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HomeMy WebLinkAboutWell Encroachment Permit - 2003ENCROACHME^IT PERMIT City Of Sui s OBISPO r 3 955 Morro Street ■ San Luis Obispo, CA 93401 Location: 363 SANTA ROSA No. 04210 X-streets: MONTALBAN Project Name: MONITORING WELLS Permittee: SECOR INTERNATIONAL INC Address: 3437 EMPRESA SUITE A City/ST/Zip: SAN LUIS OBISPO CA 93401 Phone: 546-0455 Fax: Emergency: Insurance: ZURICH AMER Amount: 2,000,000.00 Owner: CASTRO DONNA Y THE ETAL Length Width Sidewalk, 0 x 0 Curb/Gutter: Driveway: _ 0 x 0 Trench Bore Exc/encr: 0 0 Curb Ramps: No Sewer Wye: N Blanket Utility Company Permit: N Traffic Delineation Plan Requiredles Approved by: RAL onfl4/23/03 ME Other permits reqd Caltrans: Y Fire Dept: N Bldg Dept: N OSHA: N USA#: 133-992 Policy #: GL052224701 Endors #: CG 2012 Phone: Description of Work Install 2 monitoritorinq wells sidewalk per the attached plan. Pedestrian protection also per the attached plan. Finish sidewalk per City Standards. Contact Ron Faria 2 working Days prior to bebining work. CalTrans to inspect MW 6. All work performed within the right-of-way shall conform to the City of San Luis Obispo Engineering Standard Details and Standard Specifications. You are responsible for liability for personal injury and/or property damage caused by this work of your failure to do what you are obligated to do. If a claim of such liability is made against the City or any of its departments, officers, or employees, you shall, and hereby agree to, defend and indemnify the City and hold the City harmless from any claims, including costs of defense and attorney fees. All work shall be completed and the right-of-way restored by: June 23, 2003 AGREEMENT: I have read this permit and acknowledge receipt of the City of San Luis Obispo Encroachment Permit General Provisions and pages of attached special conditions a part of th SIGNATURE Print Name DEFT. of PUI ISSUED BY Final Inspection Date which I have read, agree to, and acknowledge as 0 Date-� Date '� Permit Fee Applicant Name of Well Owner Mailing Address Name of Drilling Contracto Drilling Company Name Business Address `15 0 C . JNTY OF SAN LUIS OBIS1 ,0 PUBLIC HEALTH DEPARTMENT Environmental Health Services 2156 Sierra !Nay a P.O. Box 1439 San Luis Obispo, CA 93406-1489 Phone: (805) 731-5544 FAX: (805) 781-4211 /-I WELL PEMY11T APPLICATION �—, A srwn ,, OFFICE USE Permit No. ,li. -—il.'t'_: Application Approved ❑ Date 1 1 By: Phone No. �, �� 3 � � -0Y.2 3 � c/ r r C-57 License o. '-�' - Nq 51 & Phone No. 3 / " T Proposed Well Site Address SiG��7� - 4i�,`; { ;.i's .�^;_ r�7ra�jArea of County C- r� �- �� - c Assessor's Parcel No. ti , ,; Township Range L Section Parcel Size (acres) In Coastal Zone? i_3 GPS Coordinates N W Note: The "Well Permit Plot Plan" shall be attached to this application and indicate within a two hundred foot radius around the proposed well the following items: A) Property lines, B) Sewage disposal and/or sewer lines, C) Animal enclosures and/or any other concentrated sources of pollution, D) All intermittent or perennial, natural or artificial water bodies or water courses, E) Surface water drainage pattern of the site, F) Existing wells, G) Access roads. The proposed site shall be designated with a flagged surveyor's stake labeled "Well Site." Drilling shall not commence until this application is approved. Well Type Purpose of Well Construction Domestic Private ❑ Soil Testing Destruction ❑ Domestic Public ElCathodic Repair/Modify ❑ Irrigation ❑ Industrial Inactivation ❑ Monitorin Fid Test Well Lj Rotary ❑ Reverse Rotary ❑ Air Rotary Drilling Method Cable Tool Other [] Proposed Depth ' ( Casing Diameter �. / i Annular Seal Depth Do you anticipate drilling into a water bearing formation that has the potential to degrade a higher quality aquifer? Yes ❑ No If yes, please explain Is there any known potential to encounter