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WP0041962
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COLLIER
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041962
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Entry Properties
Last modified
12/21/2021 2:45:41 PM
Creation date
12/21/2021 2:08:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041962
PE
4380
STREET_NUMBER
14000
Direction
E
STREET_NAME
COLLIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
02104302
ENTERED_DATE
4/23/2021 12:00:00 AM
SITE_LOCATION
14000 E COLLIER RD
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 />1200 E. Turner Rd. • Lodi, CA 95240 <br />ZIA (209) 368-5351 • Fax (209) 368-5824 <br />DATE /'_ / ( <br />130127 <br />NAME -)) C; 5 l <br />ADDRESS l LL j jcq <br />Ino QITC Ar'-, '-- nr�- <br />TIMEAM <br />OUT I£� PM ❑ <br />TIME AM C <br />IIN PM C <br />QTY. <br />DESCRIPTION <br />C31 <br />- <br />t( <br />NN <br />CAUTIAND <br />Freshly mixed cement, mortar, <br />concrete or grout may cause skin <br />in Avoid contact with skin <br />where possible and wash exposed <br />skin areas promptly with water. If <br />any cement mixtures get Into eyes, <br />rinse immediately and repeatedly <br />with water and get prompt medical <br />attention. KEEP OUT OF REACH <br />OF CHILDREN. <br />NT RENTED PRI <br />TROWEL <br />HAND FLOAT <br />EDGER <br />TRAILER <br />SALES & RENTAL AGRI <br />• If the equipment is not properly cleaned after use, lessee agrees to pay a V <br />• If the equipment is used more than two hours, fee of $25 per hour on %Acharged. <br />• The lessee acknowledges that the above equipment has been aelivered <br />consideration he agrees to Rey the rental charge and sign this agreement. T <br />mortgage the leased equipment and to return the same in as good condition <br />• The lessee acknowledges that he has inspected said trailer, trailer hitch s <br />and that he has found the trailer and hook-up safe and secure and the ( <br />agreeing to assume all responsibility for said leased equipment while it is in <br />- The lessee further agrees to indemnify and save California Rock & F <br />pense arising from any injury or damage to his person or property that may <br />proximate result of its being in his custody. In the event of any accident <br />California Rock & Ready Mix. <br />• The lessee agrees to comply with all laws of the State covering the use <br />sume all responsibility for tire, theft, confiscation, and all citations and <br />possession. <br />We are not responsible for any damage encountered while C <br />materials customer has ordered. Customer will pay all tow r <br />while dumping or workin in the area the customer requested <br />SiGNATURE <br />X <br />PHONE / VC, <br />-- -MAIL FR NO <br />CALIFORNIA ROCK AND READY MIX <br />1200 E TURNER RD <br />LODI CA 952110 <br />209 368-5351 <br />Merchant ID: 0449 <br />Term It: 0003 <br />Store u: 11039 <br />Rif It: 0003 <br />Phone Order <br />XXXXXXXXXXXX3933 <br />VISA Entry Method: Manual <br />Total: $ 876.83 <br />05104121 07:31:31 <br />Inv #: 000003ppr Code: 039420 <br />Transaction IO: 38112452292638 <br />4prvd: Online .Batch :000770 <br />C42 Code: MATCH M <br />I agree to Pay above total amount <br />according to card issuer agreement <br />(Merchant agreement if credit voucher) <br />Merchdnt Copy <br />HANK YDU <br />PLEASE COME AGAIN <br />
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