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m.......',.Pacific Gas aad,El8lJlrjcCoinpsny. <br />BPO !TfL1&-:;l05q~ <br />~..f..gu~!>.3a)6i.oa12IRov.l~~n <br />Paving Order . <br />TAG NO._ <br />Dale 10 Conlraclor _ <br />Dale from Conlraclor _ <br />Dale Field Checked._---------Invoice No._Po (<c.:;\:3 /'2 ,"V'.I 2C.7'" <br />I <br />Standing Order No. <br />I <br />LocaUon <br />SlreelAddress j\/flC Ie 1:,f f\IlA ;I"'i',~),:3'(1/;1,#,!}f/'Q.I I <br />CrossSlreet .s'.O/"'{.8 g4--'d <br />City 51t'?c'k-I""A <br />PermiINumber(al~_ <br />Paving Headquarters .A.,.-;J II "1/>";'Area 1.7 ::C",?~"'.I{.J?-,"'---'.{.~..~~ <br />P.O.No.ProvidarCostConlei Field Noles[J_~~~~Opllonai-allac/lskelch <br />Paving TYf-ll:PG&EMeasurements <br />(Check one --:1 ~Tl1wkness (I1k~s)(Ifsupplement attached,checkbox 0) <br />y ase Feet Inches Feel Inches <br />QmcmlaWilh 0 Q',I I [JJ By r I':I I [JJAsphallTop2-(Bone)Feel Inches.Feet Inches <br />Asph.lt 0 4'I [JJ By I J [J(Bona) <br />Concrete 0 0 lr Feel Inches Feel InchesSoeatAGO <br />Ii/I ~I I'll ~Concrete )it ,.9 4'I By--Sidewalk rFeellnch'es Fesl .Inches <br />Concrete 0 0 6'[j]By I I [j]Driveway AGO <br />Additional Items:(Show an that apply) <br />Curb ~lineal ft. <br />Sawcul linaal ft.'CONTRACTOR'S USE ONLY <br />" <br />QualifilY II1*/ <br />Quantiii' <br />.1 1*1 I <br />Quantity I1*1 <br />Quantity <br />1*1 I <br />J <br />1 <br />IlemI I <br />ItemI I <br />lIem,I <br />I ItamI I <br />CompleUonDale I <br />Refere.nca Number <br />Change's 10PG&E's Request <br />UnllPrlea . <br />DBle <br />Quantity <br />________lineal11. <br />_______sq.ft. <br />quantity <br />sq.n: <br />quantity <br />__-'--_____quantity <br />__~lineal ft. <br />paaEForman <br />liescrlption <br />Non-Contract Items:ApprovedBy ,Dale'--__ <br />*Asphaltand concrete paving require separate paving orders. <br />Gurb&Gu"er <br />WlreMesh <br />Dowel <br />Handicap Ramp <br />Malihole <br />Valve Frame <br />Sleel.Rabar