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WP0042048
Environmental Health - Public
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EHD Program Facility Records by Street Name
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BRANDT
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16727
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042048
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Entry Properties
Last modified
12/22/2021 1:40:14 PM
Creation date
12/22/2021 1:39:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042048
PE
4380
STREET_NUMBER
16727
Direction
E
STREET_NAME
BRANDT
STREET_TYPE
WAY
City
CLEMENTS
Zip
95240-
APN
01914021
ENTERED_DATE
5/18/2021 12:00:00 AM
SITE_LOCATION
16727 E BRANDT WAY
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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---"California Rock & Ready Mix <br />12010 E: Turner Rd. • Lodi, CA 95240 132003 <br />L ,5 (209) 368-5351 • Fax (209) 368-5824 <br />NAME IZ-.4-- l 1 Ll �% I'Gi .S DATE 7 Ci <br />ADDRESS i V 7 I/,— / I l i �i vlGtL�L9NE <br />I(lR CITE <br />TIME AM ❑ <br />OUT [Z' -L/ PM ❑ <br />TIME <br />IN F <br />CITY. <br />DESCRIPTION <br />1 � <br />CAU ON <br />Freshly mixed dament, mortar, <br />concrete or grout may cause skin <br />injury. Avoid contact with skin <br />where possible and wash exposed <br />skin areas promptly with water. If <br />any cement mixtures get into eyes, <br />rinse immediately and repeatedly <br />with water and get prompt medical <br />attention. KEEP OUT OF REACH <br />OF CHILDREN. <br />EQUIPMENT RENTED F <br />HAND TROWEL <br />HAND FLOAT <br />EDGER <br />TRAILER <br />SALES & RENTAL AGRE <br />• If the equipment is not properly cleaned after use, lessee agrees to pay a $51 <br />• If the equipment is used more than two hours, fee of $25 per hour on we <br />charged. <br />• The lessee acknowledges that the above equipment has been delivered to <br />consideration he agrees to pay the rental charge and sign this agreement. Th - <br />mortgage the leased equipment and to return the same in as good condition a: <br />• The lessee acknowledges that he has inspecteV said trailer, trailer hitch anc <br />and that he has found the trailer and hook-up safe and secure and the oth <br />agreeing to assume all responsibility for said leased equipment while it is in hi: <br />• The lessee further agrees to indemnity and save California Rock & Rea <br />pense arising from any injury or damage to his person or property that may cc <br />proximate result of its being in his custody. In the event of any accident, thi <br />California Rock & Ready Mix. <br />- The lessee agrees to comply with all laws of the State covering the use of ti <br />sume all responsibility for fire, theft, confiscation, and all citations and pei <br />possession. <br />We are not responsible for any damage encountered while Calif <br />materials customer has ordered. Customer will pay all tow char( <br />while dumping or working in the area the customer requested. <br />SI NATURE <br />X <br />CALIFORNIA ROCK AND READY MIX <br />1200 E TURNER RD <br />LODI CA 95240 <br />209 368-5351 <br />Merchant ID: 0449 <br />Term fl: 0003 Store It: 4039 <br />Ref If: 0007 <br />Phone Order <br />9999993933 <br />VISA Entry Method; Manual <br />Total: $ 941.78 <br />1 <br />06�15�21 �� 10:57:40 <br />Inv a: 000007 �Ppr Code: 02221D <br />1ran5action ID: 5811666A6604769 <br />Apprvd:Online BAN: 000818 <br />CVV2 Code: VCH M <br />I agree to Nay above total amount <br />according to card iaauer agreement <br />(Merchant agreement if credit voucher) <br />Merchant Copy <br />THANK YOU <br />PLEASE CUME AGAIN <br />
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