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WP0042022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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T
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26 (STATE ROUTE 26)
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5841
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042022
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Entry Properties
Last modified
11/20/2024 8:50:37 AM
Creation date
9/9/2021 3:29:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042022
PE
4369
STREET_NUMBER
5841
Direction
E
STREET_NAME
STATE ROUTE 26
City
STOCKTON
Zip
95215-
APN
10123020
ENTERED_DATE
5/11/2021 12:00:00 AM
SITE_LOCATION
5841 E HWY 26
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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DATE08/27/21 <br />ERIVER REQUESTED DELIVERY TIME: 5025 <br />AN MW RESt)<JRCES ""PANY ORDER NUMBER: 1 D 73562 <br />5.11:n: � TICKET NUMBER: <br />www wnilenver ComCYOS DEL: 22.00 <br />Dispatch: 1,. <br />S et YFirst! r _ BOY _LDAD 11: 3 <br />- ..---------- <br />TRUCK ID ORPlER PLANT ID LEAVE PLANT I ARRIVE JOB 1 START POUR ENO PDDR LEAVE JOB AT PLANT <br />_ <br />?,:::: O <br />PROJECT TNAME <br />LOT BLOCK PREVIOUS TRUCK <br />CUSTOMER ACCT ID CUSTOMER P.O. J PROJECT NO T _ 1 — <br />-- DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED. <br />t1URVIANCE <br />DRILLERS INC 5841 E.FREMONT ST <br />STOCKTON <br />NALtrvERY INSTRUCTIONS: -- DRUM REVOLUTIONS <br />COY & AVALON <br />BEGiNNiNG ' EN:::h`S ..T A - <br />Oft laws Qty Ordered City Olvd Product Code Product Description — — UOM� Unit Price - EXT Amount <br />5 <br />i ,Try <br />WATER ADDED / ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL <br />=ult Load. GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX <br />113 Load GAL SLUMPi rate per minute for orders exceeding five (5) minutes per ADDITIONAL TIME FEE TICKET TOTAL <br />113 Load GAL SLUf✓1PI cubit yard. GRAND TOTAL <br />DESIGN SLUMP REQUESTED SLUMP ACKNOWLEDGEMENT OF RECEIPT, WATER ADDED, & TERMS AND CONDITIONS ON WEB SITE <br />0.00 6.00 <br />(Signature._ -- <br />USE OF CONCRETE, AS PLACED: RELEASE: Contractor or Owners agree to indemnify and save harmless Knife River Corporation iron hablhty imposed as a <br />result of any damage caused to the property of others as a result of such delivery. FOR ADDITIONAL RELEASE <br />INFORMATION: SEE to FOR PROP 65 INFO WWW.P6SWARNING5.CA.GOV <br />ESTEO BY AIRjSLUMPJfEMp/•CPL'S <br />.. - • __ Printed Name _ ------ <br />Signature: eighmaster Certificate <br />Cnife River .ea »e g nos <br />h , N'a5 h ,^•r��, <br />,HIS IS TO CERTIFY that the follo:a:ng deSc.: Ac' .rn-r T =Y by 'a 2 <br />o.` acc F <br />who :s a recognized autho. tY admintst•. <br />/hose signature is on the certificate, 5Y <br />cf Foad an, <br />;co:nsne.^sing with section i2ipCJ di Division 5 of the Ca.:tocr.ia Susi"°e°° ane r <br />:he Division of Measurement Standards of the CalLfdraia Departarn- L,... <br />
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