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WP0039717
EnvironmentalHealth
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14353
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039717
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Entry Properties
Last modified
3/24/2022 2:28:30 PM
Creation date
7/24/2019 1:10:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039717
PE
4369
STREET_NUMBER
14353
Direction
N
STREET_NAME
CLEMENTS
STREET_TYPE
RD
City
LODI
Zip
95236-
APN
05315013
ENTERED_DATE
6/18/2019 12:00:00 AM
SITE_LOCATION
14353 N CLEMENTS RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2019
Tags
EHD - Public
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IVER BILLING OFFICE: (209) 933- <br /> 6980 ( ) <br /> CENTRAL DISPATCH: 800 464-6572 209 933-6999 DELIVERY <br /> KNIFE R ( 711680 <br /> AN MDU RESOURCES COMPANY P.O. BOX 66001, STOCKTON, CA 95206 TAC'' <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 /> PI.MV LANCIE 1)P I ► l.:Ftt:::... C/S KE::T1'1~f:.l�'IAI`J <br /> .17707 M Y ter: <br /> 1._T IJS?r:i�1 IL.0 )T <br /> I <br /> TIME MIX NO. ICU.YDS.THIS LOADI YARDS ORDERED I CIRDER# DRIVER/TRUCK PLANT <br /> DATE NO.OF • •S YARDS DEL. BATCH# SLUMP TICKET NUMBER <br /> F. `i ll1 1 I1 6 `f 8..''`:>0 <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 be weighed,measufed, 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 DYE,' on the certific6te, who is a recognized authority of accuracy, as <br /> for shortage will not be allowed unless made at the time this material Added prescribed byChapter 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 DYE,' 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 /> *Im <br /> • •- • <br /> RECEIVED BY: X • • • • • <br /> e 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 /> • •: REASON FOR DELAY TIME <br /> { Time of Jab Min. ❑ Job Not Ready -I..f F3 101 AL.. <br /> Standby Min. ❑ Job Broke Down T'A x <br /> REV.COUNT START POUR STOP •• EJ Truck Broke Down <br /> Rate of X$ Per Min I ll`i"Ai_.. <br /> ❑ Adding Water <br /> _$ ❑ Arrived Job Early <br /> TIME ON •' LEAVE JOB ARRIVE PLAN ❑ slow Placing Method <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 /> 711880 <br /> I <br /> 1,r 1..a C.k D r,i.V 6-f- U s-t 1)i S p 1'i c k e t N f-ij nt 1•i c.,k p't T 1) `1'J.nip Dztt o <br /> x"51`3.-,413 r_'7 3 89 5)14 u Is IRV, 161 H315 1.58Er 9 52' 6/1-7 19 <br /> Lciad Size Mix Code 4 Pt1..tr-rted Glty IYIix Age ark 1-.uad ID <br /> 9. 00 i:YUS 504 E, 14576 <br /> Material Desi n Qtr/ Re aired Batched z Ver Moisture Actual Wat <br /> 1"XVI-t! 9681b 87122 lb 8790 lb 0.90% <br /> KRCSAND 1935 lb 18452 1b 18480 lb 0.15% 5.95% A 124 g <br /> WATER 58.0 g1 # 307.6 g W.0 gl 0,14% 308.0 g1 <br /> Actual Nue Batches: 1 <br /> Load Total: 2'3$37 lb Design 0.430 Water/Ceoerlt 6.42; T DOsign 450.0 gi actual 4,32.6 gl To Arid: 17.6 yl <br /> SWAP: 6.50 in # Water in Truck. 0,0 gl Adjust Water: 0.0 yl i Load Trio W.ster: -2.0 911 CYD <br /> BILLING COPY 2 <br />
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