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FIELD DOCUMENTS FILE 2
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0541989
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FIELD DOCUMENTS FILE 2
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Last modified
6/21/2019 5:27:01 PM
Creation date
6/21/2019 3:14:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0541989
PE
2950
FACILITY_ID
FA0024100
FACILITY_NAME
COUNTRY CLUB VALERO
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12302012
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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STATE OF COWFORNIA•DEPARTMEt F TRANSPORTATION mit ir. <br /> ENCROACHMENT PERM Per <br /> TR-0120(NEW 9/91) 1097-6SV-0361 <br /> Dist/Co/Rte/PM <br /> In compliance with (check one): REVISED 10-SJ-5-28.53 <br /> X Your application of MAY 9, 1997 <br /> s <br /> Utility Notice No. of Ft <br /> st 1, 1997 <br /> ee ai Deposit <br /> Agreement No. of $ 2,280 $ <br /> onnanca bmd Amount ( Payment Bond Amount (21 <br /> R/W Contract No. of $ $ <br /> Bond company <br /> Bond Number (1) Bond Number (2) <br /> TO: <br /> SHELL OIL PRODUCTS CO. <br /> P.O. BOX 4023 <br /> CONCORD, CA 94524 D <br /> LLLiii+"I'I(11111�SISISI) <br /> ATTN: ALEX PEREZ <br /> PHONE: (510) 675-6168 PERMITTEE <br /> ..........: <br /> and subject to the following, PERMISSION IS HEREBY GRANTED to: <br /> Install a monitoring well at I-5/Country Club Blvd. north bound off-ramp in Stockton. Well shall be <br /> located in the landscape strip at the toe of the slope on the westside of the off-ramp. <br /> Well shall be capped with a 12" diameter steel well box. <br /> Permittee has deposited $2,000.00 In cash In lieu of Performance Bond to ensure compliance with <br /> State Water Resources standards for abandoning well. At completion of project, upon proper <br /> abandonment of well, Permittee shall be refunded $2,000.00. <br /> Work shall be performed between 9:00 A.M. and 2:00 P.M. Monday through Thursday or on weekends not <br /> including holidays between 8:00 A.M. and 4:00 P.M. Warning signs shall be placed as designated by the <br /> State's Representative. One lane of ramp shall be provided for traffic at all times. <br /> Traffic control shall be done in conformance with Caltrans Standard Plans 1995, and Manual of Traffic <br /> Controls 1996. <br /> The following attachments ore also included as part of this permit. In addition to fee the permittee will be billed ' <br /> (Check applicable): actual cosh for. <br /> X Yes _ No General Provisions _ Yes X No Review <br /> Yes X No Utility Maintenance Provisions Yes X No Inspection <br /> X Yes — No Special Provisions T X Yes Field Work <br /> Yes X No A Col-OSHA perns required prior to beginning work- <br /> s pf any Caltrans effort expended) <br /> Yes X No The information in the environmental documentation has been reviewed Land considered prior to <br /> approval of this permit. <br /> This permit is void unless the work is completed before JANUARY 31, 1998 <br /> This permit is to be strictly construed and no other work other than specifically mentioned is hereby authorized. <br /> No project work shall be commenced until oil other necessary permits and environmental clearances have been obtained. <br /> Orig - Permittee APPROVED: <br /> 1 - Permit File <br /> 3 - MIKE HONMA <br /> 1 - ENVIROS,-INC.- ... <br /> do Joe Neely Dinah Bortner, Acting District Director <br /> P.O. Box 259 gy_ <br /> Sonoma, Ca 95476 (ie <br /> YYLauR Jur ens, District Permit En ineer <br />
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