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WP0040396
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040396
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Entry Properties
Last modified
3/24/2020 1:44:57 PM
Creation date
3/24/2020 1:20:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040396
PE
4369
STREET_NUMBER
19685
Direction
S
STREET_NAME
HARROLD
STREET_TYPE
AVE
City
ESCALON
Zip
95320-
APN
24911014
ENTERED_DATE
12/16/2019 12:00:00 AM
SITE_LOCATION
19685 S HARROLD AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
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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 a recognized authority CONCRETE PRODUCTS, INC. <br /> of accuracy,as prescribed by Chapter 7(commencing with <br /> Section 12700) of Division 5 of the California Business and 1900 Roosevelt Avenue, Escalon, CA 95320 <br /> Professions Code,administered by the Division of Measurement P & <br /> Standards of the California department of Food and Agriculture. 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 <br /> NOT GUARANTEE THE COLOR OF THE CONCRETE.WE HAVE NO CONTROL OVER THE PLACING, FINISHING OR t, 1 <br /> CURING OF CONCRETE AND DO NOT GUARANTEE THE FINISHED WORK IN WHICH IT IS USED,INCLUDING CRACKING. f <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 DRIVERS TO WASH CHUTES AS NECESSARY.ANY CLEANUP COST OF CUSTOMER-PROVIDED WASHOUT SITE ARRIVE PLANT <br /> OR REMOVAL OF TRACKED-MUD FROM STREETS AND ROADS WILL BE BILLED TO CUSTOMER. <br /> SEE TERMS AND CONDITIONS ON REVERSE SIDE.READ FRONT AND REVERSE CAREFIOLLY <br /> �/ <br /> 7 f )/7//-^)/._/'� WATER ADDED CYLINDERS TAKEN <br /> BY. a '�'' CUSTOMER SIGNATURE ATCUSTOMER'SREQUEST GALLONS 1:3 YES El NO <br /> CUSTOMER ID P.O.NUMBER LOAD NUMBER I JOB NUMBER TIME DATE TICKET <br /> SOLD TO DELIVER TO DRIVER <br /> TERMS <br /> QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED <br /> THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE <br /> TRUCK PLANT SLUMP DUE AT JOB USE OF CONCRETE <br /> WAITING TIME <br /> SUB TOTAL <br /> SPECIAL INSTRUCTIONS TAX <br /> TOTAL <br /> GRAND TOTAL <br /> TICKET NO. <br /> J .1.Lkut Pd I.I.+,, <br /> S i Z to iii i. •< C c,:d c- R c-rt l..t r rr c-.-ci G!t;y 01 i < G:.1;-i(' ��k qiL.O d'a1 <br /> yd SONDOO103 <br /> Mat er•iai Design (lty Required Batched Var Moisture Actual kat <br /> SAND 1101 28510 1b 121x84 lb 12090 lb 0.05% 0.00% M 82 gl <br /> CEMENT968.0 1b 3872.0 lb 3840.0 1b -0.83% <br /> 40.4@ g I 1022.04 gl 102.V gl -Ql.03% 102.00 a! <br /> IlLtUL'i Nua Batches: 1 <br /> Load Tatal: 3.781 1b Design 0.345 WateriCe'en't 0.400 A Des��it�n 160.0 &,r <br /> Actual 184,0 gl To Adci: 2,0 nl <br /> $]uap• .44iv in Wat r in T u�k: 0.0 9 Adjust ter: 0.0 �i r' 840 Tri® : 5.$ �l; yrd <br /> F tui WI Patio: 0,y 0 dual �da er: 1 1 Ba Red Cel : lb owable a er; 0 lb <br />
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