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WP0039869
EnvironmentalHealth
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12 (STATE ROUTE 12)
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13550
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039869
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Entry Properties
Last modified
11/19/2024 3:48:24 PM
Creation date
9/12/2019 3:26:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039869
PE
4373
STREET_NUMBER
13550
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95242-
APN
05502002
ENTERED_DATE
7/25/2019 12:00:00 AM
SITE_LOCATION
13550 W HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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INVOICE 0 1 - <br /> WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity /fir ^S <br /> was weighed,measured,or counted by a weighmaster,whose 4240 L i 7 V <br /> signature is on this certificate,who is a recognized authority of <br /> accuracy,as prescribed by Chapter 7(commencing with Section ZZC _M _X <br /> 12700)of Division 5 of the California Business and Professions <br /> Code,administered by the Division of Measurement Standards, <br /> of the California Department of Food and Agriculture. - - <br /> NOTE, Excess water is detrimental to concrete quality. Increased water in concrete mix reduces strength and durability and increases shrinkage. <br /> Buyer accepts responsibility for water added on job site,which exceeds accepted water/cement ratio and workability specifications. <br /> Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: <br /> Total Amount for This Ticket Not Including Standby Charges: <br /> Cash Check k/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect <br /> Without Standby Charges: <br /> Check <br /> Charge <br /> CyrtorrlertGode -, Custorne{ Customer Job Number: Order.Codp-/Date: <br /> Project Code: Project Name: Dep,ul y Wei g <br /> hmaster. r pr ". <br /> ,. ., um eri. _ <br /> Ticket.Date:. DeliveryAddiess: Map Page: <br /> Delivery Instruplions:f;. - -- Ticket Number: <br /> Due On,Jgt�' Slump:. Load: Truck Number: Driver Number: Driver Name: End Use: <br /> LOADCUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT <br /> QUANTITY QUANTITY QUANTITY <br /> '7 <br /> Water Added Curb Line Crossed At Owner's SUB TOTAL <br /> IN GALLONS: Agent's Request: X <br /> AUTHORIZED SIGNATURE <br /> -1 TAX <br /> V � Print Name: Date <br /> xD O Signature above signifies receipt and acceptance of the listed materials and acknowledge- TOTAL <br /> INITIALS INITIALS ment of and agreement to the CEMEX terms and conditions. <br /> BATCH DATA: 42027 <br /> C,lYD S 140?i495 .=:8 41-2 <br /> Ma" E!! Des-L :` Re -tired Batched Var % "_ Moisture Actual Wat Tot_Wat Tri® <br /> +51-5.38 lb 4520.00 lb 4.62 0.16 3.80% Pi 15:84 gl 19.84 <br /> MEN:- 968.010 o 1936.00 lb 1935,00 1 b :.00 -'0.05h <br /> WATER 68.00 gal. 80.18 ga.l 57.00 gal. - 3.15 �,W 57.00 91 51-.00 -20.00 g1 <br /> Actual Nua Batches: 1 Manual :0:11:20 <br /> t nad Intal. 69.31 lb Design 0.517 t4ater CM®ent 0.371- A Desi-In 1;.0 gi Actual 76.8 nl To Add: 43.2 <br /> :t;:�ni• :� �j'. ti t: '#,t� 1-,l - I -,a,,1- T.,1.P �d�.°�� Ct�:�f^," C, <br /> ani innvcoc A, o.,..ni,n <br />
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