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STATE OF CALIFORNIA• DEPARTOT OF TRANSPORTATION <br /> ENCROACHMENT PERMIT <br /> TR-0120(REV.2/98) Permit No. <br /> 1014-6MW-0186 <br /> Dist/Co/Rte/PM <br /> In compliance with (Check one): <br /> 10-SJ-5-25.2 <br /> Your application of FEBRUARY 31, 2014 <br /> Date <br /> ❑ Utility Notice No. Of MARCH 28, 2014 <br /> Fee Paid Deposit <br /> ❑ Agreement No. of $ $ 656 <br /> Performance Bond Amount(1) Payment Bond Amount(2) <br /> ❑ RAN Contract No. of $5,000.00 $ <br /> Bond Company <br /> Liberty Mutual Insurance Company <br /> Bond Number(1) Bond Number(2) <br /> TO: 285044108 <br /> WILBUR-ELLIS COMPANY <br /> CIO GEOSYNTECH CONSULTANTS <br /> 134 NORTH LA SALLE STREET, SUITE 300 <br /> CHICAGO, IL 60602 <br /> ATTN: ERIC JENKS <br /> TEL : (530) 673-6770 <br /> � I <br /> PERMITTEE <br /> and subject to the following, PERMISSION IS HEREBY GRANTED to: <br /> Install, maintain, and sample one (1) monitoring well, as shown on the attachments, within <br /> Interstate 5 right of way at Charter Way in the City of Stockton in San Joaquin County. This <br /> Permit also allows to conduct traffic control if necessary, place, maintain, and remove temporary <br /> warning signs during sampling of the monitoring well. Upon the completion of work, the borings <br /> shall be abandoned in accordance to California Department of Transportation Standards and <br /> Specification with an approval of the State Field Representative. This Permit .does not allow <br /> lane closure at the Interstate 5 mainline. A copy of this permit shall be placed in the vehicles <br /> involved in doing this work. Permittee shall notify the State Field Representative in the area <br /> before doing any work under this permit. This Permit shall be extended in a Rider before the <br /> The following attachments are also included as part of this permit In addition to fee,the permittee will be billed <br /> (Check applicable): actual costs for: <br /> ® Yes ❑ No General Provisions ® Yes ❑ NO Review <br /> ❑ Yes ® No Utility Maintenance Provisions ® Yes ❑ NO Inspection <br /> ® Yes ❑ No Special Provisions T,TR-400 ® Yes ❑ No Field Work <br /> ❑ Yes ® NO A Cal-OSHA permit required prior to beginning 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 expires on or before: DECEMBER 31, 2015. <br /> This permit is to be strictly construed and no other work other than specifically mentioned is hereby authorized. <br /> No project work shall be commenced until all other necessary per its and environmental clearances have been obtained. <br /> ORIGINAL-Permittee APPROVED: <br /> 1 -File <br /> 2—JOSEPH A.VALDEZ <br /> I-MAINTENANCE AMARJEET BENIPAL. Acting, District Director <br /> I PIO 01 <br /> Betty Tamae if NELSON MAGSAYO, District Permit Engineer <br /> FM 91 1436 <br />