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WP0042678
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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VAN MAR
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13600
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042678
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Entry Properties
Last modified
7/20/2022 1:30:33 PM
Creation date
3/16/2022 9:52:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042678
PE
4378
STREET_NUMBER
13600
Direction
E
STREET_NAME
VAN MAR
STREET_TYPE
LN
City
GALT
Zip
95632-
APN
02102027
ENTERED_DATE
10/19/2021 12:00:00 AM
SITE_LOCATION
13600 E VAN MAR LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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". KN I FE RIVE DATE: 13:30 1 <br /> KRPR - LODI REQUESTED DELIVERY TIME: 13:30 <br /> AN MDU RESOURCES COMPANY ORDER NUMBER: 55017 <br /> Billing OFFICE (209) 933-6980 TICKET NUMBER: 1326285 <br /> www.kniferiver.com Dispatch: (800) 464-6572 / (209) 933-6999 CYDSDEL: 6.00 <br /> Safety First! P.O. BOX 66001, Stockton, CA 95206 LOAD#: 1 <br /> TRUCK ID DRIVER PLANT ID I LEAVE PLANT ARRIVE JOB I START POUR END POUR LEAVE JOB AT PLANT <br /> 550341642 WALLY W. ILODI I ! ! 77 <br /> CUSTOMER ACCT ID CUSTOMER P.O./PROJECT NO. PROJECT NAME LOT&BLOCK PREVIOUS TRUCK <br /> 378044 / <br /> SOLD TO: DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br /> VALLEY DRILLING VALLEY DRILLING;13600 E VAN MAR <br /> ADDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br /> BETWEEN E COLLIER RD & LIBERTY RD ON RIGHT, PREPAID CC <br /> BEGINNING ENDING TOTAL <br /> Qty this Load Qty Ordered Qty Dlvd Product Code Product Description UOM Unit Price EXT Amount <br /> 6. 00 6. 00 6. 00 504 10.3 SK. SAND SLURRY yd 157 .50 945. 00 <br /> 6. 00 55EFS EMERGENCY FREIGHT SURCHARGE CY 10.00 60.00 <br /> WATER ADDED/ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 1,005.00 <br /> Full Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX $77.89 <br /> 2/3 Load: GAL SLUMP rate per minute for orders exceeding five(5)minutes per ADDITIONAL TIME FEE TICKET TOTAL $1,082.89 <br /> 1/3 Load: GAL SLUMP cubic yard. GRAND TOTAL $1,082.89 <br /> DESIGN SLUMP REQUESTED SLUMP ACKNOWLEDGEMENT OF RECEIPT,WATER ADDED,&TERMS AND CONDITIONS ON WEB SITE <br /> 0. 00 7.00 <br /> Signature: Printed Name: <br /> USE OF CONCRETE,AS PLACED: 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,KNIFERIVER.COM/NCA FOR PROP 65 INFO WWW.P65WARNINGS.CA.GOV <br /> TESTED BY 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 <br />
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