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STATE OF CALIFORNIA•DEPARTMENT OF TRANSPORTATION_ <br /> ENCROACHMENT PERMIT <br /> TR-0120(REV.2198) Permit No. <br /> 1011 6SV 0427 <br /> =Dist/CoW_1Rte/PMIn compliance with (Check one): -28.53 <br /> Your application of SEPTEMBER14, 2011 <br /> ❑ Utility Notice No. of SEPTEMBER 15, 201I <br /> Fee Paid Deposit <br /> ElAgreement No. Of $ $ 328 <br /> Performance Bond Amount(1) Payment Bond Amount(2) <br /> ❑ RAN Contract No. Of $ $ <br /> Bond Company <br /> TO: Bond Number(1) Bond Number(2) <br /> PALISADES GAS&WASH <br /> C/O STRATUS ENVIRONMENTAL, INC. <br /> 3330 CAMERON PARK DRIVE, SUITE 550 <br /> CAMERON PARk, CA 95682 <br /> ATTN: SCOTT BITTINGER <br /> TEL : (530)676-2062 <br /> I I <br /> , <br /> and subject to the following, PERMISSION IS HEREBY GRANTED to: PERMITTEE <br /> Abandon monitoring well, as shown on the location of the attached plans, within Interstate 5 <br /> right of way at Country Club Boulevard and Plymouth Road in the. City of Stockton in San <br /> Joaquin County. This Permit also allows to conduct Traffic Control, place, maintain, and <br /> remove temporary warning signs. Upon the completion of groundwater monitoring,the well will <br /> be abandoned by pressure grouting with near cement to the ground surface. The well <br /> abandonment may be conducted at night to reduce the impact of traffic. All work shall be done <br /> in accordance to California Department of Transportation Standards and Specifications with an <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 /> ❑ <br /> Yes NO Utility Maintenance Provisions® ® Yes No Inspection <br /> ® Yes ❑ No Special Provisions T ® 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 complete on or before MARCH 31, 2012. <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 /> ORIGINAL-Permittee APPROVED: <br /> 1 -File <br /> 2—JOSEPH A.VALDEZ <br /> I-MAINTENANCE CARRIE BOWEN. District Director <br /> 1-ZELIE NpGUEIRA { BY: <br /> Betty Tamae `'SNE( "AGifA1%0, District emit Engineer <br /> FM 911436 J <br />