COMPLIANCE INFO_CASE 2 - Laserfiche WebLink

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Page 2 of 2 'Chis permit is issued pursti3rit to all provisions of City of Tracy Municipal node. This permit is granted upon the express condition that the permittee shall be responsible for all claims and liabilitios arising out of work performed under the permit or arislnq out of permittees failure to perforin the obligations with respect to street maintenance The permatee shall, and by acceptance of the permil agrees to, defend, indemnify, save and hold.haunnless the city, itti officers and employees, trom and against any and all suits, t,-laims o( autians brought by tiny person for or an acri),ink of arty bodily injuries, disease or illness or damage to persons an&or property sustained or arising in the construction of the work perforined,under they permit or In consequence or permittee's failure to perform tip obligations with respert to sstreer maintenance. Permittee a tees to abide by the provisions of this permit. PERMITTEE'S SIGNATURE DATE Prior to excavation, Contractor must contact the following to have boiow-ground fadlities located (48 hours prior to work). UNDERGROUND SERVICE ALERT 'roll Free; (800)227-2600 Boyd Service Center (209) 831-4420 Note: You are notified that Section 6500 or the Labor Code requires the issuance of a permit by the Division of Industrial Safcty of the State of California prior to the construction of any trenchor excavation which is five feet or deeper and into which a person Is required to descent Excavation in city street areas without an excavation permit may be!punishable by a fine. Permittee agrees_that they haroby accept complete r",ponsibility for coordination with, reporting to, and complying with the direction of, any and all boprds or districts, including but not limited to, San.Joaquin County Local Health District and California Regional Water Ouality Control Board, or any other regulatory agency having jurisdictivn or authority over soil or ground water contamination such as that currently found at the site of this work, including the preservation of the health and safety of persons working near or in .-my trench or excavation or on the surface of the construction project, or any persons passing by or observing, or any persons living in the.vicinity of the construction project, for any reason whatsoever that may adversely,or othervrise affect the health or safety, now and in the future,of these persons or group of persons. Furthermore, permittee hereby accepts complete responsibility for disposal of any petroleum affected soils, or ground water, including reparting to and complying with the requirements of any,or all, of the stated, or any other, regulatory agencies as discussed above. CITY INSPECTOR'S COMPLETION REPORT PERMIT NUMBER- L 7— DATE OF COMPLETION:. Concrete: Asphalt- Sidewalk: Backfill: Paving: Size of Cut Sq. Ft. inches _ Paved By: INSPECTOR S1GN.OFF - —