12050064FRANK LEE & ASSOCIATES
GEOTECHNICAL CONSULTANTS
10 KOOTENAI COURT, FREMONT, CA 94539
(510)676-5859
July 21, 2012
Job No: IN89-S2-L2
Ms. Tracy Hsu
21871 Dolores Avenue
Cupertino, California 95014
SUBJECT; FOUNDATION EXCAVATION INSPECTION
Proposed Two Story New Residence
10406 Palo Vista Road
Cupertino, California
Dear Ms. Tracy Hsu:
This letter is to confirm that we have inspected the foundation
excavation for the proposed two story new residence of the subject
site. Our observations indicated that the condition observed
during construction are generally in agreement with the City of
Cupertino approved plans were based and the recommendations
contained in Geotechnical Investigation Report, Project No. 7811,
dated April 16, 2012, prepared by Capex Engineering Inc. The Soil
conditions are adequate for the proposed two story residential
building.
We appreciate the opportunity to work with you on this project. If
you have any questions or if we can be of any further service,
please do nota hesitate to call. Thank you.
Very truly yours,
FRANK LEE & ASSOCIATES
CCi
F �\
Professional Engineer CE34975
QPOF ESSIO,t,,
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c� No. C 34975 m
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WEC and Associates, Inc.
.July 23, 2012
City of Cupertino
Community Development
Building Division
10300 Torre Avenue
Cupertino, CA 95014-3202
Subject: Survey Report
10406 Palo Vista Rd
Cupertino, CA
To Whom It May Concern:
This letter is to confirm in writing that WEC and Associates; Inc has provided staking for
the foundation line on the subject property. The stakes have been placed in accordance
with the plans approved by the City of Cupertino both horizontally and vertically. The
horizontal control is established by county record tract map(s)/Record of Survey(s) and
the monument line established along Palo Vista Road.
We have subsequently done a site visit on 7/23/2012. From our professional point of
view, the contractor has formed the foundation walls in accordance with the horizontal
setback requirement. The finish floor elevation, based on the measurement of top of form
elevation. is 105.25'.
We make no warranty, expressed or implied; as to the services tendered except that our
services are performed in a maturer consistent with that degree of care and skill ordinarily
exercised by members of the same profession currently practicing under similar
circumstances at the same time and in the same or similar locality.
If you have any further questions regarding this matter, please contact me at your
convenience.
Sincerely.
WEC and Associates, Inc.
OY)"
Ran Wu, PE.. LLS
2625 Middlefield (toad 0658 • Palo Alto, CA 94306 • Tel: 650-823-6466 • Fax: 650-887-0321
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SURVEYING DIAGRAMW E C 2625 MIDDLEFIELD RD #658 TEL: (650) 823-6466
10406 PALO VISTA RD
CUPERTINO, CA & ASSOCIATES PALO ALTO, CA 94306 FAX: (650) 887-0321
It& / 2 U SD a dy
FRANK LEE & ASSOCIATES
GEOTECHNICAL CONSULTANTS
10 KOOTENAI COURT, FREMONT, CA 94539
(510)676-5859
July 21, 2012
Job No: IN89-S2-L1
Ms. Tracy Hsu
21871 Dolores Avenue
Cupertino, California 95014
SUBJECT; INSPECTION OF BUILDING PAD COMPACTION
Proposed Two Story New Residence
10406 Palo Vista Road
Cupertino, California
Dear Ms. Tracy Hsu:
This letter is to confirm that we provided inspection and testing
during grading operation of the building pad compaction for the
proposed two story new residence at the subject site. The results
of field density testing performed by our firm indicated that a
minimum of 90 per cent of relative compaction was achieved on the
building pad.
We appreciate the opportunity to work with you on this project. If
you have any questions or if we can be of any further service,
please do nota hesitate to call. Thank you.
Very truly yours,
FRANK LEE & ASSOCIATES
Fx'ank" Lee`
Professional Engineer CE34975
QPOFESS/ON
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CAPEX ENGINEERING INC.
