Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2020 - PS-2002501 thru PS-2003000_ - PS-2002880

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Pacific Gas and Gas Servlce Record (GSR) orml➢-95°nP5/2.2° Date:4'' Publication Date: 04/15/2°20 Electdc Company If completing this form by hand, use non—erasable blue or black ink E(fedi2e Date: 07/15/2020 Lot j: Notif. �: 118358699 PM Order �: 35182131 Address 8850 E. LATHROP RD. City: MANTECA Applicant/Tract Name: GEORGIANN ROSE Est, IAN I8: PDT3 Date Issued: 511712020 Leak g: Install Pipe: ❑No ❑Yes Install Pipe: ❑No El Yes El New Phased Service Type: ❑PE2406/2708 El Other Type: ❑PE2406/270B El Other El Stub Mfg' F-] Performance/ Ce/ ❑Other: Mfg: ❑Peirforma Ce/ ❑Other: Completion s s New❑Servibe Mfg Date: Mfg Date: ®Full Service ❑Branch Service Ref. Replacement: Type: ❑Stub MA Other: COMPLETE SERVICE Type: ❑Com Ietion ❑Other: Excavation Agent: ®PG&E MAApplicant Instollation Agent: ®PG&E El Applicant n Excavation Agent: E: PG&E El Applicant Installation Agent: E: PG&E El Applicant ❑Full Service ❑Partial Service ❑Branch Service — Ref. B By: B y' Person in charge LAN to and signature or printed name' Person in charge LAN to and signature or printed name' ❑ Riser Date, Date: ❑ Transfer ❑ Alteration E] Soap Test ❑ Soo p Test E] Repair Tested by: `" Tested by:❑Abandonment Qualified field rep. IAN IN and signature or printed Date: name' Qualified field rep. IAN IN and signature or printed Date: name' l W ❑Uprate Convert to: El Main El Service Pressure: psig Duration: min. Pressure: psig Duration, min. El Other: Main: in. Status: ❑None ❑Existing ❑Installed 800 W. i Status, ®None ❑Existing El Installed Installed Stub/Service:—in. w Reason None: Flow Series: Mat'l ❑Plastic ❑Metallic Mfg: Nat'l: ® Plastic ❑Metallic Size:❑Y In.®1 in.❑Other: in. 82 Size, ❑Y in. ❑1 in. LJOthec m. s Existing Stub/Service: in. Mfg: ❑Elster—Perfection El Other c'.o Critical Isolation Valve: El No El Yes El Unknown Status: ❑None ❑Exlst'Ing ❑Installed Status: E] Existing El Installed Size: 1° X 3/4" in. Type: ❑Cathodic Protection Size: ®Locating Size: #10 Location: ®Outside E] Inside Bypass: ®No El Yes Start: ®Main ❑Branch ❑Other: Connection Method: ®Bond ❑Strap/Wrap Type: ®Prefabricated ❑Service Head Adapter ❑Steel End: ®Riser ❑Branch ❑Other: Connection Method: ❑Bond ®Strap/Wrap Riser Valve Mfg.: ❑Jamar ❑Other: Isolated Steel Service (ISS): ®No ❑Yes El Existing CP Read Required: ®Na El Yes Weld Inspection Required: El No ®Yes Anode: ®No ❑Existing ❑Installed Size: Ibs. By: By: (Qualified field rep, LAN ID and signature or printed name') (Qualified field rep. IAN ID and signature or printed name') Type: El Zinc E] Magnesium ✓) Installed: Pipe—to—Soil: mV Date: Date: Location: El Riser ❑Valve ❑Service Reading Location: ❑Riser El Valve El Service Type: ❑Radlographic ❑Visual ❑Mag. Particle 12 As—Built By: Contractor: Date: Z (IAN I0 (Name and company name) As—Built By: Contractor: Data: (IAN IN) (Nome and company name) APPLICANT IS TO EXCAVATE ON PRIVATE PROPERTY, PG&E IS TO EXCAVATE IN FRANCHISE. PG&E IS TO INSTALL 190' OF 1" PL HP SERVICE & (1) AL -425 METER. ENCROACHMENT PERMIT REQUIRED. z 'It IAN ID is not available, write name and company name; Include employee Identifier if available. Draw sketch in space below. J J d C1 0 z C Cn I I E. LATHROP RD. (45') P/L -- -- -- -- --� 1P/L X X702' 4° STL HP 5' (DE) HP HPHP HP (T) 40' 11 P/L -- ---- -- 1 1 1 -- -- P/L 1 1 1 1 1 1 1 � rz I= 1 I 8850 1 I I E. LATHROP RD. I� INSTALL THE GASEMETER AT THE L BACKBOARD FOR THE ELECTRICAL PANEL. PG&E Internal 0 2020 Pacific Gas and Electric Company. All rights reserved,