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05/02/2008 14:35 FAX 15106634141 GEOMATRIX 16003/003 <br /> 05;'02: aOUlf 'I <br /> I ly A,\ 2 `U�3 8;, I11'Y Et:1C] f3 <br /> E Ot):I;Oil <br /> `t I <br /> r..i� vvu ry nn rvvei+• fJf <br /> Ct,tMnitiLA f U43/(104 <br /> Page 2of7 <br /> This pen-nit is issued pumuant to all prOviz lons of City of Tn3,y Municipal Codu. This perrnit is grante'd upon the <br /> express condition that the porrrrmae shall be responsible for all claims and liabilides arising out of work perforrnrd <br /> urxder the ptirnit or arising out of pemaitteo's fallur©to porfor'm the cbtigabons with r'asRect to strc+ t mtaintsnance_ <br /> The permittee Shull, and by 0cceptanct-Of the p6rMit agrees to,defend, It'dernnify, :river and hold harml(ys the <br /> city, its Off Icem and (3Mployuus, from and against any and all suits, claims or actinnn brought by any person for ar <br /> ori account of any bodily injuries, disease or Illne s or damage to pemons and/or property sustainod or rarislncg in <br /> the conatrtactlon of the work performed under the perrnit or in conscquencw or pC mlttco's(allure to perform tale <br /> obligations with respcot to fitreet maintenance. <br /> Pirrttlttrae agrees to abide by th: rcr,,inns or fjri�;permit. r n <br /> --�-- �� <br /> PERM..I.I E'S sIGNATUi� <br /> DATE <br /> Prior to UxcaviCkon, Cunfr.actrar must cvnicf the follauving to have below-ground facilities located (48 hours prior to <br /> work): <br /> UNDEROROUND SERVICE ALERT <br /> Toll Free_ (800)2-27-2600 <br /> Boyd Service Center <br /> (209)831-4420 <br /> Nota_ you are nobtlod that S'nr_tion 9500 of the Labor Cade mquires the issuance of a permit by the I) slon of <br /> Industrial S:nfaty of ttte state of Carrornio prior to the construction of any trench or a=vrttior which is five feet or <br /> deeper and Into which a person Is regvirod to descant, Excuvr,4tion In city stru at areas without an"cavation <br /> pennit May be puaishablo by a fine. <br /> Permittec agrees that they hereby accept complete responstbIlIty for coordination with,,reporting to,,and complying <br /> Wth.the dimction of, any and all boards or district,., Including but not limited to, San Joaqutrt County Local I icalth <br /> District Ond 001`01`1110 Regional Water Qualify Control Board, or any other regulatory agency having jurisdiction or <br /> uthorlty over,oil or ground water contamination such as U-4-It currently fpund at the site of tial.work, including the <br /> preservation of the hL-alt, and safety of persons working near or in any trench or excavation or an ttte surface:of <br /> MO construction project;or¢any parsons paz;sinrg by or ob&erving,or any pemons living lrs the vicinity of the <br /> construction project, for any mason whatsoever that may advemety,or otherwise a"Ct ttte health or safety,.now <br /> and In the future.4f the*es pe sons or group of persons_ <br /> FurtMvrmore,per mince hareby accepts complato responsiblilty for disposal of any pctroleurn affected soils,or <br /> ground water, including reportinq to and complying with the;requirements of nny, or all, of the stotod,or any othar, <br /> regutntory agencies 133 discussed above. <br /> 1NSPECT(?R'S CO P C ON REPORT P._RMIT NUMBgR- 65`2)I �3 l <br /> DATE OF COMPIrETION; Concrete* <br /> Aspholtt <br /> Backfill; _ Paving: <br /> SL-0 of Cut <br /> Sq.Ft_ lncho:5 Paved By: <br /> INSPECTOR SIGN OFF <br />