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01/20/2014 05:08 1 HORIZON PAGE 05 <br /> qy�,h E.P. No.96-.014-NS <br /> COUNTY OF SAN JOAQUIN <br /> 01-24-96 <br /> DEPARTMENT OF PUBLIC WORKS <br /> •'•_ P.O.807c 1af0-1610E HAZEITON AVENUE (Date Issued) <br /> 3TOCKrON,CJyJ"M 95201 <br /> 1209)•08-MMo 07-01.-96 <br /> (Expiration Date) <br /> HENRY M. HIRATA ENCROACHME4T RMIT <br /> b1II[(.TQp G�- 1005 <br /> (Job No.) <br /> To: Horizon Environmental, Inc. Encroachment type: Monitoring Well <br /> 5011 Golden Foothill Parkway, Suite 7 <br /> E1 Dorado Hills, CA 95762 Location: a/s• Slerra Ln. 50' <br /> (916) 939-2170 e/o Waterloo Rd. <br /> in compliance with your request of December, 4 , 19 95 , permission is hereby <br /> granted to do work in County right of way as shown on attached application and subject to <br /> all the terms, conditions and restrictions written below or printed as general or special <br /> provisions on any part of this form. See reverse side and attached sheet, if any, <br /> Trench excavations for service connections will not be permitted within ten feet (101) <br /> of pavement centerline unless otherwise approved by the Director. Surface of trench patches <br /> shall match in kind and be smooth and even with that of abutting surface. Special attention <br /> shall be given to depth of utilities through roadside area in anticipation of future drain- <br /> age facilities, road profile and/or frontage development. All underground utility facili- <br /> ties are to be established and accurately dimensioned on sketches from surveyed centerline <br /> of road right of way, not from right of way (border) lines. <br /> The Department of Public Works, Field Inspection Section shall receive a notice at <br /> least forty-eight (48) hours prior to beginning any work within the County right of way. <br /> All work performed under this permit shall conform to the rules and regulations pertain- <br /> ing to safety established by the California Division of Industrial Safety and Cal-OSHA. <br /> The jobsite shall be kept in a safe condition .at all. times by the daily removal of <br /> any excess dirt or debris which might be a hazard to either pedestrian or automobile <br /> traffic. All necessary traffic convenience and warning devices and personnel shall be <br /> provided, placed and maintained by and at the sole expense of the Permittee in accordance <br /> with the latest edition of the CALTRANS Manual. of Traffic Control. <br /> After completion of the work permitted herein, all debris, lumber, barricades, or any <br /> excess material shall 'be removed and the jobsite left in a neat workmanlike manner. <br /> Immediately following completion of construction permitted herein, Permittee shall fill <br /> out and mail notice of completion provided by Grantor. <br /> Est. Permit Fee; $ <br /> FORMS- SS/WW.lt-29 HENRY M. HIRATA, Director <br /> Department of is Works <br /> WHITE - Permittee By, <br /> GOLDENROD - PWD Central File Permit Section <br /> YELLOW - Field Inspection <br />