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Field P-aving Form••Pacific GasandrF&~Electric Company <br />Date:h-~-I b . <br />Foreman Name:A </6 ~PH1 <br />PM Number:..,l~7~ <br />c~ri~r~ie,Wlc'.l/>'.[)epih' <br />PermifNumber:_ <br />Permit Expiration qate:_ <br />Street Address:3/0'1 /41 <;(1ll0m/\ <br />c~~~4/01Ck JILt <br />CI~1!!?c..boJ1 J _ <br />.'.'..,:,','".,','..:c".:,....'-'.'....','i'.:";":"."", <br />1\.,IV <br />':'i ',;:' <br />.'f <br />.':. <br />In Concrete:YIN <br />Reflective:YIN <br />Concrete [Asphalt <br />1-__1ea' <br />1-__1ea <br />ea 13'x24"117"x30'124'x36"I--~e-a 15"123". <br />I--'ea 30"x30"132'x32"148"x48"L-_-" <br />~~19-~tJ.~~~.t~_g,~:~!:'.. <br />Manhole Frame <br />Sidewalk Gas Valve Box <br />Secondary Electrical Box <br />Valve Frame <br />Valve Cover <br />',",. <br />Place Paver I Stone I Brick [d <br />Traffic Marker Dots 'ea <br />Plug 1 y,"Gas Prospect Hole,.ea <br />Color:YIN 1 Aggregate:YIN 1 Decorative/Stamped:YIN <br />Color:Y /N 1 Aggregate:YIN I Decoralive/Stamped:YIN <br />Color:Y /N I Aggregaie:YIN 1 Decoralive/Stamped:YIN <br />.Color.Y /N 1 Aggregate:YIN 1 Decorative/Stamped:YIN <br />inches <br />inches <br />4"18"112"Crosswalk <br />_'inches <br />inches <br />inches <br />inches <br />inches <br />Domes:YIN <br />f Gutter.Y/N <br />f <br />ea Size:#4[#5 <br />'jj'l,(tIi -,..Pp , <br />Kinches <br />inches <br />_"over <br />inches <br />ea <br />I <br />I <br />I <br />I <br />I <br />I <br />'"'".\-I'i6[5" <br />If <br />IT] <br />:"Wid~h,:. <br />,'..'i.,i;>~Pt~.' <br />[24Jlf <l-inches <br />L-jlf inches"~KIl';;:':~~~i <br />Slurry I Fog I Sand <br />St,ip)lig'. <br />Paint <br />Thermoplastic <br />Traffic Legend <br />Double Center Lane <br />3M 'Scotch Lane' <br />Roadway <br />Sidewalk <br />Sidewalk <br />Driveway <br />Driveway <br />Curb Ramp <br />Curb <br />Valley Gutter <br />Dowels <br />A~pM!L"WXl <br />~Mill &Fill <br />Asphalt/Concrele Combo <br />Grind <br />Asphalt Fabric <br />Asphalt Be.rm I Curb <br />5awC:~t......-",. <br />._.---_.-..:...._--7",,-_.~-..._-.._.,.. <br />, <br />"-"T~--'~~.--t--------...,----'-t---T" <br />iI <br />...-i -.i- <br />I, <br />'"..'.f'..1'-. <br />I !k' <br />I <br />,,"._....~._- <br />.+-. <br />,T ..-,,.-._~."j <br />c