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WP0041412
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041412
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Last modified
6/7/2021 12:32:08 PM
Creation date
6/7/2021 12:22:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
File Section
COMPLIANCE INFO
RECORD_ID
WP0041412
PE
4374
STREET_NUMBER
21014
Direction
E
STREET_NAME
COMSTOCK
STREET_TYPE
RD
City
LINDEN
Zip
95236-
APN
09134002
ENTERED_DATE
11/4/2020 12:00:00 AM
SITE_LOCATION
21014 E COMSTOCK RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\dsedra
Tags
EHD - Public
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KN I FE RIVER BILLING OFFICE: CH: ( 0)464- ( ) <br /> CENTRAL DISPATCH: 800 464-6572 • 209 933-6999 DELIVERY <br /> AN MDU RESOURCES COMPANY P.O. BOX 66001, STOCKTON, CA 95206 TAG 788160 <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 /> . .. . . • . <br /> TIME MIX • PLANT# <br /> 77 <br /> DATE NO.OF LOADS I YARDS DEL. I BATCH# SLUMP TICKET NUMBER <br /> 7- <br /> KNIFE RIVER AND DRIVER OF TRUCK are released from any JOB SITE CYLINDER: DYE 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, 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 EJYE1 on the certificate, who is a recognized authority of accuracy, as <br /> for shortage will not be allowed unless made at the time this material Added prescribed by Chapter 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❑YE 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 DYE,' <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 • • • • - <br /> "The 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 whhout the advice,consult tim,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 /> COUNT •: Time of Job Min. REASON FOR DELAY TIME: A <br /> tt <br /> ❑ Job Not Ready ? <br /> J Standby Min. ❑ Job Broke Down <br /> El Truck Broke Down <br /> COUNT •OUR STOP POUR t <br /> Rate of X$ Per Min d <br /> ❑ Adding Water <br /> =$ ❑ Arrived Job Early <br /> • •_ LEAVE •. <br /> El Slow Placing Method <br /> TIME ARRIVE PLANT 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 /> 1.r u1, k. Dir,i r• 1.1 E?I. i}:i :,I:► Tj.c-krct tAuw Ticket; TF) T'iIII It 788160 <br /> 550.,iy16-.4 yr,yR 9{.1 _ ..;.. ` 3/1 <br /> • ,r <br /> t w :�t�t _:s•!:1. <br /> l--4d _r;i z(-` �t Mix ( I:rcic Ret tir rIecl !'Ay ttii ;; (age z;::�c1 L o ci .117 , <br /> v Mfr 44',1 ( . T t f}' rte <br /> Material Desi�ggn �SiCty Requii ed eatc�he�d 'A Har x Hoi�tur�e Fk:trtal Wat Tris <br /> TYPE 11-H 0.1 @ I6 8712.@ lb `' '31 its.@ ]b + 4.57% <br /> 9AND t936 1b 18360 lb 18360-lb @.W, 5.37% A 93E 1 b <br /> CITY 6#9 lb AV Ib LVIa lb 0.04N ;168 it ` gl <br /> Artual wim ht,hn: t. <br /> Laid Total: 30138 1b DeAgn 0.6213 Mater/Cesent @.FAV T Deiigst 5480. Ib ktu313603.' 1b To Add.119 6.6 Ib <br /> �Iurip. c.0@ # Water in Trucks 0.0 gl Adjust Water. a.0 gl / Load Trim Water:-25.0 gl/ CYD <br /> 4a <br /> A - <br /> BILLING COPY 2 `` <br />
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