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WP0042492
EnvironmentalHealth
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KOSTER
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32875
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042492
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Entry Properties
Last modified
4/6/2022 4:47:48 PM
Creation date
4/6/2022 4:38:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042492
PE
4369
STREET_NUMBER
32875
Direction
S
STREET_NAME
KOSTER
STREET_TYPE
RD
City
TRACY
Zip
95304-
APN
25510028
ENTERED_DATE
8/27/2021 12:00:00 AM
SITE_LOCATION
32875 S KOSTER RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
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, ESC810n, CA 95320 <br />Professions Code, administered by the Division of MeasurementP �f <br />Standards of the California department of Food and Agriculture. 209-838-1 448 <br />WEIGHMASTER SIGNATURE <br />INVOICE/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 <br />LEAV 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 />r� <br />U6 <br />ANY CONCRETE TO WHICH WATER OR ANY OTHER MATERIAL HAS BEEN ADDED AT THE BUYER'S REQUEST. WE DO <br />ARRIVE JOB <br />NOT GUARANTEE THE COLOR OF THE CONCRETE. WE HAVE NO CONTROL OVER THE PLACING, FINISHING OR <br />CURING OF CONCRETE AND DO NOT GUARANTEE THE FINISHED WORK IN WHICH IT IS USED, INCLUDING CRACKING. <br />( y: <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 CAREFIULLY <br />WATER ADDED CYLINDERS TAKEN <br />BY: CUSTOMER SIGNATURE ATCUST <br />AT CUSTOMER'S REQUEST GALLONS DYES ❑ NO <br />CUSTOMER ID P.O. NUMBER LOAD NUMBER JOB NUMBER TIME DATETICKET <br />20i_C' <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 <br />SPECIAL INSTRUCTIONS <br />SLUMP <br />DUE AT JOB USE OF CONCRETE <br />WAITING TIME <br />SUB TOTAL <br />TAX <br />1 O FAL <br />GRAND TOTAL <br />INVOICE/TICKET NO. <br />FI '$A C'k Orri veer L.15et- Disp Ticket NLtm Ticket '11) Time Oat - <br />4F, ANT OhlIr:l PHILIP 38467 11:50 3/21/9--l' <br />I..uad C.ize irl.ir CoJe Ret1_tl^r►ed Oty Mix r1ye Seth Load ID <br />'5. `II'! d SAND 0101" U 40960 <br />Material Desi� gn��Otyy Reyaired Batched % Var � Moisture Actual Wat <br />SAND 1101 X850 1b 15105 1b 15090 1b -0.17% 6.00% M ill g1 <br />CEMENT 968.0 1b 48+0.0 Ib 4850.0 1b 0.21% <br />WATER 40.00 gl 102.54 gl 102.00 gl -0.53% 102.09 g <br />Actual Nun Batchei: 1 <br />LL ad Totaj: 2Q781 b Des n gg 34`" Watter/�eIll 0 A D si n ,0 1 tual 204.3 q_1 To Add: 0.0 gl <br />S�u8p: 6.00 in Water in Ouck: �.0 gl Adjus dater: ®.B gl / Noal r:s later: 0.0 gI1 yd <br />Actual W/C Ratio: 0.352 Actual Water: 204 gl Batched Cement: 4850 lb Allowable Water: 0 lb <br />
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