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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION <br />ENCROACHMENT PERMIT <br />TR -0120 (REV. 6/2012) <br />In compliance with (Check one): <br />® Your application of February 28, 2022 <br />CC" \"�_ �-q-'s '�kC-'f� <br />GPT Ia�c_PT 13� c_PTt� <br />❑ Utility Notice No, of <br />Agreement No. of <br />R/W Contract No. of <br />TO: I— <br />Ground Zero Analysis, Inc. <br />1172 Kansas Avenue <br />Modesto, CA 95351 <br />Permit No. <br />1022-6SV-0147 <br />10 -SJ -4-R7 7.057/R17.124 <br />uate — — <br />March 9, 2022 <br />Fee Pald Deposit <br />$1,680 $ <br />Performance. Bond Amount (1) Payment Bond Amount (2) <br />Bond Company <br />Number(t) Bond Number (2) <br />ATTN: Greory Stahl <br />TEL : (20� 522-4119 I , PERMITTEE <br />And subject to the following, PERMISSION IS HEREBY GRANTED to: <br />Perform drilling 3 borings in 3 locations using Cone Penetrating Testing Drill rig (CPT) for the <br />purposes of collecting discrete ground water samples inside the State Highway 4 (Crosstown <br />Freeway) right of way in the City of Stockton, in San Joaquin County. Actual work locations are <br />under the elevated portion of the Freeway. A copy of this permit shall be placed in all vehicles <br />involved in doing this work. Permittee shall notify the State Representative before doing any work <br />under this permit Traffic control may be performed from 8 AM to 5 PM Monday through Friday. <br />All work shall conform to the approved plans, Caltrans Standard Specifications Dated 2018 <br />and California MUTCD Dated 2014. <br />THIS PERMIT IS NOT A PROPERTY RIGHT AND DOES NOT TRANSFER WITH THE PROPERTY TO A NEW OWNER <br />The following attachments are also Included as part of this permit (Check applicable): <br />In addition to fee, thepermitteewill be bill <br />® <br />Yes <br />171 No <br />No <br />General Provisions <br />costs for: <br />ID Yes ❑ No Review <br />❑ <br />® <br />Yes <br />Yes <br />® No <br />Utility Maintenance Provisions <br />® Yes ❑ No Inspection <br />❑ No <br />Special Provisions T, TR -400 <br />® Yes ❑ No Field Work <br />❑ <br />Yes <br />® No <br />A Cal -OSHA permit, if required: Permit No. <br />❑ Yes ® No As -Built Plans Submittal Route Slip for Locally Advertised Projects (!f any Caltrans effort expended) <br />❑ Yes ® No Storm Water Pollution Protection Plan <br />❑ Yes ® No The information In the environmental documentation has been reviewed and considered prior to approval of this permit <br />This permit is void unless the work Is complete before August 31, 2022 <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 <br />2- Joe Valdez <br />1 -Maintenance <br />1 -File <br />Dennis T. Agar, District Director <br />Ed P Francisco J. Rodriguez, District Permit Engineer <br />ADA NOTICE: For individuals with sensory disabilities, this document is available in aftemate formats. For information, call (916) 445-1233, TTY 711, or <br />write to Records and Forms Management, 1120 N Street, MS -89, Sacramento, CA 95814. <br />1 of 6 <br />