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02/04 200'3 14: '210 299-948-7232 CALTRAHS D10 PERMITS PAGE 02/04 <br /> ' STATE OF CALIFORNA DEPARTMENT OF TRANSPORTATION <br /> ENCROACHMENT PERMIT teP <br /> 1U-09-6-zr,-u051 <br /> ' 7R-0120(;REJ 6/2000) <br /> M <br /> 10-9J-33 PM 0.16 <br /> In compliance wlth(Check one): <br /> 01/26/2009 <br /> m Your application of Jana.ary 20, 2009 /Feaid ep°'t <br /> g 322 <br /> ❑ UtilityNotice No. ofPerformsnce BcrtdAmaunt(1) Payment Bond Amount f2) <br /> 1 0.00 0.00 <br /> ❑ Agreement No. of and Company <br /> ❑ RM Contract No. of Bond Number(1) nd NumtX+.r(2) <br /> TO: Chevron Enviornmental Management Company (CEMC) <br /> 6111 Bollinger Canyon Road, BR1Y3432 <br /> San Ramon, CA 94533 ,PERMITTEE <br /> I Attn : Sean Gehlke 925-543-2353 <br /> and subject to the following. PERMISSION IS HEREBY GRANTED to: <br /> Place advance road work ahead signs, maintain, remove and accomplish temporary <br /> flagging traffic control along State Route 33 right of way and Welty Road <br /> Intersection in San Joaquin County, Traffic control shall be as directed by the <br /> State representative. <br /> In accordance with General Provision No . 6 , TWO WORKING DAYS PRIOR to the start of <br /> this work. Permittee shall notify the State Representative JOE VALDEZ, P. O. Box <br /> 2048, Stockton, CA 95201 . (209 ) 948-3656 . All work requiring traffic control <br /> ' must apply for a closure number seven days prior to start of work. No closures on <br /> HOLIDAYS or WEEKENDS. All work under this permit must meet with the approval of the <br /> State Representative. <br /> Failure on the Permittee's part to comply with any provision will be cause for <br /> revocation of this permit . <br /> THIS PERMIT IS NOT A PROPERTY RIGHT AND DOES NOT TRANSFER WITH THE PROPERTY TO A NEW OWNER. <br /> The follov ing attachments are also included as part of this permit(Check applicable): <br /> ®Yes ❑No General Provisions In addition to fee, the permittee will <br /> be billed actual costs for, <br /> ❑Yes ONO Utility Maintenance Provisions <br /> D Yes 0 No Storm Water Special Provisions ®Yes ❑No Review <br /> ' ®Yes ❑NO Special Provisions ®Yes ❑No Inspection <br /> ❑Yes S No A Cat-OSHA permit if required: Permit No. ®Yes ❑No Field Work <br /> ' ❑Yes ®No As-Built Plans Submittal Route Slip for Locally Advertised Projects <br /> ®Yes ❑No Storm Water Pollution Prevention Plan/Water Pollution Control Plan (if any Caltrans sffort expended) <br /> ❑Yes S No The information in the environmental documentation has been reviewed and considered prior to <br /> approval of this permit. <br /> This permit is void unless the work is completed before -fa Iy a.9 _2_12a <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 all the other necessary permits and the environmental clearances have been obtained. <br /> PERMrT ENGINEER:Eddo Diwala APPROVED: <br /> COPIES TO: <br /> Original•Perm Inee <br /> 1-kbintenance 4P'. Kome A11se,D stnct Direcror <br /> 2-Joe Valdez BY:/ _ <br /> Fite I /t� <br /> /zf� � C-- <br /> NELSON A O,P District Permit Engineer <br /> FIA q1 14�16(D10 PerrndApp.) JJ <br />