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PERMIT FIELD CHECKLIST <br /> <br />PM#: 45670496 <br /> <br />LOCATION: 1801 N PALM, STOCKTON LAN ID: MRDE Date: 8/29/23 <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 />0' <br />4' <br />EP <br />EP11' <br />CL ROWROWROWCOUNTYCITY4' x 4' bell hole to <br />repair gas leak