P.O.nOX 14198, FREMONT, CA 94539
'I'el: (510) 668-1815 Pas: (510) 490-8690
Building Department
City of Cupertino
10300 Torre Ave.
Cupertino, CA 95014
Project o.7911
November 15, 2012
Subject: Proposed New Residence at
10406 Palo Vista Road
Cupertino, CA
(Permit No. 12050064)
SPECIAL INSPECTION SERVICES FINAL AFFIDAVIT FOR
STRUCTURAL STEEL WELDING
Dear Sir:
CAPEX ENGINEERIA`G INC., has provided testing and special inspection services at the
subject site in accordance with section 1704A of the California Building Code (2010 Edition) as
listed below:
(1) Check Mill certification and welder's certification.
(2) Inspection of welding procedure (PCAW) specifications qualification and equipment.
(3) Check structural members for thickness adjacent to welds.
(4) Check the type and size of wire (NR 232) to be used for the various joints and positions.
(5) Observe the technique of each welder periodically with the use of a welding inspection
shield.
(6) Observe bevel complete penetration welds on connection of TS 8 s 6 bent beam, TS 8 s 6
bent beam to TS 6 x 6 column, TS column to base plate, stud welds on 5/8" � studs to TS
beam/colunut, fillet welds on connection plate to TS column/beam and ''"A" plate "U"
shape bucket to connection plate of TS bent beam.
Personnel under the general supervision of a registered Civil Engineer performed these
inspections. Based on the inspections performed and upon our substantiate reports that the
inspected work was performed, to the best of our knowledge, in conformance with the approved
plans and specifications and the applicable workmanship provisions of the California Building
Code.
Sincerely,
CAPEX ENGINEERING INC._.
"°'> Fsutl
Principal
CAPF-V ENGINEERING INC.
Y
Exp.
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Oc CgLIF�
James C. Chcn, C. L., S. E.
2881 Meridian Ave.. Unite 1 18
San Jose, CA 95124
Phone (408) 268 - 0612
October 26, 2012
Building Department
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014
RE: Proposed Residence at
10406 Palo Vista Road
Cupertino, CA 95014
Our Job No. 1205
Dear Inspector:
HLE
performed the Structural Observation Inspection per CBC 2010 for the Rough Framing
construct iori,fonthe'above referenced projection on October 24, 2012. At the time for inspection,
sub -floor WEs covered-with'plywood sheathing and roof sheathing was covered with felt. I didn't
perform the inspection for these items.
There were some minor corrections which have been fixed before me
To the best of my knowledge, the work has been perforated in according to Plan S -I through S-6
and Specifications shown. It is satisfied to me.
If you have any questions in regarding to this subject, please don't hesitate to call me.
Very truly yours,
James C. Chen, C. E., S. E. pl slAUCTUR°y
. 9rf OF CAIF00
Copy,, to:Tracy'I-Isu; Owner= -i, -
:'Judd'I Iaaland, Contractor:
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CUSTOMER'NUMBER NOTICE OF SALE NUMBER JOB P.O: NUMBER, _TIME.DUI
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HOLLISTER153
REDWOOD CITY 3818383
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,WEIGHMASTER, EPTIFICATE
CIHIS IS TO . CERTI� that the IdIcv0;g'Wwrbedl corn . maetty a in6hecl, measured,
mrad. or counted unlecl b I y4h wpiqhmaher, signaturewho�is on thIs comficale
ta�
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CUSTOMER'NUMBER NOTICE OF SALE NUMBER JOB P.O: NUMBER, _TIME.DUI
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AM,
In-
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NVILLE,� &95077 15'001
,CERTIFICATE.
'�d iVOW� of ;Dc�mcy. W PmSM130d.,
vig�er.tlosi signature is 0n Oft witficale, is a re��Z
WrniMslemd ?y Na Division cg Measurement SM ds af,oCallfpmia Oewnmenl of Food and Agriculeu!0",
CUSTOMER NUMBER
.-OLD
I JOIJ P.O. NUMBER.0 v%
BY
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1,4
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rII F 16
SALHiAs x1l 'S�DE �l SANJOSEW
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GK75 CHEBTiMUT- IW'HOSPffAL Rd.-- 355 BLOMOLIST
.!Pm
GILROY 351 HOWER 352 REQWCO) CRY 3916982
P.011BOX 50001, N
TELEPHONE (531N7 &2000 14
t
WEIGHMAS'
`THIS IS TO CERTIFY Wt the IDI&Ang desaebW =r,,64,ty.Y;aR
wel hee. measured, or =rUx
fol'Ohmotel 7 (wnmancim vnN SeLtom=)) at DjjSjW 5 of the Calilomla Business aM Professions
NVILLE,� &95077 15'001
,CERTIFICATE.
