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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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F
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4 (STATE ROUTE 4)
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21334
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3500 - Local Oversight Program
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PR0545187
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Last modified
11/20/2024 9:09:21 AM
Creation date
1/23/2020 10:43:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545187
PE
3528
FACILITY_ID
FA0007159
FACILITY_NAME
KINGS ISLAND
STREET_NUMBER
21334
Direction
W
STREET_NAME
STATE ROUTE 4
City
STOCKTON
Zip
95206
APN
12919002
CURRENT_STATUS
02
SITE_LOCATION
21334 W HWY 4
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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ANEW RMC LONESTAR �1 <br /> WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a <br /> weighmaster,whose signature is on this certificate,who is a recognized authority of accuracy,as Prescribed by <br /> Chapter 7 (commencing with Section 12700)of Division 5 of the Cal fon is Business and Professions Code, <br /> administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> i <br /> i <br /> 1 1 <br /> 1 <br /> I <br /> fi <br /> k DATE RMC LONES"AR WEIGHMASTER TIME <br /> 9 <br /> (ZJb/12!96 <br /> Clark, Valarie �j <br /> CUSTOMER ID OUR ORDER NO. CUSTOMER ORDER NO. DEPUTY 1.2:s8 i <br /> SHIPPING NUMBER <br /> �i 8: ?. s::itt 4.G, <br /> SOLD TO: DELIVERED TO: <br /> ._,t ,r!�'t•"'�' '��ii•'r .: Ch:1'^T:J�`.I R.. �i tC:? <br /> r- 1. <br /> 11 ! <br /> 1 tl'ly I I _ <br /> i <br /> PRODUCT NO. PRODUCT DESCRIPTIQN <br /> HAULER NO. HAULER DESCRIPTION <br /> i I <br /> OUR TRUCK NO. CUSTOMER TRUCK NO. LOADS TODAY TONS TODAY j i <br /> P rA •:, <br /> WEIGHED AT:(SEE REVERSE SIDE FOR PLANT I.D.) WEIGHTS I <br /> F(.er'1 ZZsa "f' 114 <br /> ! SCALE NO. DRIVER ON OFF r r=T- + <br /> •(. �C rna i <br /> NET LF,:-,: "F 6 <br /> RECEIVED BY: <br /> X G R 0 S S L_1 i <br />
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