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WP0038548
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038548
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Entry Properties
Last modified
9/30/2018 12:00:22 AM
Creation date
8/2/2018 9:08:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038548
PE
4375
STREET_NUMBER
4887
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
STOCKTON
Zip
95215-
APN
08917059
ENTERED_DATE
7/13/2018 12:00:00 AM
SITE_LOCATION
4887 N JACK TONE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Deliver Ta <br /> CALAVERAS Wei hmaster Certificate CUSTOMER COPY 1 <br /> ' •HEID�LBERGCEMENTGroup � g <br /> ,4 <br /> Calaveras Materials Inc. _ <br /> 7673 N. Ingram Avenue PLAN I b4 NH&i L.i"" <br /> Fresno,CA 93711-5838 1445 LATHjROP RD <br /> Phone 559-277-7060 <br /> Toll Free 800-726-5615 <br /> Load Leave Plant Arrive Job Start Pour End Pour Leave Job Arrive Plant <br /> Wafer Added on Job at Customer....- <br /> Customer's Request Gallons Signature x --- --- <br /> WEIGHMASTER CERTIFICATE: THIS IS TO CERTIFY that the following described commodity was-�ighed,measured,or counted by a weightmaster,whose <br /> signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the <br /> California Business and Professions Code,administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> INSTRUCTIONS.CAUTION:PORTLAND CEMENT IS INJURIOUS TO EYES: CAUSES SKIN IRRITATION. READ WARNING ON REVERSE SIDE OF THIS FORM FOR <br /> DETAILED <br /> Plant Ticket No. Order No. Customer No. Sold To: Date <br /> 6` <br /> -2 <br /> Delivery Address Zone Driver <br /> 1, ;,'. <br /> Special Instructions Project No. <br /> 0I <br /> Special Instructions Job Number <br /> WIEN 11-11 C <br /> Truck No. Load Size Mix Code Slump %Air %Call. Project Name: <br /> Load Cumulative Ordered Unit of Product Product Unit Amount <br /> Quantity Quantity Quantity Measure Code Description Price <br /> Fl.00 8. 00 ib. 00 ycl 613005 ALO. 3 Sk SAND <br /> 2,00 0.00 ea CACARO CA. CARO/ENVIRON NT <br /> CALAVERAS MATERIALS INC.ASSUMES NO CERTIFICATE OF COMPLIANCE: WE CERTIFY that the <br /> RESPONSIBILITY FOR DAMAGE INCURRED IN portland cement,chemical and mineral admixtures contained in <br /> DELIVERING MATERIALS INSIDE THE CURB LINE. the material described below are brands stated and comply with <br /> specifications: <br /> CALAVERAS MATERIALS INC. CEMENT BRAND: Sub total <br /> TYPE: II MILL LOCATION: Tax <br /> CHEMICAL ADMIX BRAND: TYPE: <br /> MANUFACTURER: <br /> ByMINERAL ADMIX MANUFACTURER: <br /> Steve w i' • -son CLASS: <br /> Tota I <br /> CONTROL <br /> 468331N0. <br /> DO NOT USE FOR TICKET NO. <br /> FORM p WC(Rei.5/06)X289327 <br /> trial Design ally RecOred ea tchad %th 46 Mdslue Actual Wat <br /> -*•IBD 24M ib 1956!9 Ib 156£0 Ib [Los% 20446 E 47 91 <br /> rEm S&O 91 091 .00 <br /> rEFIM tEnd 94 iF 365.9 91 363.8 91 [Lie% 30.9 91 <br /> WA1�R U % it 0 gl 0 911dpi .968 lb 7744 ib 7720 Ib <br /> Id Num Batches: 1 <br /> ! 30M Ib Ge!Mgn"C.- 0.474 WateYOentiert 11476 T Design 440.0 91 Actual 411E6 gl To Add: 23.4 gl <br /> rip: 8.00 In S Water In Truck: 0,0 91 A4ust Wa - ao gl 1 Low Trim Water. -3.0 gl i CY E Note:M and feed occured <br />
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