'�d iVOW� of ;Dc�mcy. W PmSM130d.,
vig�er.tlosi signature is 0n Oft witficale, is a re��Z
WrniMslemd ?y Na Division cg Measurement SM ds af,oCallfpmia Oewnmenl of Food and Agriculeu!0",
CUSTOMER NUMBER
NOTICE OF S% NUMBER
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DATE::m 3,. A
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v CUSTOMER -.'SIGNATURE X'
,�PIWA�SLOUR
DRIVERS- PLEASE: COMPLETE"..
Id'I
DRIVER COMMENTS*
NDtes�
r,f
&
'DRIVER
RUCK NO..
NAME
4.
,.-GRANITE ROCK COMPANY
WEIGHMASTER
-
Wei Master 6e9rge Hafely;'•l�BRANCH
I -WEIGHED Al
DEPUTY •7
PLEASE READINARNING OWIREVERSE:SIDE"`-
. =zmISTOMFIR COPY"-`
i.
J"hM1i `L
x
ACTUAL/BATCH WEIG TS,,
U
1 7 Qae I b
07
876 ''16'
Z.
li F,
pq
DEPART, PLANT-lil..Ii.o.64�A-.�,=A�t,..
ARRIVE JOB - z"(P.P.7
1J I
MLLE : CA 95077-5001
gh Yho is a mooffmod funhoety of a=facy. as wesenbecl
minlstared
bjr Me Division of Man -,-rn-nl Stand.nis of the Cali
000111MIleent Of F($Od aed Agdculhae.
OMBER j
SOLD
I JO.P.O. NUMBER '.A !,:lf'-Iw),TIMEZUE
ONJOB
BY.
w W. BEACH Sl'.
MCORAL ST, 11711 BERRYESSA
DRIVERS
WATS(WeUZ 331
SAMA CRUZ =1 ' SAN j0SEW1
J;
ACO WORK SL
17M DEL MONIS %`VD. 1 W GRA n ROCK WAY
.
SEASIDE 311 �JOSE 362'
DRIVER COMMENTS: a
075 CHESTNUT.
IGO H��tAL ROate BLO�IST
AGSAONAS
9100Y ml
STER352 RE,DWqODCffYml&382
P.O. BOX
,,
TEt_EPHONE (831) 768-2800
Mat the.folloW de;�;bad C",Iy.Wja,ftia
with SOWW'12 00) of ChYlsion 5 of the . Cott
gli&jLl�nOaauFeStnti.ess andd
- .
1J I
MLLE : CA 95077-5001
gh Yho is a mooffmod funhoety of a=facy. as wesenbecl
minlstared
bjr Me Division of Man -,-rn-nl Stand.nis of the Cali
000111MIleent Of F($Od aed Agdculhae.
C6STOMER
p
..J'* D
It -A
R., 1040
'JOB LOCATION =e
.,b v4i
-POD,
At,
)CAND"CONSTRUCT I,OlqlrIN `R
14136--`J.A`�r"
1'
1 IMP-,
'- f,,4 -
JORTH LFFOOTI -llLL'LF .'-.P-
A 'V � STA, TO 16406. F.AL` Ilk
LO
A.
-852/Al'- 4
.,4,ft
7
A', tCkECKJNO.
tt�-Vlf, ka,
%
TOTAL YDS; ORDERED
OMBER j
NOTICE OF SALE 04UMBER
I JO.P.O. NUMBER '.A !,:lf'-Iw),TIMEZUE
ONJOB
DATE.` _'�
'1665
01,
DRIVERS
-PLEASE COMPLETE U
425/201 '�
J;
11f;iS4'O;-Ui7idin,MitKl e"n't 60Gr'o`v'id-,e'vou` the �
customersmith-concre
C6STOMER
p
..J'* D
It -A
R., 1040
'JOB LOCATION =e
.,b v4i
-POD,
At,
)CAND"CONSTRUCT I,OlqlrIN `R
14136--`J.A`�r"
1'
1 IMP-,
'- f,,4 -
JORTH LFFOOTI -llLL'LF .'-.P-
A 'V � STA, TO 16406. F.AL` Ilk
LO
A.
