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SITE INFORMATION AND CORRESPONDENCE_FILE 2
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545003
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SITE INFORMATION AND CORRESPONDENCE_FILE 2
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Last modified
11/27/2019 11:04:58 AM
Creation date
11/27/2019 10:58:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 2
RECORD_ID
PR0545003
PE
3526
FACILITY_ID
FA0002324
FACILITY_NAME
Pacific Service Station
STREET_NUMBER
6131
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09746418
CURRENT_STATUS
02
SITE_LOCATION
6131 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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� t <br /> 4 ti <br /> mac- STOCKTON <br /> ENIV h()f lElYT AL HEALTH <br /> DEPARTMENT OF PUBLIC WORKS CJ JUN i C OS ` (~(`,✓//�/p 1n' _ <br /> CITY HALL '✓J <br /> 425 N. EL DORADO STREET <br /> STOCKTON, CA 95202-1997 <br /> June 11, 1996 <br /> Gregg Vaughan <br /> Enviros <br /> P.O. Box 259 a <br /> Sonama, CA 95476 <br /> REVOCABLE PERMIT REQUEST FOR GROUNDWATER MONITORING WELLS <br /> The permitting process required by the City of Stockton for installation of groundwater <br /> monitoring wells is a two phase process. First, a Revocable Permit must be issued, wherein <br /> the City grants permission to the property owner to install and maintain a private well within <br /> the City's right-of-way. Second, an Encroachment Permit is issued which allows the actual <br /> construction of the well to be carried out in our right-of-way. <br /> In order to issue the Revocable Permit, the City requires the following: <br /> 1 . A formal written request for a Revocable Permit in which you acknow'.edge that you <br /> have read and understand the City's Standard Conditions Applicable to Revocable <br /> Permits. An acceptable application form and copy of the Standard Conditions are <br /> enclosed. <br /> 2. A processing fee payable to the City of Stockton in the amount of $310.00. <br /> 3. A detailed work plan including a sketch showing the location of the proposed well(s). <br /> 4. A Faithful Performance Bond, or other acceptable form of financial security, in an <br /> amount of $500.00 per well will be required. This bond shall remain in effect for as <br /> long as the well remains in the City's right-of-way. <br /> 5. A certificate of insurance naming the City as additional insured. Insurance is required <br /> for the agency obtaining the Revocable Permit and the agency obtaining the <br /> Encroachment Permit. A sample form of the certificate is enclosed. Note that the <br /> limits are higher than shown in the Standard Conditions. <br /> "STOCKTrON...CAUF-ORNf A'S SUNRISE SEAPORT" <br />
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