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PR0503634
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Last modified
5/7/2019 4:25:20 PM
Creation date
5/7/2019 4:13:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0503634
PE
2950
FACILITY_ID
FA0005914
FACILITY_NAME
VICTOR ROAD SHELL
STREET_NUMBER
880
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
APN
04905032
CURRENT_STATUS
02
SITE_LOCATION
880 VICTOR RD
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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STATE OF CALIFORNIA•DEPARTMENT OF TRANSPORTATION <br /> ENCROACHMENT PERMIT <br /> TR-0120(REV.2/98) Permit No. <br /> 1003-6SV-0035 <br /> Dist/Co/Rte/PM <br /> In compliance with (Check one): <br /> ® Your application of JANUARY 13, 2003 10-SJ-12-18.13 <br /> Date <br /> ❑ Utility Notice No. of JANUARY 23,2003 <br /> Fee Paid Deposit <br /> ❑ Agreement No. of $ $ 320.00 <br /> Performance Borg Amount(i) Payment Bond Amount <br /> ❑ R/W Contract No. Of $ $ <br /> Bond Company <br /> Bond Number(1) Bond Number(2) <br /> TO: <br /> CAMBRIA ENVIRONMENTAL TECHNOLOGY <br /> 114465 th STREET, SUITE B <br /> OAKLAND, CA 94608 <br /> ATTN: AUBREY COOL <br /> TEL : (510)420-3336 <br /> I I <br /> and subject to the following,PERMISSION IS HEREBY GRANTED to: PERMITTEE <br /> Install two monitoring wells inside the Park and Ride along the southerly side of State <br /> Highway 12 and easterly of State Route 99 in the City of Lodi. The monitoring wells will <br /> be completed with a two inch schedule 40 PVC pipe. The monitoring wells shall be <br /> done as shown on the attached typical monitoring well construction, and located as <br /> shown on the attached location plan for MW-8 and MW-9. Installation shall be done on <br /> weekend or on holiday. Monitoring can be done at any day and time. Permittee shall <br /> request for extension of permit when monitoring goes beyond expiration date. <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 /> 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 <br /> Yes No Special Provisions ® Yes ❑ No Inspection <br /> ® ❑ ® 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 is void unless the work is completed before JULY 31 2003 <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 unlit all other necessary Is 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 /> ,r l <br /> Pete ALE/ rict P it En ineer ;Za�l�3 <br /> FM 91 1436 <br />
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