-852/Al'- 4
.,4,ft
7
A', tCkECKJNO.
tt�-Vlf, ka,
%
TOTAL YDS; ORDERED
J_TOTAL' YOS. DELIVERED
I LOAD NO.—
CUMULATIVE TOT
I
LIVERY.�ONAIME?.::
V!YtS -6 t.
NOff': �Ar� USTO'M"ER'SI'G**NAt E:
oil
DRIVERS
-PLEASE COMPLETE U
11f;iS4'O;-Ui7idin,MitKl e"n't 60Gr'o`v'id-,e'vou` the �
customersmith-concre
N, T�.: 1�/KGRA -222
CU. t=1I -6
DANVAIR.
brll}'c`%IWRX %,0'
—vt
. V.4
%
4
'E T4;
S m
-A
xi4l
5�-'070 411' X7 462t 16t n0 50% N
500lb
b-4 St.
27,:-
287�.„ ' T 00'Z 207L" "c"D
4 W
2
2
LIVERY.�ONAIME?.::
V!YtS -6 t.
NOff': �Ar� USTO'M"ER'SI'G**NAt E:
oil
DRIVERS
-PLEASE COMPLETE U
DRIVER COMMENTS: a
_4 v
rim? m
"-t`TRUCK
DRIVER NAME
t
GRAN. -'WEIGHMASTE lz
COMPANY. R
Z' ,�T�'.ROCK I
Mase r�;. Gi0qe.Hifely,*, .:.
- E. �T*f
: '. ; , — . BwCHNO.
., .
. .
DEPUTY
PLEASE READ• WARNINGON REVERSE SIDE,
2
%{ �Y i0 s3.n\' '1 �T'1• ti'• i
�540 W BEACH ST.'R OW CORAL ST I , }t 11211 BERRYESSA �� BV dY t " Y 4 , b: rt 4_
WATSOWILLE 51�#SAMACRUZ 5210 J. SANASEwI^. Y
Ape WORKST. 1)SSOELMONTEBLVO T 10010 i.` rt�^OCK wgYC --^t - ..-'� � Y�( i€� t! li •tl k i' >� / / ��
( SALIHAS 35 �: /=SEAStOESat E50i - !:TIE,iTa ,j �,=4
8125 CHESTNUT 100 HOSPRgL fl0 5x BLOM0015T • ITqq
OBAOY W, -,,v HOLLISTIi 352 flEOWOPDCm 5815582 '_PO BOX 50007; WAJBONVILLE CA 950P:5001} - ,i T' \ ,
TEIX' ONE '3000' I` i;WEIGHMASTER CERTIFICATE Y ,gip -�
L s 9. n n4i :iv.,osrtkClaO'.,'+55>",1v x'1A.. „_
yI ',T IS 1510 CERTIFY That Ule lol��po�wIIlIqq oexnoeo mm cammoolry was weighetl meesureo Or counle0 oY a welghmeslar, whose elgrleture Is pn Nb ceNhOata who b e reoopNzeE euNonry d�eowrery u pI¢scrlEeE f
t l01 Cf!epler 7 (oommanorg wiN Sectlon,12700) 01 Divisbn 5 of the Celilom a euvnese en0 f�ralesslms Cotlo�B4mlNstaratl by the Oh'IGdJoL.Maewrelhonl Stenearas b the Ce44lomla DeP✓3Rma10 oI Faod eM Ag wiWre r
Gi r CUSTOMER NUMBER NOTICE'OE SALE NUMBER •JOB / P O NUMBERt 'n , TIME DUE ON JOB n /i KiS DATE 1 o C� 17
+ q5 .✓ 'k J'w
04754 'Sti9 ". E05r17,1?(tiA'Al}�i/1,tEsr�}'tc�S�'r!?JiliJ+t , A3a.Q10'PM� iEOJ 25/'2IDIc-f '
F5i to�Cl1S�'OMER `,'.+��d.•t l^' �,``"u .� a �:.<+ c -: ,d Mc R ¢' ' l� o%uta�" ��e y� �}y
"+ 't�.Js-µ ':rli(at'rt / +..h 3'{> b T'i j l �� 1 r./(•� i L 5 U+/ ,xH14 a
t Z
w i�P1«?ii Jill HAAT AND'-CONSTRUCTIOWITNC �r �ATsrtv>at sti r�tt ttl�`.c to14Yc6} �^Ji'�''{ Esfa '� *
A HfZ'��,406"PFLOti'V{ISTA
rJcaCU�ERTINO`�� '�7tt1 t'r(t1�aL- iYr>`x`}c6ry�rr�0'k�S r If 1r hj':)
g.crJOB OCAT �80taNORTH ,LF"" FOOTHILL L.F. 41G '' < ` '� `�Y'/'ttt'A3.p,'�+�. t�ii1 3✓it�'IC.
