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CITY OF RIPON-ENGINEERING DEPARTMENT NO. 3315 <br /> 259 North Wilma Aveaae,Ripo%CA 95366 <br /> 209/599-2108—Fu: 209/S9-2655 , /E /j.% wT <br /> ENCROACHMENT PERMIT /l f <br /> Applicant's Name: Date Submitted: 11/3/2009 <br /> 800 North Brand Blvd-, <br /> Nestle USA, Inc. Glendale, CA 91203 GreggDrilling Co. <br /> Contractor. 99 9 <br /> A" �9ntEnvironmental Cost Management, Inc. Phone (925) 313-5800 <br /> 3525 Hyland Ave, 200, Costa Mesa, 92626 Contact Name: Binayak Acharya or Holly Trejo <br /> Phone: (661)255-1693 or(510) 799-0233 License Number: C-57: 485165 <br /> Parsuaat to Cheptar 12.11 of the City ofltipnm Municipal Cork and all the terms;conditions,and restrictions <br /> written below or pdated as genaai or special provisions on any part of this form,and/or attaeW hereto. <br /> PLEASE READ THIN PERMIT CAREPUILY AND JOUT TT AT THE WORK SITE. <br /> DESCR7�j'[Q QF itiROILC7` !-1'roaade afaH daxrrpifoa ofivort;to bedovre at alllantioas. <br /> PjVzNLw ONLSH1"9YGx4NZw TD ..__2.Anwht"(2Jw&ofpkmor Avil ew ifappA=bla <br /> Destruction of a soil vapor extraction well in the roadway on Industrial Avenue. <br /> VJELt_ DESTRUCT/o" YR6CE5S & PoWEbURE P6R SAN 3'0NQUlN Coyyry <br /> PpovlpE coPY of caum y PERM it, To c/ry of R11b;j Mot -no sr4kT OF MO <br /> xrtiliwMi�'�ar-+t: aa��s�r.wit� S'_(�520.50 .. <br /> _qS4 <br /> CNE 150 A,Wft q_ 10/0.14 <br /> TO ARRANGE FOR AN PMECMN,PHONE 209/599.2108 AT LEAST 48 HOURS mm TO COmwcTtON <br /> This permit shall be void unless the work herein descn'bed is completed by: I -.I -2010 - <br /> Due <br /> Accepting this permit or zwr ing work herain denaibed,shall constitute acceptance and agreement to all the <br /> conditions and requirements of this permit. <br /> Signa46 of A�llcsat/Permittee City Engineer(or authorized Agent) <br /> f- ( AafhmiaxY }yr�ismed <br /> NO Yom at0®tiem ie daated to the geaaalpmvisions pmord on Bis bole ofthis fmn This pumit is tobe strictly <br /> construed and no work,o9a thea that specilkgy mwfloa d abovo,is hereby amhoriaed. <br /> PERMIT NOT VAU D UNLESS EXECUTED BY QTY ENGINEER OR HIS AGENT <br /> WORK COMPLETED: BY: <br />