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�CITV'uJF STOCKTON til r A;P DEPARTMENT OF PUBLIC WORKS - - CITY HALL " 425 N. EL OORAOO STREET STOCKTON. CA 95202-1997 o '°°'" PUBLIC HEALTH SERVICES "' SANJOAQUW COUNTY "°"" MIQIAB.J.Il�iJRNAJRRFILS Senior Registered Environmental Health Specialist Environmental Division (209)4 I 4 D (209)468-3454 304 E.Weber Avenue,Third Floor FAX(209)468-3433 Stockton,CA 95202 REVOCABLE PERMIT REQUEST FOR GROUNDWATER MONITORING WELLS The permitting process required in the City of Stockton for installation of groundwater monitoring wells is a two phase process. First, a Revocable Permit must be issued, wherein the City grants permission to the property owner to install and maintain a private well within the City's right-of-way. Second, an Encroachment Permit is issued which allows the actual construction of the well to be carried out in our right-of-way. In order to issue the Revocable Permit the City requires the following: 1. A formal written request for a Revocable Permit in which you acknowledge that you have read and understand the City's Standard Conditions Applicable to Revocable Permits. An acceptable application form and copy of the Standard Conditions are enclosed. 2. A processing fee payable to the City of Stockton in the amount of$310.00. 3. A detailed work plan including a sketch showing the location of the proposed well(s). 4. A Faithful Performance Bond, or other acceptable form of financial security, in an amount of$500.00 per well will be required. This bond shall remain in effect for as long as the well remains in the City's right-of-way. 5. A certificate of insurance naming the City as additional insured.. Insurance is required for the agency obtaining the Revocable Permit and the agency obtaining the Encroachment Permit. A sample form of the certificate is enclosed. Note the limits are higher than shown in the Standard Conditions. "STOCKTON...CALIFORNIA'S SUNRISE SEAPORT" ® -