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~ STATE OF CAUFORNIA•DEPARTME*,.,)F TRANSPORTATION <br /> 11–W — �� 1,4 <br /> ENCROACHMENT PERMIT Permit "°. <br /> TR-0120(NEW 9/91) 1096-6SV-0622 <br /> Dist/Co/Rte/PM <br /> In compliance with (check one): D 10-SJ-04-R16.49 \NC <br /> X Your application of AUGUST 24, <br /> Date <br /> Utility Notice No. of December 2, 1996 Q <br /> Fee PaidQ <br /> Agreement No. of $ 280 �1 $ <br /> Pe ormance Bond Amount (1) Payment Bond Amount (2) <br /> R/W Contract No, of $ 2,000.00 $ <br /> Bond Company <br /> UNITED PACIFIC INSURANCE CO. <br /> Bond Number (1) Bond Number (2) <br /> TO: U80 51 20-1329 <br /> CHEVRON PRODUCTS COMPANY/PACIFIC <br /> ENVIRONMENTAL GROUP INC. <br /> 11315 SUNRISE GOLD CIRCLE, SUITE M <br /> RANCHO CORDOVA, CA 95742 <br /> ATTN: JOHN GRIFFIN <br /> PHONE: (916) 858-2350 I PERMITTEE <br /> and subject to the following, PERMISSION IS HEREBYGRANTED to: <br /> DRILL AND INSTALL ONE 8 INCH GROUNDWATER MONITORING WELL APPROXIMATELY 52 FEET <br /> DEEP WITHIN THE STATE RIGHT OF WAY, IN THE SIDEWALK, ON THE NORTH SIDE OF STATE <br /> ROUTE 4 AND THE WEST SIDE OF CENTER STREET, IN THE CITY OF STOCKTON. INSTALL ONE 2 <br /> INCH SCH 40 PVC CASING IN WELL. COMPLETE SURFACE INSTALLATION WITH A LOCKING <br /> EXPANDABLE WELL CAP IN A FLUSH MOUNTED TRAFFIC RATED WELL HEAD STREET BOX. <br /> A pre-job conference with the permittee, contractor, and State representative is required prior to start of <br /> work. Permittee shall contact the State representative and arrange the meeting. This meeting may be <br /> waived at the direction of the State representative. <br /> Permittee shall, prior to commencement of any work, provide the State representative with the name and <br /> phone number of the person in responsible charge of the work to be performed under this permit. <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 /> X Yes No General Provisions _ Yes X No Review <br /> _ Yes X No Utility Maintenance Provisions _ Yes X No Inspection <br /> X Yes No Special Provisions T X Yes ____— Field Work <br /> Yes X No A Cal-OSHA permit required prior to beginning work <br /> # (If any Caltrans effort expended) <br /> Yes X No 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 MAY 31 1997 <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 /> RC ;C <br /> Lauri Jur ens, District Permit En ineer <br />