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ARCHIVED REPORTS XR0000774
Environmental Health - Public
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EHD Program Facility Records by Street Name
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16470
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3500 - Local Oversight Program
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PR0544155
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ARCHIVED REPORTS XR0000774
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Last modified
2/15/2019 5:09:30 PM
Creation date
2/15/2019 2:12:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000774
RECORD_ID
PR0544155
PE
3526
FACILITY_ID
FA0000185
FACILITY_NAME
CITY GAS & LIQUOR
STREET_NUMBER
16470
STREET_NAME
CAMBRIDGE
STREET_TYPE
ST
City
LATHROP
Zip
95330
APN
19643032
CURRENT_STATUS
02
SITE_LOCATION
16470 CAMBRIDGE ST
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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P LIC WORKS DEPARTMENT � 2 441 <br /> 16 5 South Howland, Suite 1 <br /> Lathrop, California 95330 <br /> (209) 858-5592 <br /> ax 858-.5259 <br /> ENCROACHMENT PERMIT <br /> TO: Nanle__secer >nteru,ri,anal' Tn�. Date Issued 4-16-02 <br /> Address 3017 Kilgore Rd. , #100 Contractor Fisch Env./Cascade Drilling <br /> Phone 916-861-0400/916-774-2910 Phone 916774-2910 <br /> (Permittee) <br /> Date work to begin t,icense No. Fisch 693965/Cascade 717510 w_ <br /> PERMISSION IS HEREBY GRANTED TO: <br /> Construct (3) each groundwater monitoring wells and (8) each geoprobe <br /> Investigational borings as shown on the 5ecor figure 2 extended site <br /> map dated Feb. 1, 2002 subject to the attached conditions on Exhibit "A" <br /> dated April 16, 2002. <br /> 1 <br /> (Attach Z set of plans or sketches) <br /> Abo work in City right of way as shown 6n attached application and subject to all the <br /> terms, conditions and restrictions written below or printed as general or special provisions <br /> on any part of this form, and/or attached hereto. <br /> Your attention is directed to the general provisions printed on the back of this form. This <br /> permit is to be strictly construed and no work, other than that specifically mentioned above, <br /> is hereby authorized. <br /> This permit shall be void unless the work herein contemplated shall have been completed <br /> bye <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement <br /> to all the conditions and iequirements of this permit. <br /> X <br /> Signature of Permittee Directo P tA — <br /> B <br /> ks <br /> By: <br /> Permittee or Authorized Agent / V1, <br /> &1!T IS NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR <br /> GENT. <br /> 3 <br /> WHU&Permittee YELLQWAOcaunting PINK-Fde <br /> S <br />
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