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I <br /> John Cussen <br /> January 15 , 1997 <br /> Page 2 <br /> 4 . A certificate of insurance naming the City as additional insured . Insurance is <br /> required for the agency obtaining the Revocable Permit and the agency obtaining <br /> the Encroachment Permit. A sample form of the certificate is enclosed . Note the <br /> limits are higher than shown in the Standard Conditions . <br /> The Revocable Permit application should be made by, and financial security supplied by , the parry <br /> responsible for the permanent maintenance of the well. Usually , the party responsible is the <br /> owner of the site requiring the well . <br /> Please return all documents to this department for processing. Questions may be directed to Jason <br /> Ender at (209) 937-8349 . <br /> g <br /> BOB BROTHERS <br /> SENIOR ENGINEERING TECHNICIAN <br /> i <br /> RB :JME:jla <br /> Enclosures <br /> cc : Margaret Lagorio , San Joaquin County Public Health Services , <br /> Environmental Health Division, Post Office Box 388 , <br /> Stockton, CA 95201-0388 <br /> f <br /> i <br /> i <br /> t <br /> I <br />'t <br />