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Site Address: 15571 N. HOERL RD
<br />Date: 5/7/2018
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<br />California Ready Mix
<br />nia Rock
<br />1200 E. Turner Rd. - Lodi, CA 95240
<br />(209) 368-5351 Fax (209) 368-5824 9400$
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<br />YX"! ! t"' �`� tr• ,{,Nr:r•� ,i_•a��r:T'a NAME . 1 4TYI' C �f C`
<br />ADDRESS / ����• /Ly %� / � r
<br />�`s `� r•IJ --'f r•.+,,r� p JOB SITE cle.' r
<br />TIME AMO TIME a
<br />I.�
<br />:yf OUT PM ❑ IN PMO
<br />OTY. DESCRINION PRICE AMOUNT
<br />EOUIPMERREIREg PPICEIDAY SUB -TOTAL
<br />CAUTION HAND TROWEL
<br />Freshly mixed cement, mortar, HAND FLOAT SALES TAX
<br />concrete or grout may cause skin EDGER EQUIPMENT
<br />In Avoid contact with skin RENTAL
<br />where possible and wash exposed TRAILER
<br />skin areas promptly with, water. If
<br />CC
<br />LE
<br />any cement mixtures get Into eyes, CHARGE
<br />rinse immediately and repeatedly
<br />with water and get prompt medical
<br />attention. KEEP OUT Or REACH
<br />OF CHILDREN. TOTAL `''-•�
<br />SALES & RENTAL AGREEMENT
<br />•
<br />KIN- erp•pnavn Is nnl Mnpnny rMar,ed alter uu e W -1.
<br />topay a $h09kag Marpe.
<br />• II ttx• nnuipmenl k used nota Iran ten hours, leo of S25 Per I,aa on wMAtlays and $35 per hour en w k,nds, will he
<br />hanged
<br />. The Iss— "r., tl tr. n wlrnpnwnr IU M leev d w lis cusludr end r'IXater r.v 1J a arrrl ie
<br />.or,jM,.tlrx, ta• :grass I. WY Itro a lal FM ), nrM sign In a�a'g'erhanl. The lessee r.oper'Wrest: riot b W `Axn vuDlei nr
<br />m ,duaw are leased equip re >I and to reM,n ow wine I, s y�n.0 roe6aon os when recqI11e l /
<br />•
<br />The lessee ackrrMWedgos 11 al l,e 1 nspecrea'EMrI haaB 1 albr hath wM solely dloxt, arM dk eater -al egwM^srii.
<br />nor, In.: he has hxmd the haibr and t.o, up solo ,ed'ecure and a,b other egrdpaent sami ole ar he —W. stone
<br />agra"Pli 1p assu"w all ler. oosibialy loi said leased equipment WNW if Is In his Custody.
<br />• The I—— lunher MMeas to IndomMly Hort save Calllorala Rock & Ready Mh hamNhorn ROY hoairy aabaay, claim or es-
<br />pense arising Iran any Injury or damage Io Ms person or popedy that may occur WhAb said eq Apmald as In ids Cas 1001 M es a
<br />proxiroate result of its hong in ids custody. In the ew+M of any acndem, the lessee agrees to make a mitten rapbrt to
<br />Csllio nla Rork & Ready Mlx.
<br />• The losses agrees to (YMlply -illi all laws nl the Stale c—ing the use M Neftel', to Navel waMn a,e'Peed Irma, end m as-
<br />sn ne all responsibildy for It,. the". conliscalion. and as citations and pennate' fncl+lled agektbl said bailer v+hae In Ms
<br />possession.
<br />We are notresponsible for any damage encountered while Cs111ornia Rock A Ready A1iw is delivering
<br />malertafs customer has ordered. Customer will pay all tow charges it our truck or equVpment gels stuck
<br />while dumping or working In the area the customer requested.
<br />JSII;NAIIJIII LVC ^!SE
<br />X ---
<br />Naseem Ahmed, Environmental Health Specialist
<br />Record ID VVP0038023
<br />Page 3 of 5
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