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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION <br />ENCROACHMENT PERMIT <br />rn n4nn MMI ninal <br />In compliance with (Check one): <br />Your application of NOVEMBER 30, 2012 <br />® <br />Utility Notice No. <br />❑ <br />Agreement No. <br />® <br />RNV Contract No. <br />Of <br />of <br />Of <br />101 <br />10 -SJ -580-8.015 <br />Date <br />DECEMBER 3, 2012 <br />Fee Paid De <br />$ EXEMPT $ <br />TO: 17-- _� I <br />SAN JOAQUIN COUNTY PUBLIC WORKS SOLID WASTES <br />PO BOX 1810 <br />STOCKTON, CA 95201 <br />ATTN:' W. MICHAEL CARROL <br />TEL : (209) 468-3066 <br />I I <br />PERMITTEE <br />and subject to the following, PERMISSION IS HEREBY GRANTED to: <br />Install one (1) permanent monitoring well for landfill gas (LFG) migration and conduct sampling <br />of the monitoring well required by CRWQCB, as shown on the attachments, within Interstate <br />580 right of way approximately 300 feet southeast of Corral Hollow Road in San Joaquin <br />County. This Permit does not allow Interstate 580 lane or shoulder closures and access to the <br />monitoring well is from the shoulder of the Corral Hollow Road. A copy of this permit must be <br />placed in all vehicles involved in doing this work. A copy of this permit must be placed in all <br />vehicles involved in doing this work. <br />In accordance with General Provision No. 6, SEVEN WORKING DAYS PRIOR to the start of <br />this work, Permittee shall notify the State Representative JOSEPH A. VALDEZ, P.O. Box 2048 <br />The following attachments are also included as part of this permit I In addition to fee, the permittee will <br />(Check applicable): <br />❑ <br />Yes <br />® <br />Yes <br />❑ <br />❑ <br />NO <br />General Provisions <br />❑ <br />Yes <br />❑ <br />® <br />No <br />Utility Maintenance Provisions <br />® <br />Yes <br />® <br />No <br />Special Provisions T <br />❑ <br />Yes <br />Z <br />No <br />A Cal -OSHA permit required prior to beginning work; <br />actual costs for: <br />❑ <br />Yes <br />® <br />No Review <br />❑ <br />Yes <br />® <br />No Inspection <br />® <br />Yes <br />❑ <br />No Field Work <br />(If any Caltrans effort expended) <br />U Yes ZI No The intormation in the environmental aocumentation nas oeen reviewea ano is consiaerea prior to approval OT Trns <br />permit. <br />This permit expires on or before DECEMBER 31, 2014. <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 other necessary per its and environmental clearances have been obtained. <br />ORIGINAL - Permittee APPROVED: <br />1 —ALI JUMA <br />2 — Joseph A Valdez <br />I -Maintenance CARRIE BOWEN, District Director <br />1-PIO & 1 -FILE 12. 3, <br />Betty Tamae �MAGVAYOtstrlct Permit Engineer G• <br />FM 91 1436 <br />