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,.Pacific!flasamff fueldll?avul'ig form I 0 lAN.DSCAPINGCheCkBoxI~~flee1fic Coml{JfiflJl' <br />Date:~-\"2..•!<;""StreelAddress:1'178'e,q..mt5..f.b SJ.: <br />Foreman Name:jill I ~~PHI u...fS Cross Street:>'•B.S -,--• <br />PM Number:'N €GP Pl.",f!fiJ£reM Ii!!Ret!)City/County:~"t-:-TlJ flJ l $~ <br />Concrete IJlh,L Depth tf'Z 115"1z.fJ ~. <br />WxL <br />O"plh <br />~Z.Ilf,}~inc~es <br />~j~._~jncp8s <br />...:-' <br />ea <br />ea <br />ea 13",x 24"[17"x 30"[24"x 36" <br />ea 15".,]'23' <br />ea 3D'x 3D'/32'x 32"[48"x48" <br />Adjust/Replace <br />Manhole Frame <br />Sidewalk Gas Valve Box <br />Secondary Electrical Box <br />Valve Frame <br />Valve Cover <br />Noles <br />Olher W J(L ,jc; <br />Place Paver /Stone /Brick ~In COQorete:Y /N <br />Traffic Marker Dots ea Refiecfuie:Y /N <br />'Plug.'1 )1,;G~sPr;spect Hol~,.',.i;cq~c(~te 'IAsphalt <br />SNIFF~~HOlES __.t <br />i"i Mtu1 Color:Y /N I Aggreg"le:Y /N /Decorative/Stamped:Y/N <br />4IM_"ot Cohir:Y /N I Aggregale:Y /N /Decorative/Stamped:Y /N <br />a&•.1 J Color:Y /~I Aggregate:Y /N I Oecorative/Slamped:Y /N <br />,LO:QQ;a;Coi,;,r:Y /N /Aggregale:Y /N I Decorative/Stamped:Y /N <br />Widlh <br />:"0;".," <br />_tiover <br />...:c..inches <br />inches <br />inches <br />inches <br />inches <br />inches <br />Domes:Y /N, <br />I Gutter:Y /N <br />I <br />ea Size:#4 [#5 <br />Deplh <br />Ji,inches <br />inches <br />vii l(L <br />I <br />I <br />8 6 <br />I <br />Asphalt <br />Fill' <br />Asphait /Concrete Combo <br />Grind <br />Asphalt Fabric <br />Asphalt Berm /Curb ~ <br />Asphalt (LINEAR FT) <br />FT) <br />Saw Cui <br />"Seal <br />Slurry /Fog /Sand <br />Striping, <br />Roadway <br />Sidewalk <br />Sidewalk <br />Driveway <br />Driveway <br />Curb Ramp <br />Curb <br />Valley Gutter <br />,Dowels <br />Paint <br />Thermoplastic <br />Traffic Legend <br />Double Center Lane <br />3M "Scotch Lane" <br />I Inches <br />I Inches <br />ea <br />II <br />III 4"18"[12"Crosswalk <br />I I <br />,I <br />I <br />I <br />III I <br />t--\i <br />II <br />II I <br />I IIII III <br />II IIII <br />'III III <br />IIIi,I ",I <br />I <br />,,]111II 1I,I,i <br />'f III <br />",1,1'1'/k' <br />11./I I