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WP0042047
EnvironmentalHealth
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16727
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042047
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Entry Properties
Last modified
12/22/2021 1:35:01 PM
Creation date
11/12/2021 10:08:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042047
PE
4378
STREET_NUMBER
16727
Direction
E
STREET_NAME
BRANDT
STREET_TYPE
WAY
City
CLEMENTS
Zip
95240-
APN
01914021
ENTERED_DATE
5/18/2021 12:00:00 AM
SITE_LOCATION
16727 E BRANDT WAY
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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----"California Rock & Ready Mix <br /> 12010 E: Turner Rd. • Lodi, CA 95240 <br /> 132003 <br /> _0I L ,5 (209) 368-5351 • Fax (209) 368-5824 j <br /> NAME l t 1 / L-7IDATE 7 A <br /> !� <br /> ADDRESS t V 7 /i / f2l"i l"I' V / yC 0 C' l YC' <br /> NE <br /> JOB SITE Cc <br /> TIME AM ❑ TIME <br /> OUT L Z 137L/ PM ❑ IN F <br /> CITY. DESCRIPTION <br /> CALIFORNIA ROCK AND READY MIX <br /> 1200 E TURNER RD <br /> LODI CA 95240 <br /> 209 369-5351 <br /> Merchant ID: 0449 <br /> Term fl: 0003 Storetl: 4033 <br /> Ref It: 0007 <br /> Phone Order <br /> � <br /> 9999993933 <br /> EQUIPMENT RENTED F VISA Entry Method; Manual <br /> CAU ON HAND TROWEL <br /> Freshly mixed ment, mortar, HAND FLOAT Total: 941.�S <br /> concrete or grout may cause skin EDGER <br /> injury. Avoid contact with skin <br /> where possible and wash exposed TRAILER <br /> skin areas promptly with water. If 1 <br /> any cement mixtures get into eyes, 06/15/21 ` 10:5J':90 <br /> rinse immediately and repeatedly <br /> with water and get prom t medical <br /> attention. KEEP OUT OF REACH Inv b: 00007 APPr Code; 422218 <br /> OF CHILDREN. Tran5actlon 1: 5811666A6604769 <br /> SALES & RENTAL AGRI APPrvd: Online BAN: 080818 <br /> •If the equipment is not properly cleaned after use,lessee agrees to pay a$51 CVV2 Code: MATCH M <br /> •If the equipment is used more than two hours,fee of$25 per hour on we <br /> charged. <br /> •The lessee acknowledges that the above equipment has been delivered to <br /> consideration he agrees to pay the rental charge and sign this agreement.Th- <br /> mortgage the leased equipment and to return the same in as good condition a: I agree to Nay above total amount <br /> •The lessee acknowledges that he has inspecteV said trailer,trailer hitch anc according to card issuer agreement <br /> and that he has found the trailer and hook-up safe and secure and the oth (Merchant agreement if credit voucher) <br /> agreeing to assume all responsibility for said leased equipment while it is in hi: <br /> •The lessee further agrees to indemnity and save California Rock&Rea <br /> pense arising from any injury or damage to his person or property that may cc <br /> proximate result of its being in his custody.In the event of any accident,thi <br /> California Rock&Ready Mix. <br /> -The lessee agrees to comply with all laws of the State covering the use of ti ------___________�-��_�__�»_-__r <br /> sume all responsibility for fire, theft, confiscation, and all citations and pei <br /> possession. <br /> We are not responsible for any damage encountered while CaliG Merchant Copy <br /> materials customer has ordered. Customer will pay all tow char THANK YOU <br /> while dumping or working in the area the customer requested. <br /> SI NATURE PLEASE COME AGAIN <br /> X <br />
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