3 ; it:'- <br /> Sluffp: B." in M Wat-?r ift Truclf: 0:43 gal �uijgSt Water:-325 ydi .f load Trip We+er.. 0.9gaY/ Cyl) <br /> SITE C PY . <br />
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