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SR0085236_SSNL
EnvironmentalHealth
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2600 - Land Use Program
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SR0085236_SSNL
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Entry Properties
Last modified
5/25/2022 10:54:24 AM
Creation date
5/25/2022 10:13:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0085236
PE
2602
FACILITY_NAME
12405 E BRANDT RD
STREET_NUMBER
12405
Direction
E
STREET_NAME
BRANDT
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237
APN
05132006
ENTERED_DATE
5/4/2022 12:00:00 AM
SITE_LOCATION
12405 E BRANDT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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CAUTION <br />Freshly mixed cement, mortar, <br />concrete or grout may cause skin <br />injury. Avoid contact with skin where <br />possible and wash exposed skin <br />areas promptly with water, if any <br />cement mixtures get into eyes, rinse <br />immediately and repeatedly with <br />water and get prompt medical <br />attention. <br />KEEP OUT OF REACH OF CHILDREN. <br />Dear Customer. <br />NOTICE: WE MAKE DELIVERIES INSIDE THE CURB LINE <br />AT CUSTOMER'S RISK ONLY, AND ACCEPT NO <br />RESPONSIBILITY WHATSOEVER FOR DAMAGES <br />RESULTING FROM SUCH DELIVERIES. <br />The driver of this truck, in requesting the Additional signature below, Is of the opinion <br />that the size and weighi at the truck may possibly cause damages to the premises <br />arrd/or adjaeent property if the driver places the mmetial In this load where you desire <br />q it. It is our wish to help you in every way that we can, but in order to do this, the driver <br />v is requesting that you or your representative sign below Indicating you have released <br />the driver and PEARSONS CONCRETE from all responslbilty for any damage that <br />4 may occur to the promises and/or adjacent property, buildings, sidewalks, driveways, <br />Q curbs, etc. by the dsI'svery of this maltatrial. Further, as additional consideration, you <br />agree to help the driver remove mud froth the wheels of the driver's vehicle so that <br />the driver will not litter the public sweat, and you agree to indemnify and hold <br />harmless'the driver of this truck and PEARSON$ CONCRETE for any and all liabilities <br />—� and damages to the premises and/or adjacent property which may be claimed by <br />anyone to have arisen out of delivery of this order, <br />Signature: <br />C9ERMANYt3ROTHCnSPRINTING — REV. 9/01 <br />1MEIGHMASTER CERMCATE _ <br />THIS IS TO CERTIFY that tha lopowing dmerlbed commodity w" wvjgW, maaaured. or <br />counted by a W8Wtnagar, whose aienature U On 11115 eartlrwata. who le a mcopnkod authority <br />of accuracy, as pnaadibad by Chapter 7 fcommerKYte vrkh Sac Ian 17700) of Divldon 5 of Me VY •��iw' <br />Calltomla 1duaVrrms and Procession God., adminlatared by the Mvblon of Mo"ammaM <br />Slandwda or the Calaornla oepartment of Food and Agrkullum, <br />PEARSONS CONCRETE <br />10284 UNDERWOOD RD., ACAMPO, CA 95220 <br />_ TELEPHONE (209) 334-9234 <br />ORDER NO. DATE 200 <br />CUSTOMER <br />DRIVER TRUCK -' " LOAD CU YDG <br />CONCRETE MIX STARTTIME y+ <br />---------- r� <br />CEMENT ARRIVEJOB ?o <br />ADMIX i <br />A -Y LEAVE JOB <br />A-2 ENO TIME <br />aDMIX 2 <br />A-3 TOTAL <br />A-4 FREE <br />fHl$WATER NET <br />GUARANTEED <br />LOAD SACK WEIGHED AT <br />TOYIELD <br />CU91C CON MIX 901 SIMMERHORN <br />TO VIELD YARDS CRETE No. GALT, CA_ <br />13 A SSONS REAdy MIX CONCRETE INC. — WEIG14MASTER <br />BY <br />QUANTITY <br />UNITS <br />DESCRIPTION <br />UNITPRICE <br />AMOUNT <br />CU YDS <br />CONCRETE <br />MIN. <br />STANDBY TIME <br />HOURS <br />RENTAL <br />UMLOADINGTIMEA <br />LOWEt) CHARGE C,O.o. <br />TOTAL <br />--^-�-- --- -nary■r 1ve43,vo.1r_1.1 ILt:uM11tGIIUNS <br />TERMSI Net 30 Days. One and one-half (1112x) percent per month will be charged on past due account . <br />Arty reasona�blle legal feea Incurred in collection of above will be added to thts charge. <br />Received By: /\. <br />
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