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Field Paving FormPacificGasanrlElectricCompal1V <br />Date:£./""~..•..\b <br />Foreman Name:I>r\..t;L ~V"Y'eh <br />PM Number:4 'ZIoOfel Ole <br />Permit Number:_ <br />Permit Expiration Date:_ <br />Street Address:5"W rJ vJ maW Ave- <br />Cross Street:~~Disk <br />CityE~u~c..-\-o (~~'" <br />Color:Y /N 1 Aggregate:'Y /N 1 Decorative/Stamped:Y /N . <br />Color:Y /N I'Aggregate:Y /N 1 Decorative/Stamped:Y /N <br />Color:Y /N 1 Aggregate:Y /N I Decorative/Stamped:Y /N <br />Color:Y /N I Aggregate:Y /N I Decorative/Stamped:Y /N <br />Depth <br />inches <br />inches <br />inches <br />inches <br />inches <br />Domes:Y /N <br />I Gulter:Y /N <br />f <br />ea Size:#4 1 #5 <br />WxL <br />I <br />I <br />Concrete' <br />Roadway' <br />Sidewalk <br />Sidewalk <br />Driveway <br />Driveway <br />Curb Ramp <br />Curb <br />Valley Gulter <br />Dowels <br />Asphalt <br />Q Asphalt I'(i;'~/¥f\w..\~ <br />Asphalt /Concrete Combo <br />Grind <br />Asphalt Fabric <br />Asphalt Berm /Curb <br />Saw Cut <br />'Asphalt <br />Cilncrete <br />Seal <br />II inches <br />if inches <br />ea <br />If <br />I 4"18"112'CrosswalkI <br />Slurry /Fog /Sand <br />Striping <br />Paint <br />Thermoplastic <br />Traffic Legend <br />Double Center Lane <br />3M "Scotch Lane" <br />-_._---.-.._--_._---_.._----_._----- <br />\~r.'"',o!I <br />Ii";..~B~'~l::., <br />IV) <br />..."3 ..J:1 <br />I .Z ~L.._._-...-----------------..-.---