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WP0043600
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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10831
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043600
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Entry Properties
Last modified
2/14/2025 11:09:39 AM
Creation date
2/12/2024 10:31:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043600
PE
4380 - PUMP PERMIT - NEW
STREET_NUMBER
10831
Direction
E
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
APN
05115058
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
10831 E STATE ROUTE 12 LODI 95240-
Tags
EHD - Public
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California Rock & Ready Mix <br /> 1200 E.Turner Rd. • Lodi, CA-95240 153359 <br /> (209) 368-5351 Fax (209) 368-584 <br /> NAME r v S S DATE - Z ) <br /> ADDRESS L �l � � t <br /> PHONE <br /> JOB SITE <br /> TIMEA ❑ TIME AM ❑ TRUCK NO. TRAILER NO. <br /> OUT �/ . PM ❑ IN PM ❑ <br /> CITY, DESCRIPTION PRICE AMOUNT <br /> i5 <br /> EQUIPMENT RENTED PRICE/DAY SUB-TOTAL <br /> CAUTION HAND TROWEL <br /> Freshly mixed cement, mortar, HAND FLOAT <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 <br /> any cement mixtures get into eyes, <br /> rinse immediately and repeatedly <br /> with water and et prompt medical <br /> attention. KEEP OUT OF REACH <br /> OF CHILDREN. <br /> SALES & RENTAL AGR <br /> y •If the equipment is not properly cleaned after use,lessee agrees to pay a$: <br /> •If the equipment is used more than two hours,fee of S25 per hour on�N <br /> charred. <br /> -The lessee acknowledges that the above equipment has been delivered I <br /> consideration he agrees to pay the renta,charge ana 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 nispb„ted said trailer,trailer hitch al <br /> and that he has found the trailer and hook-up safe and secure and the of <br /> agreeing to assume all responsibility for said leased equipment while it is in t_- . ...... . <br /> -The lessee further agrees to indemnify and save California Rock&Read <br /> pense arising Irom any injury or damage to his person or property that may occL <br /> proximate result of its being in his custody.In the event of any accident,the t'A r d h o I(ler ii c K 11 o td I e d g e ti <br /> California Rock&Ready Mix. (1 I g 0 o d 5 a It tl <br /> -The lessee agrees to comply with all laws of the State covering the use of trai 1"e��e l I1 t <br /> sume all responsibility for fire, theft, confiscation, and all citations and pena t t 11 1 1 at-1 U 11 <br /> possession. 1)y the cardiftjer <br /> We are not responsible for any damage encountered while Califon r e t:01e11 t W 1 t It 1 5511e r. <br /> materials customer has ordered.Customer will pay all tow charge: <br /> while dumping or working in the area the customer requested. <br /> SIGNATURE <br /> X --------------------- <br /> MERCHANT COPY <br />
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