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State of California — Department of Fish and Wildlife <br />NOTIFICATION OF LAKE OR STREAMBED ALTERATION <br />FISH AND GAME CODE SECTION 1602 <br />DFW 2023 (REV. 01/01/18) Pagel <br />FOR DEPARTMENT USE ONLY <br />Date Received <br />Amount Received <br />Amount Due <br />Date Complete <br />Notification No. <br />lr _l <br />$ <br />$ <br />209-948-7889 <br />00- <br />Assigned to: <br />J <br />sam.sherman@dot.ca.gov <br />NOTIFICATION OF LAKE OR STREAMBED ALTERATION <br />Complete EACH field, unless otherwise indicated, following the enclosed instructions and submit ALL required <br />enclosures. Attach additional pages, if necessary. <br />1. APPLICANT PROPOSING PROJECT <br />Name <br />Sam Sherman, Caltrans Project Manager ildll e <br />Business/Agency <br />California Department of Transportation (Caltrans) - District 10 <br />Mailing Address <br />1976 Dr. Martin Luther King Jr. Blvd. <br />City, State, Zip <br />Stockton, CA 95201 <br />Telephone <br />209-948-7889 <br />Fax <br />jason.meigs@dot.ca.gov <br />Email <br />sam.sherman@dot.ca.gov <br />2. CONTACT PERSON (Complete only if different from applicant) <br />Name <br />Jason Meigs <br />Street Address <br />1976 Dr. Martin Luther King Jr. Blvd. <br />City, State, Zip <br />Stockton, CA 95201 <br />Telephone <br />209-932-2371 <br />Fax <br />Start Date <br />(month/day) <br />Email <br />jason.meigs@dot.ca.gov <br />3. PROPERTY OWNER (Complete only if different from applicant) <br />Name <br />Stockton Viaduct Bridge Stage 2 Geotechnical Investigation Project <br />Street Address <br />0 Regular (5 years or less) <br />❑ Long-term (greater than 5 years) <br />City, State, Zip <br />D. Seasonal Work Period <br />Telephone <br />Beginning <br />(year) <br />Fax <br />Start Date <br />(month/day) <br />Email <br />2018 <br />4. PROJECT NAME AND AGREEMENT TERM <br />A. Project Name <br />Stockton Viaduct Bridge Stage 2 Geotechnical Investigation Project <br />B. Agreement Term Requested <br />0 Regular (5 years or less) <br />❑ Long-term (greater than 5 years) <br />C. Project Term <br />D. Seasonal Work Period <br />E. Number of Work Days <br />Beginning <br />(year) <br />Ending <br />(year) <br />Start Date <br />(month/day) <br />End Date <br />(month/day) <br />2018 <br />2018 <br />8/1/2018 <br />10/31/2018 <br />+/-30 <br />