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ATE <br />06PAF IM OF OOa <br />INDUSTRIAL <br />IATIC <br />DIVISION OF OCcupATINAt SAFETY A t:ALTH <br />perm;[ rsstqd ro <br />PERMIT NO: 2004- 900287 <br />(Insert Employeeg Name, Addro" and Telephone No.) <br />No, <br />FParadiso Mechanical Ino Qat. 11/17/2003 <br />2800 Williams St <br />San Leandro CA 94577-3153 Region 1 <br />DWkt 4 <br />1!201 et4- TOL (510) 822-2810 <br />r Pe of permit T1 -ANNUAL TRENMEXCAVATION <br />Fu,nant to Labor Code <br />done 8600 and9.,, e+h mPam�it b tamed to the above-named emp for the <br />Pf* is deea6ed bekawr. or", �kenee Number <br />877909 Penni vest[ through <br />pesd'Cptlon of Proms 677909 <br />31, 2004 <br />Location AddreaCOY and County AnDates <br />Various <br />Statewide <br />1/1/200, <br />or Issue date <br />whichever is <br />later. <br />12/31MU <br />hie Penni[ is <br />(sated upon the following conditions.- <br />That <br />onditions:That the work is performed by the same employer. If this Is an annual permit the appropriate District Office shali <br />notified, In writing, of dates and location of job site prior tCommencement, <br />h standards or orders applicable to the above <br />The employer will comply with all 000upatlonal safety and health pproP <br />Orfs, and any other lawful Orden of the Division. <br />chat if any unforeseen condition causes deviation from the plans or statement, <br />m the employer will notary the Division immediately. contained in the Permit Application <br />ny variation from <br />ause to revoke th• specification and aaaertiona of the Permit the permit, Application Form or violation of safety orders may <br />lis permit .hall be poked at or near eaoh place of employment as provided In 8 <br />CCA 341.4 <br />Mattasano Permit Unit lntAd by <br />A Amount pap f s� <br />eck 425M Dale <br />$100.00 11/17173 Approved by 11 I <br />ArouftMamodftmd ur* Date <br />