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Environmental Health - Public
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2900 - Site Mitigation Program
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PR0508238
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Last modified
1/30/2020 2:38:00 PM
Creation date
1/30/2020 1:21:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0508238
PE
2950
FACILITY_ID
FA0008010
FACILITY_NAME
GRANITE CONSTRUCTION CO
STREET_NUMBER
10500
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
FRENCH CAMP
Zip
95231
CURRENT_STATUS
01
SITE_LOCATION
10500 S HARLAN RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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CALAVERA S " Calaveras Materials Inc. Delivery Tag <br /> • ' HEIDELBERGCEMENTGroup 3451 West Shaw Avenue Weighmaster Certificate <br /> Fresno, California 93711-3204 CUgTC�ER COPY 2 <br /> Telephone 559-277-70¢0 <br /> Fax 559-277-7134 - <br /> Toll <br /> - <br /> Toll Free 800-726-5615 <br /> Manteca Ready Mix Plant Tracy Ready Mix Plant Thorne Ave.Ready Mix Plant Thorne Ave.Ready Mix Plant River Ready Mix Plant Selma Ready Mix Plant <br /> #54 1945 E.Lathrop Road #53 28983 S.Mac Arthur #60 410 N.Thorne Avenue #61 410 N.Thorne Avenue #62 1000 W.Nees Avenue #63 1475 Whitson <br /> Lathrop,CA 95330 Tracy,CA 95376 Fresno,CA 93706 Fresno,CA 93706 Pinedale,CA 93650 Selma,CA 93662 <br /> Load Leave Plant Arrive Job Start Pour End Pour, .r Leave Job Arrive Plant <br /> Water Added on Job atCustomer <br /> Customer's Request Gallons Signature x <br /> WEIGHMASTER CERTIFICATE: THIS IS TO CERTIFY that the following described commodity was weighed,'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 /> DETAILEDCAUTION: PORTLAND CEMENT IS INJURIOUS TO EYES: CAUSES SKIN IRRITATION. READ WARNING ON REVERSE SIDE OF THIS FORM FOR <br /> INSTRUCTIONS. <br /> Plant Ticket No. I Order No. Customer No. Sold To: Date <br /> 'I Ctl I 1 .Sel , <br /> Delivery Address TZone Driver P.O.Number <br /> Special Instructions Project No. <br /> i <br /> Special Instructions Job Number <br /> Truck No. Load Size Mix Code Slump %Air %Call. Project Name: <br /> Load Cumulative Ordered Unit of Product '� Product Unita #A r <br /> Quantity Quantity Quantity Measure Code Description PPlee�+}1q n <br /> s <br /> r <br /> y <br /> k <br /> d <br /> CALAVERAS MATERIALS INC.ASSUMES NO '�•'' <br /> RESPONSIBILITY FOR DAMAGE INCURRED IN CERTIFICATE OF COMPLIANCE: WE CERTIFY that the <br /> Portland cement,chemical and mineral admixtures contained In <br /> DELIVERING MATERIALS INSIDE THE CURB LINE. <br /> 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: <br /> CHEMICAL ADMIX BRAND: TYPE: Tax <br /> MANUFACTURER: ,a• <br /> B' -------- MINERAL ADMIX MANUFACTURER: „ <br /> CLASS: <br /> CONTROL Total <br /> ((�'�r p /� <br /> No. ,J U 7 8 2, -4 DO NOT USE FOR TICKET No. <br /> I , t.i !Yt(ew.hr.M4). <br /> r" nE L Ac-tl_tal. StaA mu <br /> 7.e <br /> �<''a1 F38 In Tot <br />
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