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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HAMMER
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1210
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3500 - Local Oversight Program
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PR0545245
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
1/30/2020 11:53:34 AM
Creation date
1/30/2020 10:33:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545245
PE
3528
FACILITY_ID
FA0003730
FACILITY_NAME
TIWANA GAS & FOOD
STREET_NUMBER
1210
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09403012
CURRENT_STATUS
02
SITE_LOCATION
1210 E HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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C <br /> CITY -� <br /> OF-PAPI TMENT OF PURL-1C WORKS ` <br /> c'T',e HAL APR 15 1999 <br /> 4�5 N.EL OORAOO STREET <br /> ;TOCKTOPJ,GA 952015 1997 �i� <br /> r:•,,IVll�uiMENTAL HE a�L� , <br /> April 6, 1999 PERMIT f SERVICES <br /> Lou Smith <br /> Horizon Environmental Inc. Suite 7 <br /> 5011 Golden Foothills Parkway, <br /> El Dorado Hills, CA 95762 <br /> REVOCABLE PERMIT REQUEST FOR GROUNDWATER MONITORING WELL: <br /> 1210 EAST HAMMER LANE <br /> The per <br /> mitting process required in the City of Stockton for installation of groound water <br /> wells is a two phase process. First, <br /> weer to�bstaPandle jt must bema nta�rt a private <br /> wherein the City grants permission to the property y <br /> well within the City's right-of-way. Second, an Encroachment Permit is issued which allows <br /> the actual construction of the well to be carried out in our right-of-way. <br /> In order to issue the Revocable Permit the City requires the following: <br /> 1. A formal written request for a Revocable Permit in which you acknowledge that you <br /> have read and understand the City's Standard Conditions Applicable to Revocable <br /> Permits. An acceptable application form and copy of the Standard Conditions are <br /> enclosed. <br /> 2. A processing fee payable to the City of Stockton in the amount of $310.00. <br /> ' 3. A detailed work plan including a sketch showing the location of the proposed well(s). <br /> 4. A Faithful Performance Bond, or other acceptable form of financial security, in an <br /> amount of $500.00 per well will be required. This bond shall remain in effect for as <br /> long as the well remains in the City's right-of-way. <br /> 5. 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 /> "STOCKTOI�I...CALMORMA'S SUNRISE SEAPOF7T" \i/ <br />
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