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0 <br /> CITY OF RIPON-ENGINEERING DEPARTMENT NO. .3317 <br /> 259 North Wilma Avenue,Ripon,CA 95366 <br /> 209/599-2108-Fax: 209/599-2685 <br /> ENCROACHMENT PERMIT <br /> Applleant's Name: Date Submitted: November 13, 2009 <br /> Nestle USA, Inc. 800 North Brand Boulevard Boart Longyear: : 1333 West th Street, <br /> Glendale, California 91203 Contractor: Upland California 91786 <br /> Consuan <br /> Address t' Environmental Cost Management, Inc. Phone: Boart Office# 909-946-1605 <br /> 3525 Hyland Avenue, Suite <br /> Costa-Mesa CA 92626 Contact Name: ECM: Binayak Acharya <br /> Phone: ECM Contact: (661) 255-1693 License Number: C-57 License: 694686 <br /> FPursuant to Chapter 12.12 of the City of Ripon-Municipal Code and all the terms,conditions,and restrictions <br /> written below or printed as general or special provisions on any part of this form,and/or attached hereto. <br /> PLEASE READ THIS PERMIT CAREFULLY AND KEEP TT AT THE WORK SITE. <br /> DFSC"HON OF PRO IF -T• /.Provide a full dercriptlon of work to be done at all locations. <br /> PRRM=0N13 JW RRPORANTRD TO Z Attach Avo(2)sets ofplaw or sketches,if applicable- <br /> installation <br /> pplicableInstallation of a 2-inch groundwater monitoring well in Fifth Street,to a depth of approximately 165 feet,with a borehole diameter of 4 inches <br /> Drilling method is truck mounted sonic rig. Flush mount well cover installation monument and well box will be placed over well <br /> Please see the proposed boring location on the attached map The actual location may change slightly depending on access and utility locations <br /> Tol&control on this side street will be completed based on the drillers traffic control plan,which includes coning off the drilling area and the area <br /> leading up to the drill rig on either side.Caution tape will be used as wet to indica e e coo area <br /> Soil anwater from the drilrin and development activities will be contained and disposed of at a location owned by the applicant. <br /> a unnu- n,.raa 0.EG c p . rsp-n era SHAkl. Nor sTAR7 lfS B V30AJA <br /> rrti A a <br /> -1490. !It-e .ust..- • ;a. ,4,'_.-_�.,,, <br /> d <br /> C��EcL+k 15 t`� Tty,,,.,5 <br /> TO ARRANGE FOR AN INSPECTION,PHONE 209/599-2108 AT LEAST 48 HOURS PRIOR TO CONSTRUCTION, <br /> ION_ <br /> This permit shall be void unless the work herein described is completed by: February 10, 2010 <br /> Date <br /> Accepting this permit or starting work herein described,shall constitute acceptance and agreement to all the <br /> conditions and requirements of this permit. <br /> Signature of Applicant/Permittee City Engineer(or authorized Agent) <br /> ApplicanvYumittee or Authorized Agent - Date lssa ed <br /> NOTE: Your attention is directed to the general provisions printed on the back of this form. This ptnmit is to be strictly <br /> construed and no work,other than that specifically mentioned above,is hereby authorized. <br /> PERMTT NOT VALID UNLESS EXECUTED BY CITY ENGINEER OR HIS AGENT <br /> WORK COMPLETED: BY: <br /> Iede-l'411, yNbwgnepector Pinkalppaoant <br /> tlnear <br />