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WP0039616
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ELLIOTT
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24173
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039616
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Last modified
12/15/2020 2:22:41 PM
Creation date
12/15/2020 2:16:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039616
PE
4366
STREET_NUMBER
24173
Direction
N
STREET_NAME
ELLIOTT
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00740058
ENTERED_DATE
5/15/2019 12:00:00 AM
SITE_LOCATION
24173 N ELLIOTT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\fgarciaruiz
Tags
EHD - Public
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California Rock & Ready Mix <br /> 1200 E. Turner Rd. • Lodi, CA 95240 106501 <br /> 1 (209) 368-5351 • Fax (209) 368-5824 <br /> NAME DATE <br /> ADDRESS V' 'y '57 <br /> PHONE S-5 �G <br /> JOB SITE ��•-�'� U <br /> TIME f AM ❑ TIME AM p TRUCK NO. TRAILER N . <br /> OUT Lam' PM p IN PM p <br /> QTY. II DESCRIPTION PRICE AMOUNT <br /> EQUIPMENT RENTED PRICE/DAy SUB-TOTAL <br /> CAUTION HAND TROWEL <br /> Freshly mixed cement, mortar, HAND FLOAT SALES TAX <br /> concrete orgrout may cause skin <br /> injury. Avoid contact with skin EDGER EQUIPMENT <br /> where possible and wash exposed TRAILER RENTAL <br /> skin areas promptly with water. If CLEANING <br /> any cement mixtures get Into eyes, <br /> rinse immediately and repeatedly CHARGE <br /> with water and get prompt medical <br /> attention. KEEP OUT OF REACH <br /> OF CHILDREN. <br /> TOTAL <br /> SALES & RENTAL AGREEMENT <br /> •If the equipment is not properly cleaned after use,lessee agrees to pay a$50 cleaning charge. <br /> •If the equipment is used more than two hours,fee of$25 per hour on weekdays and$35 per hour on weekends,will be <br /> charged. <br /> •The lessee acknowledges that the above equipment has been delivered to his custody and control for his own use,and in <br /> consideration he agrees to pay the rental charge and sign this agreement.The lessee further agrees not to sell,loan,sublet or <br /> mortgage the leased equipment and to return the same in as good condition as when received. <br /> •The lessee acknowledges that he has inspected said trailer,trailer hitch and safety chain,and the other items of equipment, <br /> and that he has found the trailer and hook-up safe and secure and the other equipment serviceable and he accepts same <br /> agreeing to assume all responsibility for said leased equipment while it is in his custody. <br /> •The lessee further agrees to indemnity and save California Rock&Ready Mix harmless from any liability,claim or ex- <br /> pense arising from any injury or damage to his person or property that may occur while said equipment is in his custody or as a <br /> Proximate result of its being in his custody.In the event of any accident,the lessee agrees to make a written report to <br /> California Rock&Ready Mix. - <br /> •The lessee agrees to comply with all laws of the State covering the use of trailers,to travel within the speed limit,and to as- <br /> sume all responsibility for fire, theft, confiscation, anif all citations and penalties incurred against said trailer while in his <br /> possession. <br /> We are not responsible for any damage encountered while California Rock&Ready Mix is delivering <br /> materials customer has ordered.Customer will pay all tow charges If our truck or equipment gets stuck <br /> while dumping or working in the area the customer requested. <br /> SIGNATURE <br /> LICENSE <br /> X <br />
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