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SU0005752
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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PA-0500730
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SU0005752
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Entry Properties
Last modified
5/7/2020 11:31:45 AM
Creation date
9/6/2019 10:29:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0005752
PE
2611
FACILITY_NAME
PA-0500730
STREET_NUMBER
11230
Direction
E
STREET_NAME
JAHANT
STREET_TYPE
RD
City
ACAMPO
APN
00738011
ENTERED_DATE
11/3/2005 12:00:00 AM
SITE_LOCATION
11230 E JAHANT RD
RECEIVED_DATE
11/1/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Supplemental fields
FilePath
\MIGRATIONS\J\JAHANT\11230\PA-0500730\SU0005752\APPL.PDF \MIGRATIONS\J\JAHANT\11230\PA-0500730\SU0005752\CDD OK.PDF \MIGRATIONS\J\JAHANT\11230\PA-0500730\SU0005752\EH COND.PDF \MIGRATIONS\J\JAHANT\11230\PA-0500730\SU0005752\EH PERM.PDF
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EHD - Public
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WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following doacrlbed commodity was weighed,menurM,or <br /> counted by s we190mester,who»slgnelurela on Nle eenitKate,who is•reeopnlzM aulhodry t <br /> of accuracy.as preseribsd by Chapter 7(Commencing with Section 12]00)of DlvWon 5 of Ne �Y'/y.�� <br /> California Business end ea <br /> Professions Cade,administered by the Division W Msurement ` <br /> � Standards of the California Department of Food and Agriculture. <br /> r� K <br /> f �,-r i.Z . PEARSONS CONCRETE <br /> \pp CAUTION •02 ' 10284UNDERWOODRD., ACAMPO, CA95220 <br /> o TELEPHONE (209) 334-9234 <br /> Freshly mixed cement, mortar, <br /> ' (1� concrete or grout may cause skin ORDER NO. DATE 7`Z 200- <br /> injury. <br /> 00-injury. Avoid contact with skin where CUSTOMER' r '" <br /> I� possible and wash exposed skin t ti"ifg .f$�t <br /> areas promptly with water. If any '' L <br /> } cement mixtures get into eyes, rinse DRIVER t '1 TRUCK LOADCU YDG <br /> immediately and repeatedly with 2 <br /> water and get prompt medical CONCRETE MIX STARTTIME <br /> attention. CEMENT ARRIVEJOB <br /> I ADMIT( 1 <br /> KEEP OUT OF REACH OF CHILDREN. A-t LEAVE JOS <br /> t A-2 ENDTIME <br /> ADMIX a <br /> A-3 TOTAL <br /> A-4 FREE <br /> Dear Customer: <br /> ATER NET <br /> THIS LOAD �'./f SACK WEIG HED AT <br /> NOTICE: WE MAKE DELIVERIES INSIDE THE CURB LINE GUARANTEED t CUBIC CON- NO. ;� 9�e01T,CA. HORN <br /> TO YIELD CYARDSUBIC CRET MIX -� GALT,CA. <br /> AT CUSTOMER'S RISK ONLY, AND ACCEPT NO PEARS01115READY MIX CO RETE INC.—WEIGHMASTER <br /> RESPONSIBILITY WHATSOEVER FOR DAMAGES BY <br /> RESULTING FROM SUCH DELIVERIES. QUANTITY UNITS DES•RIPTION UNITPRICE I AMOUNT <br /> The driver of this truck.In requesting the additional signature below,is of the opinion CU YDS CONCRETE <br /> that the size and weight of the truck may possibly cause damages to the premises <br /> and/or adjacent property if the driver places the material in this load where you desire <br /> it.It is our wish to help you in every way that we can,but in order to do this,the driver <br /> is requesting that you or your representative sign below indicating you. have released <br /> the driver and PEARSONS CONCRETE from all responsibilty for any damage that <br /> may occur to the premises and/or adjacent property,buildings,sidewalks,driveways, <br /> curbs, etc. by the delivery of this material. Further,as additional consideration, you <br /> agree to help the driver remove mud from the wheels of the driver's vehicle so that <br /> the driver will not litter the public street, and you agree to indemnity and hold <br /> ,F harmless the driver of this truck and PEARSONS CONCRETE for any and all liabilities MIN. STAND BY TIME <br /> and damages to the premises and/or adjacent property which may be claimed by <br /> anyone to have arisen out of delivery of thls order. HOURS RENTAL <br /> t-p5 MINUTENG TIME A S PER L OWFREED <br /> CHARGE C.O.D. TOTAL <br /> Signature: <br /> ERRORS IN PRICE EXTENSION AND ADDITION SUBJECT TO CORRECTIONS <br /> TERMS: Net 30 Days.One and one-half(I1/2R)percent per month will be chay#6.4 on'pist duceccounte. <br /> Any reasonable legal fees Incurred in collection of above will be add_gdt�o this iharge. <br /> I �z <br /> Received By: X <br /> GERMANY BROTHERS PRINTING — REV.9/01 <br />
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