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3500 - Local Oversight Program
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PR0545776
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Last modified
5/28/2020 4:43:22 PM
Creation date
5/28/2020 4:35:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545776
PE
3528
FACILITY_ID
FA0002231
FACILITY_NAME
JACK FROST ICE SERVICE
STREET_NUMBER
425
Direction
N
STREET_NAME
UNION
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15112003
CURRENT_STATUS
02
SITE_LOCATION
425 N UNION ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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t <br /> E. F. M.ITCHLER CO. <br /> Cental Mix Concrete & Building Materials <br /> 400 S.LINCOLN ST. (209)466-8941 STOCKTON,CALIF.95203-3398 <br /> COUNTER <br /> START DRIVER'S TIME <br /> FINISH LEFT PLANT r, <br /> TOTAL ARRIVE JOB (f) C/� <br /> C.O.D. STARTED JO - © } <br /> STANDING <br /> TIME LEFT JOB fir/ i <br /> TOTAL JJ <br /> C.O.D. ARRIVE PLANT <br /> WATER i\ { <br /> ADDEDAUTHORIZED BV DRIVER I � <br /> SLUMP PLACED i <br /> t <br /> 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 this certificate,who is a recognized authority of accuracy,asprescribed by Chapter?(commencing, i <br /> with Section 12700) of Division 5 of the California Business and Professions Code, administered by the Division of + <br /> Measurement Standards of the California Department of Food and Agriculture. <br /> WEIGHED AT: E.F.MITCHLER CO. 400 S.LINCOI-N ST. STOCKTON,CA 95203 <br /> SOLD <br /> TO DELTA' PUMP } <br /> 425 NORTH UNION ST. <br /> JOB STOCKTON I <br /> SITE <br /> c MIX NO SLUMP <br /> 7Et • <br /> MIX NAME BATCH TIME <br /> 124 9-00 1 01 10.56 SK 299^ 100i3 <br /> 8/14/94 STEVE NOWAKI 7.8 9, 00 <br /> I <br /> WATER 4255 LRS <br /> A0012 19350 LDS misc. <br /> CEM21 8860 LESS <br /> MIX TIME= 15.0 WARNING <br /> Freshly mixed cement,mortar,grout or concrete may cause skin irritation. f <br /> Avoid direct contact where possible and wash exposed skin areas promptly <br /> withfresh water.hanycementitious material gets intoeyes,rinse immediately I <br /> and repeatedly with water and get prompt medical attention. I P <br /> SOME OF THE PRODUCTS THAT WE SELL COULD CONTAIN ONE OR <br /> MORE CHEMICALS KNOWN TO THE STATE OF CALIFORNIA TO CAUSE <br /> CANCER.BIRTH DEFECTS OR OTHER REPRODUCTIVE HARM. <br /> 31557 Received by X <br /> NOTICE:Our drivers will make every effort to place material where Customer designates,but the Company <br /> assumes no responsibility for damages inside curb or property be <br /> line. on claims e considered unless Buyer <br /> will <br /> �. <br /> materiel is delivered and receiptetl for. Late charges will be made on delinquent accounts. Buyer will pay ' <br /> reasonable costs of collection and attorney fees. INSPECTOR <br />
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