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WP0042158
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042158
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Entry Properties
Last modified
3/18/2025 9:01:46 AM
Creation date
2/17/2023 4:07:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042158
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
20555
Direction
N
STREET_NAME
BUCK
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
01721028
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
20555 N BUCK RD ACAMPO 95220-
Tags
EHD - Public
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California Rock & Ready Mix <br /> 1200 E. Turner Rd. • Lodi, CA 95240 137618( 09) 368-5 51 • Fax (209) 368-5824 <br /> NAME l I S S n� DATE <br /> ADDRESS i �r.lUli� �((.1 PHONE (GLS / Cl/ L <br /> r <br /> JOB SITE d <br /> TIMEI , A ❑ TIME AM — TRUCK NO. TRAILER NO. <br /> OUT 21z ...� PM ❑ IN PIV <br /> QTY. DESCRIPTION <br /> _) C\ CALIFORNIA ROCK AND READY MIX <br /> 7 1200 E TURNER RD <br /> LODI CA 95240 <br /> Lay 209 360-5351 <br /> Merchant Ib: 0ggg <br /> Term if; 0003 <br /> Stare 11: 4039 <br /> Ref It: 0014 <br /> Phone Order <br /> XXXXXXXXXXXX0820 <br /> EISA Entry Method; Manual <br /> EOUIPM RENTED P <br /> C TIO ND TROWEL 1 <br /> Freshly mixed ar, HAND FLOAT Total: 1,098. 74 <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 12/07/21 <br /> any cement mixtures get into eyes, <br /> rinse immediately and repeatedly 13:24:23 <br /> with aattention rKEEf�Oet UT OFt REACH medicalInv 4: 004414 APPr Code, 027210 <br /> OF CHILDREN. Transaction 10: 581341710636852 <br /> SALES & RENTAL AGF Apprvd: Online Batcha: 000001 <br /> •If the equipment is not properly cleaned after use,lessee agrees to pay a C42 Code; mgcC M <br /> •If the equipment is used more than two hours,fee of$25 per hour on <br /> Charged. <br /> •The lessee acknowledges that the above equipment has been delivered <br /> consideration he agrees to pay the rental charge and sign this agreement. <br /> mortgage the leased equipment and to return the same in as good conditio, I agree to Pay above total amount <br /> •The <br /> lessee acknowledges that he has inspected said trailer,trailer hitch according to card issuer agreement <br /> and that he has found the trailer and hook-up safe and secure and the (fierchant a9reraent if credit vo <br /> agreeing to assume all responsibility for said leased equipment while it is it ocher) <br /> •The lessee further agrees to indemnify and save California Rock& <br /> pense arising from any injury or dam.ge to his person or property that mai <br /> proximate result of its being in his custody.In the event of any acciden' <br /> California Rock&Ready Mix. X______ <br /> •The lessee agrees to comply with all laws of the State covering the use _ <br /> sume all responsibility for fire,theft, confiscation, and all citations anc <br /> possession. <br /> We are not responsible for any damage encountered while C Merchant Copy <br /> materials customer has ordered. Customer will pay all tow i THANK YUII <br /> while dumping or working in the area the customer re uested <br /> G TU E PLEASE COME AGAIN <br /> X <br />
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