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WP0043542
EnvironmentalHealth
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MICKE GROVE
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11250
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043542
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Entry Properties
Last modified
6/26/2024 11:12:27 AM
Creation date
6/5/2024 2:20:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043542
PE
4366
STREET_NUMBER
11250
Direction
N
STREET_NAME
MICKE GROVE
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
05914069
ENTERED_DATE
7/27/2022 12:00:00 AM
SITE_LOCATION
11250 N MICKE GROVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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California Rock-& Ready Mix <br /> 1200 E. Turner Rd. • Lodi, CA 95240 146190 <br /> (209) 368-5351 • Fax (209) 368-5824 <br /> Z12�/ <br /> NAME I ` 1 � DATE <br /> ADDRESS L Z JL/ (\�1%l� l/,PHOyNE '�.Sei 9-0 <br /> JOB SITE rl� L, <br /> TIME ` AM ❑ TIME AM ❑ TRUCK NO. TRAILER NO. <br /> OUT - PM ❑ IN PM ❑ <br /> QTY. DESCRIPTION PRICE AMOUNT <br /> 3 <br /> rr <br /> EQUIPMENT RENTED PRICE/DAY SUB-TOTAL <br /> CAUTION HAND TROWEL <br /> Freshly mixed cement, mortar, HAND FLOAT SALES TAX <br /> concrete or grout may cause skin EDGER EQUIPMENT <br /> injury. Avoid contact with skin <br /> where possible and wash exposed TRAILER RENTAL <br /> skin areas promptly with water. If CLEANING <br /> any cement mixtures get into eyes, CHARGE <br /> rinse immediately and repeatedly <br /> with water and get prompt medical <br /> attention. KEEF OUT OF REACH <br /> OF CHILDREN. TOTAL <br /> SALES & RENTAL AGREEMENT <br /> 9 •If the equipment is not properly cleaned after use,lessee agrees to pay a$50 cleaning charge. <br /> •If the equipment is used more than two hours,fee of S25 per hour on weekdays and S35 per hour on weekends,will be <br /> _. charged. <br /> •The lessee acknowledges that the above equipment has been delivered to his custody and control for his own use,and in <br /> considerat;pn he agrees to pay the rental charge and sign this agreement.The lessee further agrees not to sell,loan,sublet or <br /> mortgage the leased equipment and to return the same in as good condition as when received. <br /> •The lessee acknowledges that he has inspected said trailer,trailer hitch and safety chain,and the other items of equipment, <br /> and that he has found the trailer and hook-up safe and secure and the other equipment serviceable and he accepts same <br /> agreeing to assume all responsibility for said leased equipment while it is in his custody. <br /> •The lessee further agrees to indemnity and save California Rock&Ready Mix harmless from any liability,claim or ex- <br /> pense arising from any injury or damag:;to his person or property that may occur while said equipment is in his custody or as a <br /> proximate result of its being in his custody.In the event of any accident,the lessee agrees to make a written report to <br /> Californh.Rock&Ready Mix. <br /> •The lessee agrees to comply with all laws of the State covering the use of trailers,to travel within the speed limit,and to as- <br /> sume all responsibility for fire, theft, confiscation, and all citations and penalties incurred against said trailer while in his <br /> possession. <br /> We are not responsible for any damage encountered while California Rock&Ready Mix Is delivering <br /> materials customer has ordered.Customer will pay all tow charges if our truck or equipment gets stuck <br /> while dumping or working in the area the customer requested. <br /> SIGNATURE LICENSE <br /> X <br />
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