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STATE OF CALIFORNIA•DEPARTMENT OF TRANSPORTATION_ <br /> ENCROACHMENT PERMIT <br /> TR-0120(REV.2/98) Permit No. <br /> 1011-6SV-0427 <br /> Dist/Co/Rte/PM <br /> In compliance with (Check one): <br /> 10-SJ-5-28.53 <br /> Your application of SEPTEMBER 14, 2011 <br /> Date <br /> ❑ Utility Notice No. of SEPTEMBER 15, 2011 <br /> Fee Paid Deposit <br /> ❑ Agreement No. of $ $ 328 <br /> Performance Bond Amount(1) Payment Bond Amount(2) <br /> ❑ RAN Contract No. Of $ $ <br /> Bond Company <br /> Bond Number(1) Bond Number(2) <br /> TO: <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 <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 /> ❑ 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 Z 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 NOGUEIRA BYr@' <br /> Betty Tamae 'NA �Districtmit Engineer <br /> FM 91 1436 !J <br />