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WP0042097
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BRITTANY
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10283
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042097
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Entry Properties
Last modified
3/2/2022 4:50:55 PM
Creation date
3/2/2022 4:14:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042097
PE
4380
STREET_NUMBER
10283
Direction
E
STREET_NAME
BRITTANY
STREET_TYPE
LN
City
ACAMPO
Zip
95220-
APN
00707049
ENTERED_DATE
5/27/2021 12:00:00 AM
SITE_LOCATION
10283 E BRITTANY LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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I <br />DRIVER <br />DATE: <br />LEAVE PLANT ARR!VE JOB <br />FE RIS VE <br />"KNY <br />END POUR <br />REQUESTED DELIVERY TIME: <br />12:00/21 <br />12:00 <br />SCOTT C <br />STOCKTON <br />I <br />Load ID <br />AN MMU RESOURCES COMPANY <br />504 <br />ORDER NUMBER: <br />55027 <br />LOT & BLOCK <br />Billing OFFICE (209) 933-6980 <br />TICKET NUMBER: <br />1069489 <br />www.kniferiver.com <br />S LD TO: <br />DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Ll Check <br />VALLEY DRILLING <br />Dispatch: (800) 464-6572 / (209) <br />933-6999 CYDSDEL: <br />9.00 <br />Safety First! <br />P.O. BOX 66001, Stockton, CA <br />95206 LOAD #: <br />1 <br />TRUCK ID <br />DRIVER <br />PLANT ID I <br />LEAVE PLANT ARR!VE JOB <br />START POUR <br />END POUR <br />LEAVE JOB AT PLANT <br />550341609 <br />SCOTT C <br />STOCK <br />I <br />Load ID <br />9.00 CYDE <br />504 <br />CUSTOMER ACCT ID <br />CUSTOMER P.O. / PROJECT NO. PROJECT NAME <br />LOT & BLOCK <br />PREVIOUS TRUCK <br />378044 <br />/ <br />S LD TO: <br />DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Ll Check <br />VALLEY DRILLING <br />VALLEY DRILLING; 10283 EAST BRIT <br />ACAMPO <br />ADDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br />PREPAID C/C <br />BEGINNING ENDING TOTAL <br />Qty this Load Qty Ordered Qty Dlvd- Product Code Product Description UOM Unit Price EXT Amount <br />9.00 9.00 9.00 504 10.3 SK. SAND SLURRY yd 157.50 1,417.50 <br />I <br />I <br />WATER ADDED / ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 1,417.50 <br />Full Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX $109.86 <br />2/3 Load: GAL SLUMP rate per minute for orders exceeding five (5) minutes per ADDITIONAL TIME FEE TICKET TOTAL $1,527.36 <br />1/3 Load: GAL SLUMP cubic yard. GRAND TOTAL $1,527.36 j <br />DESIGN SLUMP <br />REQUESTED SLUMP <br />ACKNOWLEDGEMENT OF RECEIPT, WATER ADDED, & TERMS AND CONDITIONS ON WEB SITE <br />0.00 <br />8.00 <br />Signature: Printed Name: <br />USE OF CONCRETE, AS PLACED: <br />RELEASE: Contractor or Owners agree to indemnify and save harmless Knife River Corporation from liability 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 WWW.I<NIFERIVER.COM/NCA FOR PROP 65 INFO WWW;P65WARNINGS.CA.GOV <br />TESTED BY <br />AIR/SLUMP/TEMP/CYL'S <br />Signature: Printed Name: <br />Knife River Weighmaster Certificate <br />THIS IS TO CERTIFY that the following described commodity was weighed, measured or counted by a weighmaster, <br />whose signature is on the certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 <br />(commencing with section 12700) of Division 5 of the California Business and Professional Code, administered by <br />the Division of Measurement Standards of the California Department of Food and Agriculture. <br />Deputy J <br />Truck <br />Driver <br />User Disp Ticket Num Ticket ID <br />Time Date <br />550341609 <br />592378 <br />user 1069489 98583 <br />11:45 6/10/21 <br />Load Size <br />Mix Code <br />Returned Qty Mix Age Seq <br />Load ID <br />9.00 CYDE <br />504 <br />D <br />74 <br />Material Design Qty Required Batched % Var% Moisture Actual Wat Tot.Wat <br />TYPEII-V 968.0 Ib 8712.0 Ib 8660.0 Ib -0.60% <br />SAND 1936 Ib 18301 Ib 18440 Ib 0.76% 5.03% A 883 Ib 1194 <br />CITY 609 Ib 2726 Ib 2696 Ib -1.10% 2696 Ib 2696 <br />Actual Num Batches: 1 <br />Trim <br />-25.00 gl <br />
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