s� s`'xi5X5 rJRLMr LF15RL0 `ISTA, TO 10406 tj
"2 0FIS�W 852AYjaU31IS�t C�I Zvi F �r3k? t1�S ?'�}�¢tt5(7 A54laz,tTi fT[3^ i4iXC��'i�F ittlti) . s
xt c i.COD+,{~= CASf�,ij CEIVED(�
�,} c IRIT�?�'71t'1 UlCftlt .rJ t/t11T?
,+'% z.. _ _ .. .i . � •'Yv _. _! ♦ I... ._(�- - � . ..e.n o.. � _.._:. N. f.. ..int.{....r... 'i/ .n ..� :.. _ : JY Y...c a.i f ��t
CODE QUANTITY UNI I DESCRIP710N PRICE AMOUNT
5
670kID3�"f3AfJ:i9 00�311IJ_FA `r�,? 3/ al.-A,SI>40fD0t��SI3i�Iu r G:ONC1r'f�Fs�l 1"t�ylF;i'j„ � Tt,'��'46l "-�'clf�+t+�:? .�
i Ft/ifAG`S h9iiffy I' �Y iIA j �clfA ��ll 1t� lt�+' l'lrA� '�H�r� :iNi� 4Y �{MhVa}fr/SJ e r' }rAt :i moi, J.:
�r W. , tF �Mf r .r.j✓, 1.t ,j >�' rl F e 1J A : • i � , .. "{2.CfJr. @.t t'a..Tf �a'Gxu� �I'��) Sx,� Z..-7. �{'b+.�tet`Y+X f•F'ii'i r1L ,1.�,d�ti�
�r 41%lAa?�MAg T-ya,+ .
2.'"'�{�'. �?�C,''v -`'' 4' ti'•�'ti' r'q�
try .`•c `vr ..ri3'T:y�iyiL J tl'r�s�'sj`a'�..9JtPr1'F 1QR:4-' t. qII i { "
",.s `pY�v " , ' 'Iv 1 'tn' t '3�SU>Gi7`i?�,yy++�i, ZMIr'0i'tf1 ', �" 1,5"a .J l v s h 5,13 "'4-yrk 1,`! } S•i'�`f7n� . _ J
trAL. ri4 1`I -:Ac'x IiG' ��_..t+�iG E3D * 34 .c. ..�, 4'K2 1 �. �� f+,,d•1, �it� 1. �+' +i.r �F�.t:
3�itPg'C3�"��'.��?�
El- J;;.,% 1^m3r3? "fid 4Fyf1.°Ji J:3 $�9[c}.P le)OPi4 A` 2i P,:i`G A't'[ (I s JLtFt� O�fi to r {J`4r i� f. w Yi+) s��J fd
Z,
°•n+t`C13't'.A��39R`Q64�s•49�I11;J',fOFi+' 'AUT.�,.,t�Ci?�/_ LciM H•�'h / a � • ",v, � xR4r &mt.• u�•,, ..'.:.
KIITOTAL V 0FjaAED TOTAL YDS: DELIVERED . LOAD N q CUMULATIVE TOTAL r ,yypJ'�j jyJ z'^ S1,hS >,Iry
i.r <�, ;+ 1> �`, 2 H >l?9T;9J TM�J2lPlkj$H Bd3T31sJjT/.J
r1 1^nC.a, tit -i _
+4_ Rm i . ..{ti: ti ./ J/.� TfA a,..�.. i5 • , Y�,YI?x F. .
rl,..T 1 •! ' J� Ay` Ar ,artf�r nl. t' { 'sS r C.j, T..
