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EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0530063
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/6/2019 3:55:34 PM
Creation date
2/6/2019 3:42:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0530063
PE
2957
FACILITY_ID
FA0019769
FACILITY_NAME
FORMER SHELL GAS STATION
STREET_NUMBER
3011
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
10018010
CURRENT_STATUS
01
SITE_LOCATION
3011 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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STATE OF CALIFORNIA.D", T OF TRANSPORTATION <br /> ENCROACHMENT P ;yEFWT <br /> TR-0120(REV.2/98) <br /> Permit No. <br /> 1003-6SV-0235 <br /> In compliance with (Check one): Dlsuco/Rte/PM <br /> ® Your application of March 25, 2003 10-SJ-5-26.46 <br /> ❑ Date <br /> Utility Notice No. of July 31, 2003 <br /> ❑ Fee PaDepositld <br /> Agreement No. Of <br /> $ $ 320.00 <br /> Pedonnance Bond Amount(1) Payment Bond ArnowRNY Contract No. Of <br /> $7,5 $ <br /> Bond Company <br /> Libert Mutual Insurance Com an <br /> TO: Bontl Number(1) Bond Number(2) <br /> CAMBRIA ENVIRONMENTAL TECHNOLOGY, INC. --1 <br /> 270 Perkins Street <br /> Sonoma, CA 95476 <br /> ATTN: Scott Lewis ASG F 2003 <br /> TEL : (707) 933-2360 <br /> I <br /> and subject to the following, PERMISSION IS HEREBY GRANTED to: r PERMITTEE <br /> Install three groundwater monitoring wells in the west side of the planter area along the <br /> southbound off-ramp of Interstate Highway 5 at West Benjamin Holt Drive in the City of <br /> Stockton. <br /> In accordance with General Provision No. 6, TWO WORKING DAYS PRIOR to the start <br /> of this work, Permittee shall notify the State Representative MARCEL DE LA CRUZ, <br /> P.O. Box 2048 Stockton, CA 95201, (209) 948-3656. All work under this permit must <br /> 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 <br /> of this permit. <br /> The following attachments are also included as part of this permit <br /> (Check applicable): In addition to fee,the permittee will be billed <br /> ® Yes ❑ No General Provisions actual costs for: <br /> ❑ Yes No Utility Maintenance Provisions ® Yes ❑ No Review <br /> ® Yes ❑ No Special Provsions T ® Yes ❑ No Inspection <br /> ❑ Yes ® NO A Cal-OSHA permit required prior to beginning work; ® Yes El No Field Work <br /> (If any Caltrans effort expended) <br /> ❑ Yes ® rlp The information in the environmental documentation has been reviewed and is considered rior to a <br /> ertnR. P pproval of this <br /> This permit is void unless the work is completed before <br /> December 31, 2004. <br /> This permit is to be strictly construed and no other work other than specifically mentioned is hereby authorized. <br /> No Dr9jeo <br /> work shall be commenced until all other necessaryits and environmental clearances have been obtained. <br /> 1 -Permittee APPROVED: <br /> 1 -File <br /> 3—M.De la Cruz <br /> MARK LEJA, District Director <br /> BY: <br /> Eddie LE MEN R, Dis ict Perm ineer <br /> FM 91 146 <br />
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