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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION <br />NGRMENT PERMIT <br />Tit -0120 (REV 2198) <br />.In compliance with (Check one) <br />® Your application of DECEMBER 20,1999 <br />❑ Utility Notice No <br />❑ Agreement No <br />❑ RNV Contract No <br />1� <br />of <br />of <br />of <br />GETTLER- RYAN INC <br />3164 GOLD CAMP DRIVE, SUITE # 240 <br />RANCHO CORDOVA, CA 95670 <br />ATTN DAVID W HERZOG <br />TEL (916) 631-1300 <br />i <br />and subject to the following, PERMISSION IS HEREBY GRANTED to <br />Permit No <br />1099-6SV-1069 <br />10 -SJ -12-27.25127.41 (PM 16.93117.03) <br />DECEMBER 22,1999 <br />, PERMITTEE <br />$ 210 <br />Amount <br />Install two ground water monitoring wells about one foot south of sidewalk on south side of Kettleman Lane (SR12) between South <br />Hutchins Street and South Pleasant Avenue in Lodi as shown in attached plans The monitoring wells are temporary and will be <br />,10 backfilled upon completion and the surface should be sealed without any holes or hazards Parttclpants or people Involve in <br />doing this work should understand traffic safety procedure requirements while working alot:g :he s,de of travelled way <br />There should not be any Interference to pedestrian and public traffic at any time In conducting the work allowed under this <br />permit Permittee should furnish a copy of collected survey data and the test results to Caltrans without charge A traffic <br />control plan shall be submitted to the State representative before doing any work <br />In accordance with General Provision No 6, TWO WORKING DAYS PRIOR to the start of this work, permittee shall <br />notify the State representative MARCEL DE LA CRUZ, P 0 Box 2048 Stockton, CA 95201, (209) 948-3656 All work <br />under this permit must meet with the approval of the State representative <br />Failure on the permittee's part to comply with any provision will be cause for revocation of this permit <br />The following attachments are atso included as part of this permit <br />(Check applicable) <br />for <br />® Yes <br />❑ No Review <br />® Yes <br />❑ <br />No <br />General Provisions <br />❑ <br />Yes <br />® <br />No <br />Utility Maintenance Provisions <br />® <br />Yes <br />❑ <br />No <br />Special Provisions T <br />❑ Yes <br />® <br />No <br />A Cal -OSHA permit required prior to beginning work, <br />In addition to fee, the permittee will be balled <br />actual costs <br />for <br />® Yes <br />❑ No Review <br />® Yes <br />❑ No Inspection <br />® Yes <br />❑ No Field Work <br />(If any Caltrans effort expended) <br />❑ Yes ® No The information in the environmental documentation has been reviewed and is considered prior to approval of this <br />permit <br />This permit is void unless the work is complete before JUNE 30, 2000 <br />This permit is to be strictly construed and no other work other than specifically mentioned is hereby authorized <br />nice nrmcPet work shall be commenced until all other necessary permits and environmental clearances have been obtained <br />1 - Permittee <br />1 - File <br />3 — MARCEL DE LA CRUZ <br />1 <br />PSV O <br />MARK LEJA, District <br />6Y. J , <br />v4rv, <br />FRANKLIN L WEISH <br />JR , District <br />I-.-- <br />Engineer <br />f <br />Engineer <br />