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e - .r ---� 1 v.TT I fIell C-vU vv I 't-'Tvv U1 1 1 V1 1 i)nki i 1gJ V V01 V V 4 <br /> 09/11/2003 09-32 FAA 209 621 d4J0 �l 1 Y Ur 1 HAL'Y 199 Ili ud <br /> '���. <br /> �°, A CITY OF TRACY <br /> C` <br /> 04a <br /> n <br /> �partm�nt of t�evelopl�t��t and Engineering ��rvlca� <br /> r <br /> ' ® Tele hone: 209 �l31-4600 <br /> 520 Tracy Eoulevard P t • ) <br /> Tracy, California 85376 Fax: (209);831-4606 <br /> CS *70& <br /> PAGE 2 OF?_ PERMIT NlJl1ABER . _ <br /> This permit Is Issued pursuant to all provisions of City of Tracy Municipal code, This permit is granted upon the <br /> express condition that the permittee shall be responsible for all claims and liabilities arising out of work performed <br /> under the permit or arising out of permWe's failure to performs the obligations with respect to street maintenance_ <br /> The parmiitee shall,and by aoptance of the permit srgrevs to,defend,ind@mniry,save and hold harmless the <br /> city, Its officers and employeee,from and against any and all suils, claims or actions brought by any person for-or- <br /> on account of any bodily injuries,disease or illness or damage to persons and/or property sustained or arising In <br /> the construction of the work performed under the permit or In consequence or permittee's felure to perform the <br /> obligations wlth respect to etreet mainlenance. <br /> Pe agrees to 0bid the4 is. s of this penmlt. . <br /> s e.,14- FSAIC.) z 103 <br /> P MITTEE'S SIGNATURE DATE <br /> Prior to excavation,contractor must contaCt the following to have below ground facilities localed(48 hours prior to <br /> WorK): <br /> UNDERGROUND SERVICE ALERT <br /> Toll Free:(900)227-2600 <br /> Boyd Service Center <br /> (209)831-4420 <br /> (Vote: You are notified that Section 6500 of the Labor Code requirm the issuance of a permit by the Mislon of <br /> Industrial Wety of the State of ColiTomla prier to the construction of any trench or excavation which is five feet or <br /> deeper and into which a person Is required to descent. Excavation in city suet areas wfthout an excavation <br /> permit R1sy be punishable by a tins. <br /> permittee agrees that they hereby accept complete responsibility for coordination with,reporting to,and complying <br /> with the direction of,any and all board®or districts, including but not Ilmiled to,San Joaquin County local Health <br /> District and California Regional Water Quality Control Board,or any ether regulatory agency having jurisdiction or <br /> authority over sail or ground waster cbntaminadon such as that currently found at the site of this work,including the <br /> preservation of the health and safety of persons wonting near or in any trench or excavation or on the surface of <br /> the construe0on project,or any persons passing by or observing,or any persons living in the vicinity of the <br /> construction project;for any reason whatsoever that may adversely, or otherwise a the neefth or suety,now <br /> and In the future,of these persons or group of persons. <br /> Furthermore,pern''+fte hereby accepts complote wponsibility for disposal of any petroleum affected soils,or <br /> ground water,lnckiding reporting to and complying with the requirements of any.or ell.of tho stilted,or any other, <br /> regulatory agenclee ed discussed above. <br /> CITY INSPECTOR'S COMPLEMON REPO <br /> DATE OF COMPLETION: BY INSPECTOR <br /> COMMENTS <br />