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Q'►ARTMENT c:TAA//$IpNTAt10N IcALtwuai ermit o. <br /> ENCROACHMENT PERMIT <br /> DM-M-P202A (Rev 1 901092-6SV-0816 <br /> Dist/Co/Rte/PM <br /> 10-SJ-04-R-16 . 5 <br /> In compliance with (check one) : <br /> Date <br /> X Your application of 9-15-92 October 6 , 1992 <br /> Fee Paid inspection <br /> Utility Notice No. of S 260 . 00 <br /> Bond Amount <br /> Agreement No. of $ <br /> Bond Company <br /> R/W Contract No. of <br /> Bond Number <br /> TO: <br /> GROUNDWATER TECHNOLOGY, INC. -� <br /> 1401 HALYARD DRIVE, SUITE 140 <br /> WEST SACRAMENTO, CA 95691 <br /> ATTN• BRUCE H. EPPLER, GEOLOGIST <br /> (916) 372-4700 I <br /> J PERMITTEE <br /> and subject to the following, PERMISSION. IS KEREBY GRANTED to: <br /> Drill and install one 8 inch diameter soil boring to <br /> approximately 60 feet below grade, and install 2 inch diameter <br /> PVC casing and screen in boring. Complete surface with traffic- <br /> rated 12 inch diameter well head street box. <br /> Permittee shall apply for and obtain an annual maintenance permit <br /> in order to monitor well after this permit expires. <br /> In accordance with General Provision No. 5, TWO WORKING DAYS <br /> PRIOR to the start of this work, permittee shall notify the state <br /> representative BILL LaMASCUS, 142 N 9th Street, Suite 8 , Modesto, <br /> CA 95350, (209) 576-6167 . All work under this permit must meet <br /> with the approval of the state representative. <br /> Failure on the permittee's part to comply with any provision will <br /> Continued <br /> The following attachments are also included as part of this permit (Check in addition to fee the permittee will be billed <br /> applicable) actual costs for: <br /> X Yes General Provisions _ Yes ,,2� No Review <br /> _Yes X No Utility Maintenance Provisions _ Yes 2!k No Inspection <br /> X-Yes_ No Special Provisiais 7- Yes Field Work <br /> —Yeses No Excavation permit required prior to beginning work: <br /> (If any Caltrans effort expended) <br /> Yes N.A. The information in the environmental documentation has been reviewed and considered prior to <br /> approval of this permit. <br /> This permit is void unless the work is completed before M A R C H 3 1 1 9 9 3 . <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 permits and environmental clearances have been obtained. <br /> Orig.- Permittee APPROVED- <br /> 1- Permit File <br /> 3- BLaMascus <br /> GORDON A. MARTS, District Director <br /> BY: „ <br /> BDL:svl <br /> y HN GAGLIAND, District Permit Engineer <br /> 1 <br />