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WP0039255
EnvironmentalHealth
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HANSEN
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27004
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039255
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Entry Properties
Last modified
2/4/2026 10:17:57 AM
Creation date
12/30/2024 4:46:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039255
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
27004
Direction
S
STREET_NAME
HANSEN
STREET_TYPE
RD
City
TRACY
Zip
95377-
APN
25104001
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
27004 S HANSEN RD TRACY 95377-
Tags
EHD - Public
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California Rock & Ready Mix <br /> 1200 E. Turner Rd. • Lodi, CA 95240 105110 <br /> , ,- (209) 368-5351 Fax (209) 368-5824 <br /> NAME ✓7 1`I 1 t DATE / <br /> ADDRESS �� r`Li f/! y7 PHONE Cj <br /> JOBSITE <br /> TIM AM ❑ TIME AM ❑ TRUCK NO. TRAILER NO. <br /> OUT(Z 111 PM ❑ I IN PM ❑ <br /> QTY. DESCRIPTION PRICE AMOUNT <br /> EL <br /> EQUIPMENT RENTED PRICE/DAY SUB-TOTAL <br /> CAUTION HAND TROWEL <br /> Freshly mixed cement, mortar, HAND FLOAT <br /> SALES TAX ' 7 L <br /> concrete or grout may cause skin EDGER EQUIPMENT <br /> injury. Avoid contact with skin RENTAL <br /> where possible and wash exposed TRAILER <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 et prompt medical <br /> attention. KEE�OUT OF REACH <br /> OF CHILDREN. TOTAL 7 -S 76, <br /> SALES & RENTAL AGREEMENT <br /> •If the equipment is not property cleaned after use,lessee agrees to pay a$50 cleaning charge. <br /> •If the equipment is used more than two hours,fee of$25 per hour on weekdays and$35 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 /> consideration he agrees to pay the rental charge and sign this agree„ent.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 indemnify and save California Rock&Ready Mix harmless from any liability,claim or ex- <br /> pense arising from any Injury or damage 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 /> California 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. i <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 /> V <br />
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