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FIELD DOCUMENTS FILE 1
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0544591
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FIELD DOCUMENTS FILE 1
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Last modified
6/21/2019 2:26:57 PM
Creation date
6/21/2019 11:30:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0544591
PE
3526
FACILITY_ID
FA0005220
FACILITY_NAME
CHEVRON #9-4054
STREET_NUMBER
2103
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12308029
CURRENT_STATUS
02
SITE_LOCATION
2103 COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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CZ o0 /3'tz <br /> �qutH <br /> oE.P. No. 96-021-CC <br /> 5 .�.co <br /> COUNTY OF SAN JOAQUIN <br /> yi . :� 02-02-96 <br /> DEPARTMENT OF PUBLIC WORKS (Date Issued) <br /> P.O. BOX 1910- 1610 E HAZELTON AVENUE <br /> • • STOOKTON,OAUFORNN 95201 <br /> C.j ...., 12091469-3000 03-01-96 <br /> HENRY M. NIRATA <br /> ENCROACHMENT PERMIT (Expiration Date) <br /> ou,c.o� 11005 <br /> (Job No.) <br /> To: Terra Vac Corporation Encroachment type: Monitoring Well <br /> 14798 Wicks Boulevard <br /> San Leandro, CA 94577 Location: W/s Franklin Ave. 20' <br /> (510) 351-8900 n/o Elmwood Ave. <br /> In compliance with your request of February 2 , 19 96 , permission is hereby <br /> granted to do work in County right of way as shown on attached application and subject to <br /> all the terms, conditions and restrictions written below or printed as general or special <br /> provisions on any part of this form. See reverse side and attached sheet, if any. <br /> Trench excavations for service connections will not be permitted within ten feet (10' ) <br /> of pavement centerline unless otherwise approved by the Director. Surface of trench patches <br /> shall match in kind and be smooth and even with that of abutting surface. Special attention <br /> shall be given to depth of utilities through roadside area in anticipation of future drain- <br /> age facilities, road profile and/or frontage development. All underground utility facili- <br /> ties are to be established and accurately dimensioned on sketches from surveyed centerline <br /> of road right of way, not from right of way (border) lines. <br /> The Department of Public Works, Field Inspection Section shall receive a notice at <br /> least forty-eight (48) hours prior to beginning any work within the County right of way. <br /> All work performed under this permit shall conform to the rules and regulations pertain- <br /> ing to safety established by the California Division of Industrial Safety and Cal-OSHA. <br /> The jobsite shall be kept in a safe condition at all times by the daily removal of <br /> any excess dirt or debris which might be a hazard to either pedestrian or automobile <br /> traffic. All necessary traffic convenience and warning devices and personnel shall be <br /> provided, placed and maintained by and at the sole expense of the Permittee in accordance <br /> with the latest edition of the CALTRANS Manual of Traffic Control. <br /> After completion of the work permitted herein, all debris, lumber, barricades, or any <br /> excess material shall be removed and the jobsite left in a neat workmanlike manner. <br /> Immediately following completion of construction permitted herein, Permittee shall fill <br /> out and mail notice of completion provided by Grantor. <br /> Est. Permit Fee: $ <br /> FORMS: SS/WW,R-29 HENRY M. NIRATA, Dir <br /> Department of P c Works <br /> WHITE - Permittee By <br /> GOLDENROD - PWD Central File Permilr Section <br /> YELLOW - Field Inspection <br /> PINK - Permit Section 4A 3 <br /> ,vj. / v�ciCN PW 27 <br />
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