�7c' �.30i ..7387 9 iLrs 0.933 7448 '41brg71462y{ID3»BTSBIt�p`�a
I .r1 t
u
�...
j! ill
rSTART UNLOA01N0
UNLOA01N0
Ix, y J}..E, -. !;`IpOL1 t,- ♦H, r i '1;d
d
'+
�"r: �. My{cl
RT
DEPAJOB)+
5
..rt
•. .L I tU {J. f T
e.4 �' rI F
r
'„
i�
DRIVER NAME" ,t . Cf Lt
iL,`RETURN PLAtJI
f•.t>' A
....�=a.S�. .<:1Pi._Iu_6..sti_...:._.. h 5,. ..a t
.. C• l
e 1
j .12'1'. 'IL.triZ I i71 +tyle Fa- .{A ke" � C4 r, `t Zk5
^f,. i -.,i �i•u. t ::rt"I
WEIGHMASTER -' } ' '� *'
1y3
A•
DEPUTY: r
. '•V� n- &+
i�.:
.. ..` i -
t :f. „
PLEASE READ WARDING ON'REVERSE
SIDE
V
CUSTOMER CO
al:S'P.Y;:.,:"`
SO W. BEACH ST. MOCORAVEii: I I ];I'SEhIIYESSA
WATSCMftL-E 311 SANTA CRUZ =1 I SAN JOSE 351
ROCK WAY
17M DEL MONTIE BLVD, IN GRANITE
AN WORK ST.
SAUNAS ml SEASIDE $Il SAN JOSE 382
6,75 CHESTNUT IN HOSPITAL RD. 355 BUDMWST
-GILROY 351 HOLUSTER 352 R5D'W00D CITY WI & 382 P.
TELEPHONE (831)
THIS )S,T0 DER tlufl:jha, WHOM do; C �ood conumoty MS'woig�od,'
Cr-qipNN7(NmnNT0 rigmth.SOdOrIll 00)of0MSiw.5oICN0CallaI,2a:SuId
-SOLD
BY
# I.
.,BOX s00011- WATSONY1111 "CA'950-77-5001
IGHMASTMCERTIFICATE
wvgwaiwrwh
, &e s�uieet-..
. . I . I I . � - — ..--
----- -- teNOrete,.wDe--- ----
BB
rrly
wn
qNtriio III Food BNB Agroufturo.^,
CUSTOMER NUMBER
I NOTICE OF SALE NUMBER.
• JOB f P.O. NUMBER Ax' 117 TIME'DUE-ON -JOB
i"' v--il:- DATE. �- 7
et
--A�
Zi4754
1.el
--
'051.71`
-,CUSTOMER - -,
' " " A,-
J:.l
JOB LOCATION,
-AD
.'dQDI�
)LAND'r-oNSTRLJCTlI0r4'- INC ;.. 14127,'�.
)AL'0-lviC"TA--:-'CLjPERTlN0 26431",-�
W- , 7
JORTH
LF'..FOOTHILL
pAL0 VISTA, -
a r852 /Iqj
:Dt'
ED TOTAVYBV DELIVERED
'LOA 40.
CUMULATIVE
et
--A�
X. Z
1.el
--
t
�P
NAx
ED TOTAVYBV DELIVERED
'LOA 40.
CUMULATIVE
0.
X. Z
--
Ji Y RII CC
-CE&E
*,V tnb A--
5.1
'w qpAy7t; 'v.1-.
e.' I.,
I- . . , , T A,
vxl
S,OUR;DELIVERY-*ONTIMEl-.-.'.---.y &
Ey
EPARTP
DRIVER COMMENTS .
Notes
START UNLOADING T""
14�& LINLOADING-7
%
t.
y
-iy.NHHV KL tYl I---
4�- It r4am
DEPART JOB` 7 jc-
2®r'
TRUCK' N'O'. - DRIVER.NA0E
_j
-
-�-GhANITE'666K' COMPANY -iWEIGHMASTER
i hNasie
"WEIGHED AT
beurge HBtely. DEPUTY BRANCH N0.
-7
PLEASE READ WARNING -'ON REVERSE SI
CUSTOMER COPY
6sT,0,MER,
ll IH I ILI,f
-,JOB LOCATION- e
M N
71 -60D.
