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WP0037283
Environmental Health - Public
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JACK TONE
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037283
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Entry Properties
Last modified
9/30/2018 12:09:56 AM
Creation date
12/2/2017 5:52:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037283
PE
4374
STREET_NUMBER
4887
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
STOCKTON
Zip
95215-
APN
08917059
ENTERED_DATE
9/7/2017 12:00:00 AM
SITE_LOCATION
4887 N JACK TONE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
DAfonskaia
Supplemental fields
FilePath
\MIGRATIONS\J\JACK TONE\4887\WP0037283.PDF
QuestysFileName
WP0037283
QuestysRecordID
3680640
QuestysRecordType
12
Tags
EHD - Public
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CAL AVERA S Delivery Tag CUSTOMER COPY 2 <br /> HEIDELEI ERG CEMENTcroua Weighmaster CertificateCalaveras Materials I I <br /> ,CA 9 7-7060 Inc. FLAN L :T4 [IAN L LLA <br /> 7673 N. Ingram Avenue 1945 LATHROP RD 1111 <br /> Fresno,CA 93711-5838 <br /> Phone 000-1016-3201. <br /> Toll Free 800-726-5615 <br /> Load Leave Plant Arrive Job I Start Pour End Pour Leave Job Arrive Plant <br /> y — <br /> Water 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 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 /> DETAILED CAUTION: PORTLAND • • IRRITATION. ,D • a • •• 4• <br /> Plant Ticket No. Order No. Customer No, Sold To: Date <br /> 54 -:3 97 6647323 HENNINGS BROS. DRILLIk 04-Oct-17 <br /> Delivery Address Zone Driver <br /> 42'. ZKTONE RD STOCKTON KA JOHAL <br /> SAI Project No. <br /> i iti SLUMP/PUMP/99H TUICA-26 LFT ON N JACKTONE RD 6647'32"3 <br /> Special Instructions Job Number <br /> Truck No. Load Size Mix CodeSlump %Air %Call. Project Name: <br /> 9. 5 x005 14 0t 2 <br /> Load Cumulative Ordered Unit of Product Product Unit Amount <br /> Quantity Quantity Quantity Measure Code Description Price <br /> . r�-; 0, t+t: ry.a C.a"tt_rftYiti CA• CHr.3ii ENt�i lttt;vrt hi 7 <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. CEMENTBRAND: Subtotal <br /> TYPE: II MILL LOCATION: <br /> CHEMICAL ADMIX BRAND: TYPE: Tax <br /> By Steve Willson MANUFACTURER <br /> MINERALADMIX MANUFACTURER: <br /> CLASS: <br /> CONTROL 496367 Total <br /> NO. -4 DO NOT USE FOR TICKET NO. <br /> FORM#We (Rev S'06)x289327 <br /> VIA Dealyn Qty Required Batched %Var%MN41ve Actual 'aYal <br /> >150 2449 Ib Z'$348 Ib 33241 Ib -11.30% 3.@%M 55171 <br /> r1i 55.4 44&.1 91 44a LI am% 449.4 IIIrtKtt d s u a <br /> �y1TCK .0 % s .4 171 .1 y <br /> AFI X4 IU <br /> 3,.;; ;M 3ZJ IU r 1.11'91 <br /> Ib11p tV•'netiCheS 1 <br /> i 36286 Ib DebpIVy1C. 4474 WffimCemen: 1.469 T Design 522.5 of Actual SMA 0 To Add 16.4 al <br /> M: lam In 0 Wderin Tmch: 1191 Aclud"hit : 4.1 0,i Load TdmWater -24 d l CYEMAE Mtawdte- duccwed <br />
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