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PERMIT FIELD CHECKLIST <br /> <br />PM#: 45243697 <br /> <br />LOCATION: 2716 E MINER, STOCKTON LAN ID: MRDE Date: 5/17/22 <br />PROJECT TYPE: New Business☐ Leak☒ Corrosion☐ G4E☐ Emergency☐ Other☐: ____________ <br />• If emergency, is work completed already? Yes☐ No☒ (Date)? ____________ <br />AGENCY: City☐ County☒ CalTrans☐ Other☐: ____________ <br />EXCAVATION DIMENSIONS (W x L x D): 4X4X4 <br />PAVEMENT REMEDIATION: Asphalt☒ Concrete☐ Both☐ No Paving☐ <br />• Sidewalk Closure Required? Yes☐ No☒ <br />• Bike Lane Closure Required? Yes☐ No☒ <br />• Street Closure Required? Yes☐ No☒ <br />• Lane Closure Required? Yes☒ No☐ <br />• Parking Closure Required? Yes☐ No☒ <br />• Any Restriping Required? Yes☐ No☒ <br />• Traffic Signal Loop Involved? Yes☐ No☒ <br />• No Parking Signs Needed? Yes☐ No☒ <br />• Other Traffic Impacts? ____________________________________________________________________ <br />• Other Comments? _______________________________________________________________________ <br />LOCATION (INCLUDE DIMENSIONS FROM PROPERTY LINE, NEAREST CROSS STREET, CURB OR LANDMARKS) <br /> <br /> <br />200'4' x 4' bellhole <br />at ROW line <br />approx. 5.5' from EoP