MID
4
1 E01
6- box
1j.'WATSONV(LLE CA 95oT7-5601'
4"I30;N
05 17f�!:
VISTA iuUPERTJ.,NO:
LF- FOOTHII L,:'LF Pl-
TO,104
0 VISTA,
I/ 'r ,
Fl
>,CHEC1K'N
��'�"CUSTOMMSIG X �2fd
TURE----
Ste W. -BEACH ST 309 CORAL ST
11711 BERRYESSA
WATSONVIULE 311 SANTA CRUZ =1
l_'SAN JOSE MI
*X) WORK ST. 17M DEL WNTIE EILVD,
IM GRANITE ROCK WAY
SAUNAS M, SEASIDE 3t1 t
SAN =E 302
IA75CHESTNUT IM 40SPRAL RD.
'm etomculsT
GILROY351 ;HOLUSMER352
REDWOOD CITY 381 & 002
_0,
..ii.
THIS ISJO CERTIFY UWt the following
-1 ----- I ----------
datictileeil �.W
. l -1 —1— . -1 1
6sT,0,MER,
ll IH I ILI,f
-,JOB LOCATION- e
M N
71 -60D.
MID
4
1 E01
6- box
1j.'WATSONV(LLE CA 95oT7-5601'
4"I30;N
05 17f�!:
VISTA iuUPERTJ.,NO:
LF- FOOTHII L,:'LF Pl-
TO,104
0 VISTA,
I/ 'r ,
Fl
>,CHEC1K'N
UP 6ELIV M
WAS.6 E?,
��'�"CUSTOMMSIG X �2fd
TURE----
"Z "7,���i-t'�"DRIVERS-PLEASE.',COMPLETE'-�'-'-.""V,-'z'
�N' Jim orf I
CODE QUANTITY
UNIT
DESCRIPTION
PRICE
R
RIVE JO: _`-
704q3 --4-,W- --ig! 0 y
�41
:i;ff 0 0 0.1+ PS I
7. START UNLOADING -
L
_0,
..ii.
FINISH UNLOADING ,1P. Iv -
�1 'T
4
R1VER,N
R K �N' DRIVER
NA`M' E
IT
,RETURN PLA.
ZCA
%.GRANITE:ROCK COMPANY - WEIGHMASTER*
_`-
Wi
v: ."8ED_Ai
IaRA`
... DEPUTY
PLEASE
READ WARMNGl�OWREVLKbLt: 'blU
huicrrniisi; COPY: w
7
a "T.3il
1.1,
A
SAc s
,TOTAL�,YOS! LOAD NO., CUMUtAnVE IT
ORDERED YDS. DELIVERED
IPT_�IIT
3i
2 1... 0 0
t�'l "'o om m n r g1e Y he 664f teproducts
0 ...... . . . . . . IdWInj trued!
ATI. N
INGREDIENT
!4MX DESIGN SPECIFICATION,?,
N't" ACTUALBATCH
L'
&g(
umrrsAsrM(r,�s
U
34
y Batctlejanger
3471
t is 2;�
4l 7
7
3
1/2 -0. 387s
69:,4 zl5k'93 X7440
Ili ly 4
-;tl.'I
510U 3B`1 5060
'B9rJ 232
Ab5,976 Ibti
I -
-it R
Jbse ;kms CRS >y951t3t+ 07 MI, ppFL
r t�.K,f-�"."t�-NI�,z.
4 moi, y2
"elm
Riii, -:207,Pjclriizla `1
a
Iw
Ua I n
WATER ADDED TO THIS
LOAD
'I*�I`I'o
IF:APPROVED-BVf,
ta.,
UP 6ELIV M
WAS.6 E?,
��'�"CUSTOMMSIG X �2fd
TURE----
"Z "7,���i-t'�"DRIVERS-PLEASE.',COMPLETE'-�'-'-.""V,-'z'
�N' Jim orf I
DRIVER COMMENTS'
R
RIVE JO: _`-
Nate
�41
7. START UNLOADING -
L
_0,
..ii.
FINISH UNLOADING ,1P. Iv -
2241
R1VER,N
R K �N' DRIVER
NA`M' E
IT
,RETURN PLA.
ZCA
%.GRANITE:ROCK COMPANY - WEIGHMASTER*
_`-
Wi
v: ."8ED_Ai
IaRA`
... DEPUTY
PLEASE
READ WARMNGl�OWREVLKbLt: 'blU
huicrrniisi; COPY: w
m
j
-'t WATSONVZZdW954077-_6w' I
!R FI.FAI
T e rr�, ity,of ;icurac�, as proscribed
cions .!d CERTIFICATE
is'�nthis'm'Mlicale.-�ho�sa.reoognizedauM
,.dmrhddNd by " D Measurement Standar" Na Coluo-mia Deparemnt'of Food and! Agriculture:
SOLD
OB P.O. NUMBIER-:)5, 17-54
BY
W W. BEACH iT. :Mo 6011AL ET.
