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STATE OF CALIFORNIA• DEPARTME _. OF TRANSPORTATION <br /> ENCROACHMENT PERMIT <br /> TR-0120(REV.2/98) Permit No. <br /> 1003-6SV-0202 <br /> DisVCo/Rte/PM <br /> In compliance with (Check one): 10-SJ-33-0.00/0.09 <br /> 10-STA-33-26.9/27.07 <br /> ® Your application of MARCH 3,2003 <br /> Date <br /> ❑ Utility Notice No. of APRIL 1,2003 <br /> Fee Paid Deposit <br /> ❑ Agreement No. of $ $ 320.00 <br /> Performance Bond Amount(1) Payment Bond Amount <br /> ❑ R/W Contract No. of $ $ <br /> Bond Company <br /> Bond Number(1) Bond Number(2) <br /> TO: <br /> GEOMATRIX CONSULTANT <br /> 2101 W EBSTER STREET <br /> OAKLAND, CA 94612 <br /> ATTN: MARTIN BLOES <br /> TEL.#: (510)663-4100 <br /> I I <br /> PERMITTEE <br /> and subject to the following,PERMISSION IS HEREBY GRANTED to: <br /> Make six soil boring to about 80' deep along the shoulder of State Highway 33 right of <br /> way to about 20' from the center line. Three bores northerly of the county line on San <br /> Joaquin side and three southerly of county line on Stanislaus side as shown on the <br /> attached sketch. Only shoulder closure will be allowed for traffic control. Abandonment <br /> of bores shall be in compliance with the Department of Water Resources standards. <br /> In accordance with General Provision No. 6, TWO WORKING DAYS PRIOR to the start <br /> of this work, Permittee shall notify the State Representative MARCEL DE LA CRUZ, <br /> P.O. Box 2048 Stockton, CA 95201, (209) 948-3656. All work under this permit must <br /> meet with the approval of the State Representative. <br /> The following attachments are also included as part of this permit In addition to fee,the permittee will be billed <br /> (Check applicable): actual costs for: <br /> ® Yes ❑ No General Provisions ® Yes ❑ NO Review <br /> ❑ Yes ® NO Utility Maintenance Provisions ® Yes ❑ NO Inspection <br /> ® Yes ❑ NO Special Provisions T ® Yes ❑ No Field Work <br /> ❑ Yes ® No A Cal-OSHA permit required prior to beginning work; <br /> # (If any Caltrans effort expended) <br /> Yes ® No The information in the environmental documentation has been reviewed and is considered prior to approval of this <br /> permit. <br /> This permit is void unless the work is completed on SEPTEMBER 30, 2003. <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 permits and environmental clearances have been obtained. <br /> 1 -Permittee APPROVED: <br /> 1 -File <br /> 3—M. DE LA CRUZ <br /> MARK LEJA, District Director <br /> BY: �/-IA Pete LE istrict Permit E � er <br /> FM 91 1436 <br />