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C <br />Q SAN.JOAQUIN <br />—COU N T Y--- <br />°q "oo�" Greatness grows here. <br />ZACHARY C. WONG <br />(Please print) <br />Department of Public Works <br />Kris Balaji, Director of Public Works <br />Fritz Buchman, Deputy DirectordDevelopment <br />Waddag for YOU David Tolliver, Deputy DirectodOperations <br />Nalee Zarif, Deputy Director/Engineering <br />Krisd Rhea, Business Administrator <br />Acknowledgement of Monument Preservation <br />a duly Licensed Land Surveyor or a Professional Engineer <br />authorized to perform Land Surveying in the State of California, Registration No. L.S. 7600 <br />hereby acknowledge and accept all responsibility for the monument preservation as required <br />per Section 8771(a -f) of the Business and Professions Code within the bounds of the <br />construction activity permitted by San Joaquin County Permit No. BP -2003479 PS -2203585 <br />I further acknowledge that I am hereby responsible for the Acknowledgement of Monument <br />Preservation prior to final acceptance of the construction activity. <br />G <br />Si ature Seal <br />JUNE 1, 2022 <br />Date <br />No. 76W <br />t5f. 1t -01 - <br />PS -MONUMENT PRESERVATION <br />11.22.2022: FC & ZW Spoke about Monument Preservation Scopes and the Use for this document <br />to be used on our site/ per our UG & Gas Scopes in areas per this form signed by Zack Wong. No <br />Other information is needed at this time as noted above. <br />1810 East Hazelton Avenue I Stockton, California 95205 1 T 209 468 3000 1 F 209 468 2999 <br />in Follow us on Facebook @ PUblicWOrksSJC Visit our website: www.sjgov.org/pubworks <br />