Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2020 - PS-2002501 thru PS-2003000_ - PS-2002642

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PaI�C Gas and Gas Service Record (GSR) rm 401, Rev. 2a FoPulnation Date: 03/20/2019 Publication Date: 03/20/2019 ' Electric Company' � y If completing this farm by hand, use nonemsable blue or black ink. Effective Date: 05/20/2019 Map/Plat/Block: 3006-H2-2 Lot #: Notif. #: 118725554 Address: 5621 CARPENTER RD City: STOCKTON PM Order#: 35172223 Leak #: Applicant/Tract Name: JOSE LOPEZ/ 209-992-2960 Est. LAN ID: 1GH5 Date Issued: 8/16/2020 Install Pipe: ❑No❑Yes Install Pipe: ❑No❑Yes ❑ New Phased Service Type: ❑ PE2406/2708 ❑ Other: : Type: ❑ PE2406/2708 ❑ other: ❑ Stub ❑StubCompletion d d Performance/ Mfg: El Performance/❑cher: a d Performance/ Mfg: ❑Driscoplex ❑cher: New Service: Mfg Date: Mfg Date: ® Full Service ❑ Branch Service - Ref. # Replacement: Type: ❑Stub ®other: COMPLETE SERVICE Type: ❑Completion El Excavation Agent: ®PG&E ®Applicant Excavation Agent: ❑PG&E ❑Applicant v El Full Service Installation Agent: ®PG&E ❑Applicant 4 Installation Agent, PG&E Applicant ❑❑ El Partial Service El Branch Service - Ref.# N Z B y N Z B Y o El Riser Person in charge LAN In and signature or printed name Person in charge LAN In and signature orpdntedname El Transfer Date: Date: ❑ Alteration ❑ Repair ❑ Soap Test ❑ Soap Test Tested by: Tested by: ❑ Deactivation (Qualified field rep. LAN ID and signature or printed name-) h (Qualified flod rep. LAN ID and signature or printed name') in E] Uprate Date: Date: Convert to: ❑ Main ❑Service Pressure: psig Duration: min. Pressure: psig Duration: min. ❑ other F Main: in. Status: ❑ None ❑Existing El Installed Reason None: Status: ®None ❑Existing ❑Installec 5Mat'I:®Plastic c Installed Stub/Service: in. ❑Metallic Flow Series:❑400®800❑other: MatTE1Plastic ❑Metallic Size: ❑1/2"®1"❑other: in. c Size: ❑1/2"❑1"❑other: it s Existing Stub/Service: in. Mfg: ❑Elster-Perfection ❑Other: u Mfg: Status: ❑ None ❑Existing❑Installed Status:❑Existing❑Installed Size: 1"X34" in. Type: El Cathodic Protection Size: ®Locating Size: #10 N Location: ® Outside ❑Inside Bypass: ®No❑Yes �+ Start: [XI Main ❑ Branch ❑Other: Connection Method: [XI Bond ❑ ❑SStryeel End: [XI Riser ❑ Branch ❑Other: Connection Method: ❑ Bond [XI Strap/Wrap Riser Valve Mfg.:❑Jomar❑Other: Isolated SteelService(ISS): D➢No❑Yes ❑Existing CP Read Required: [X1 No El Yes Weld Inspection Required: ❑No®Yes `� Anode:®No❑Existing ❑Installed Size: Ibs. N By: (Qualifed field rep. LAN ID and signature or printed name') d z By: (Qualified field rep. LAN IDand signature or printed name' —Type:❑Zinc❑Magnesium #Installed: Pipe -to -Soil: mV Date: w �' Date: Location: ❑Riser ❑Valve El Service Reading Location: ❑Riser El Valve El Service Type: ❑Radiographic El Visual El Mag. Particle rH As -Built By: Contractor: Date: F(LAN ID) (Name and company name) 0 As -Built By: Contractor: Date: (LAN ID) (Name and company name) APPLICANT TO EXCAVATE ON PRIVATE PROPERTY. PG&E TO EXCAVATE IN FRANCHISE. PG&E IS TO INSTALL 1" PL HP SERVICE & METER. oENCROACHMENT PERMIT REQUIRED. z 'If LAN ID is not available, write name and company name; include employee identifier if available. Draw sketch in space below. 5621 CARPENTER �I Y I I I I I I I I I � I I ° I I CARPENTER RD. (55) / I P L �__ __ P/L S 4" HP STL 3' Z_ TIED HP- — - A—HP HP HP HP D.E. X730' P/L I I 0 Cn 0 w I w I J d