• 11711 BERRYFS!Uk
WATWWIUE 313 SANTA CRUZ V
SAN JOSE MI,
4400 WORK ST, 1755 DEL WNTE BLVD.
too GRANITE ROCK WAY
SAUNAS WI SEASIDE 4I
SAN. E W
G
Un CHESTNUT 100 HOSPITAL RD.
3iS 0LOArOLIST
COUROY 351 HNDLOSTER Me REDWOOD CITY MI M2 P.O. Box
TELEP E (101) 768,20DO
•
1
I -WEIGI
THIS IS TO CERTIFY dMet the loll sidded oonvhocit' was weighed, ineosurea
1 019090 riDivision
lo',chapter,7 (bommand with Section
ng
1 .1 5 of the California Busfness and
CUSTOMER NUMBER.'
-I
NOTICE OF SALE NUMBERI
m
j
-'t WATSONVZZdW954077-_6w' I
!R FI.FAI
T e rr�, ity,of ;icurac�, as proscribed
cions .!d CERTIFICATE
is'�nthis'm'Mlicale.-�ho�sa.reoognizedauM
,.dmrhddNd by " D Measurement Standar" Na Coluo-mia Deparemnt'of Food and! Agriculture:
.CUSTOMER
v.
JOB, LOCATION
: E cob
ND CONSTRUCTION INC"'`
O'V:ISTA-'-CUPERTINO
YH :Ir LF 'FOOTHILL LF
ALO,V.ISTA,`TO.:1040G PAL
fa"! , S_.Oi
2
6EPAR I
OB P.O. NUMBIER-:)5, 17-54
AAIME OUE'ONiJO§
_,�CT
�3/4 GRA�. �-22 i._:4130% 7422.
DRIVER COMMENTS
•Joey
5 0a":00 PM..,. -+:,-io
047,94
60" 1-il
'sTARtYNCOADING
ITAL.YOS;DELIVERED
LOAD NO.
cumuun
N ?
;FINISH UNL6;flNG
.CUSTOMER
v.
JOB, LOCATION
: E cob
ND CONSTRUCTION INC"'`
O'V:ISTA-'-CUPERTINO
YH :Ir LF 'FOOTHILL LF
ALO,V.ISTA,`TO.:1040G PAL
fa"! , S_.Oi
2
-tt-1 " ...
TOT
lt-;- 1F n- I, I-1-1 - . -11, . -5
N GREDIENT ` 3
6EPAR I
'Ate-yar -IV,Yar,' !7'�Und
F I
.141%ii 13440
71
_,�CT
�3/4 GRA�. �-22 i._:4130% 7422.
DRIVER COMMENTS
•Joey
1/2 GKI:'.-22
'sTARtYNCOADING
ITAL.YOS;DELIVERED
LOAD NO.
cumuun
N ?
;FINISH UNL6;flNG
-tt-1 " ...
TOT
lt-;- 1F n- I, I-1-1 - . -11, . -5
N GREDIENT ` 3
6EPAR I
'Ate-yar -IV,Yar,' !7'�Und
F I
.141%ii 13440
71
_,�CT
�3/4 GRA�. �-22 i._:4130% 7422.
DRIVER COMMENTS
•Joey
1/2 GKI:'.-22
'sTARtYNCOADING
4;
N ?
;FINISH UNL6;flNG
WI 1ENKEL,` M1161JEL
Iij
.. .....
7
%
m
0m,
DRIVERS -PLEASE n PLETE"�',
I
6EPAR I
SA -Sp C. q iT
DRIVER COMMENTS
•Joey
7
%
m
0m,
DRIVERS -PLEASE n PLETE"�',
I
6EPAR I
.'COM
DRIVER COMMENTS
•Joey
'sTARtYNCOADING
N ?
;FINISH UNL6;flNG
WI 1ENKEL,` M1161JEL
Iij
.. .....
TRUCKNO. DRIVER NAME
RETURN PLANT
_�OCK'CO�PANY,
GRANITE.. WEIGHMASTER
Wei 11aster:,,:Giqr§eHafp1y�. V
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