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WP0044953
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BROVELLI WOODS
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24790
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4200/4300 - Liquid Waste/Water Well Permits
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WP0044953
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Last modified
9/30/2024 11:14:14 AM
Creation date
3/20/2024 2:22:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0044953
PE
4366
STREET_NUMBER
24790
Direction
N
STREET_NAME
BROVELLI WOODS
STREET_TYPE
LN
City
ACAMPO
Zip
95220-
APN
00310033
ENTERED_DATE
10/6/2023 12:00:00 AM
SITE_LOCATION
24790 N BROVELLI WOODS LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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California Rock & Ready Mix <br /> 1200 E. Turner Rd. • Lodi, CA 95240 159159 <br /> (209) 36y8-5351 Fax (209) 368-5824 <br /> NAME l"�l �, S DATE <br /> ADDRESS G Ll 7�C IBJ�C7�r�` [ U����Hv PPt�ONE, /l0 C% 2% ' <br /> JOB SITE G v�C <br /> TIME AM ❑ TIME AM ❑ TRUCK NO. TRAILER NO. <br /> OUT I /I. 3:' PM ❑ IN PM ❑ <br /> QTY. DESCRIPTION PRICE AMOUNT <br /> // <br /> < ^r <br /> California <br /> Rock & Ready Mix <br /> 1200 E Turner Rd <br /> Lodi CA 95240 <br /> (209 368-5351 <br /> EQUIPMENT RENTED 11/28/2023 8:13 <br /> CAUTION HAND TROWEL Sale <br /> Freshly mixed cement, mortar, HAND FLOAT <br /> concrete or grout may cause skin EDGER Trans #: 1 Batch #: 185 <br /> injury. Avoid contact with skin <br /> where possible and wash exposed TRAILER CREDIT CAR <br /> skin areas promptly with water. If P <br /> any cement mixtures get Into eyes, VISA MANUA L <br /> rinse immediately and repeatedly ......649 �f1F/SHF <br /> with water and et prompt medical 1 <br /> attention. KEVOUT OF REACH <br /> OF CHILDREN. BASE AMT: $1071,68 <br /> SALES & RENTAL AGR Non-Cash AdJUS then t <br /> •If the equipment is not properly cleaned after use,lessee agrees to pay a S $34,83 <br /> •If the equipment is used more than two hours,fee of S25 per hour on% TOTAL AMT: USD $1106.51 <br /> charged. <br /> •The lessee acknowledges that the above equipment has been delivered Resp: APPROVAL 02223D <br /> consideration he agrees to pay the rental charge and sign this agreement.l Code: 02 22 3 D <br /> mortgage the leased equipment and to return the same in as good condition <br /> •The lessee acknowledges that he has inspected said tralle"trailer hitch a Ref #: 333215499172 <br /> and that he has found the trailer and hook-up safe and secure and the c Trans I D: 463332550600486 <br /> y agreeing to assume all responsibility for said leased equipment while it is in <br /> •The lessee further agrees to indemnify and save California Rock&R <br /> pense arising from any injury or damage to his person or property that may, Card}10 l de r acknowledges <br /> 0 W l e d <br /> proximate result of its being in his custody.In the event_of any accident, ge s <br /> California Rock&Ready Mix. receipt of goods and <br /> •The lessee agrees to comply with all laws of the State covering the use o o b l i a l�i o n s set fort h <br /> sume all responsibility for fire, theft, confiscation, and all citations and I by T.11e Cardho l der' s <br /> possession. agreement With issuer, <br /> We are not responsible for any damage encountered while Cal <br /> materials customer has ordered.Customer will pay all tow ch <br /> while dumping or working in the area the customer requested. <br /> SIGNATURE <br /> X MERCHANT COPY <br />
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