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WP0041779
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041779
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Entry Properties
Last modified
3/20/2024 2:19:19 PM
Creation date
3/16/2022 10:33:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041779
PE
4380
STREET_NUMBER
2551
Direction
E
STREET_NAME
ACAMPO
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
01315046
ENTERED_DATE
3/10/2021 12:00:00 AM
SITE_LOCATION
2551 E ACAMPO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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r. <br /> California Rock & Ready Mix <br /> 1200 E. Turner Rd. • Lodi, CA 95240 132324 <br /> ��c (209) 368-5351 Fax (209) 368-5824 <br /> DATE <br /> NAME <br /> ' wL Gr T PHONE l <br /> ADDRESS <br /> JOB SITE (� L AM ❑ TRUCK NO. TRAILER NO. <br /> TIME . AM TIME <br /> OUT GT`C�) PM ❑ IN PM ❑ <br /> QTY. DESCRIPTION PRICE AMOUNT <br /> iy <br /> ' L <br /> EQUIPMENT RENTED P' <br /> CAUTION HAND TROWEL <br /> Freshly mixed cement, mortar, HAND FLOAT <br /> concrete or grout may cause skin EDGER <br /> wereAvoid contact with skin <br /> wuere possible and wash exposed TRAILER •v,u,,vu <br /> skin areas promptly with water. If i0U p: D0�u27 <br /> any cement mixtures get Into eyes, Appf,Code: 03705D <br /> rinse immediately and repeatedly <br /> with water andet prompt medical transaction ID: 461179794963238 <br /> attention. KEEF OUT OF REACH <br /> OF CHILDREN. Apprvd; Online Batcha: 000832 <br /> SALES & RENTAL AGF C42 Code: MATCH M <br /> •If.he equipment is not properly cleaned after use.lessee agrees to pay a S <br /> •It the equipment is used more than two hours,fee of$25 per hour on <br /> C <br /> harged. <br /> •The lessee acknowledges that the above equipment has been delivered I agree to oav above total amount <br /> d sign this agreem'it. according to card issuer agreement <br /> consideration he agrees to pay the rental charge an <br /> mortgage the leased equipment and to return the same in as good conditiot (Merchant agreement if credit voucher-) <br /> •The lessee acknowledges that he has inspected said trailer,trailer hitch <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 it <br /> •The lessee further agrees to indemnity and save California Rock&I <br /> pense arising from any injury or damage to his person or property that ma, k____________________________ <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 /> surae all responsibility for fire, theft, confiscation, and all citations anc 11�r;hmt Cun, <br /> possession. <br /> li+alilc you <br /> We are not responsible for any damage encountered while c PLERSE COME AGAIN <br /> materials customer has ordered.Customer will pay all tow r <br /> while dumping or working in the area the customer requested <br /> SIGNATURE <br /> X <br />
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