a water bearing formation where levels of water quality constituents such as nitrate, selenium, hydrogen sulfide, boron, organics, etc., are a concern? Yes ❑ No-q_ If yes, please explain hereby agree to comply with all applicable laws and regulations of the County of San Luis Obispo and the State of California pertaining to well construction, destruction, repair or modification. Within fifteen days after completion of the well, I will furnish Environmental Health Services with a completed well Iega This application becomes a valid permit following sign off by Environmental Health Services. _ SignedZ ' _ Date , z-5- Applicant OFFICE USE ONLY - C� Received By ` Date Z S Fee Paid $ _S ' Check # SS �C Well Site Approved Yes FZNo ❑ By Date Al 1 Site Letter X-Conn Letter Special Requirements and/or Comments for Drilling Contractor Water Quality Testing Conducted? Yes ❑ No ❑ Constituents Tested for _ Well Seal Witnessed? Yes ❑ No ❑ By Date —Seal Depth Well Site Approval GPS Coordinates _ N W Well Seal GPS Coordinates _ N - W Final Letter Sent? Yes f-1 No ❑ Date Comments PERMIT IS VALID FOR SIX MONTHS FROM ISSUANCE Page 1 of 2 repro 1184 0:\D000MENnncjil1Nn!1 Permit Andicationl doc 2-Mar-02 1 . r.1 Name of Well Owner Mailing Address = CUJ TY OF SAN LU7S 'gym'S�'4 ,i ,`Yd PUBLIC HEALTH DPPART1j IENT Environmental Health Seraicas 2156 Sierra Way a P.O. Box 1439 San Luis Obispo, CA 93406-1439 Phone: (805) 781-5544 FAX: (805) 781-4211 WELL PERMIT APPLICATION OFFICE USE � r Permitftva;�_ Application A p oVed ❑ Date / / By: C�. -� [� -1, ,';'�� C� j •"' ��� Phone No. YGq�� �O [ A;? �'"" :� l i,l -5 Cry, i1A Name of Drilling Contractor Drilling Company Name Business Address L/ 5G' Ad /017,.7;41nr9 r _ L C-57 License No. (,2 Phone No. f , Proposed Well Site Address.�� ,�� �� �, ��• ,=�VJ I r.5CC j7Q j Area of Countyr k T S. [,,, 1 _ r.7 S ��r Assessor's Parcel No. cl : - o`,, 1 Township ref~7 Range U Section Parcel Size (acres) llo,"4 In Coastal Zone? r • -� GPS Coordinates N W Note: The "Well Permit Plot Plan" shall be attached to this application and indicate within a two hundred foot radius around the proposed well the following items: A) Property lines, B) Sewage disposal and/or sewer lines, C) Animal enclosures and/or any other concentrated sources of pollution, D) All intermittent or perennial, natural or artificial water bodies OF water courses, E) Surface water drainage pattern of the site, F) Existing wells, G) Access roads. The proposed site shall be designated with a flagged surveyor's stake labeled "Well Site." Drilling shall not commence until this application is approved. Well Type Construction Destruction Repair/Modify Inactivation Domestic Private ] Domestic Public ] Irrigation ] Monitoring Purpose of Well ❑ Soil Testing ❑ Cathodic ❑ Industrial �c Test Well i Drilling Method Rotary 0 Cable Tool ❑ Reverse Rotary ❑ Other [] ❑ Air Rotary ❑ Proposed Depth Casing Diameter �F Annular Seal Depth Do you anticipate drilling into a water bearing formation that has the potential to degrade a higher quality aquifer? Yes ❑ No If yes, please explain /lz Is there any known potential to encounter a water bearing formation where levels.of water quality constituents such as nitrate, selenium, hydrogen sulfide, boron, organics, etc., are a concern? Yes ❑ No 0 If yes, please explain hereby agree to comply with all applicable laws and regulations of the County of San Luis Obispo and the State of California pertaining to well construction, destruction, repair or modification. Within fifteen days after completion of the well, I will furnish Environmental Health Services with a completed w 11 logThis application becomes a valid permit f Ilowing sign off by Environmental Health Services. / Signed t. Date/Z Applicant OFFICE USE ONLY Received By r ; ^� Date '`� �S �Q j Fee Paid $ s -- Check # Well Site Approved Yes KNNo ❑ Site Letter Comments for Drilling Contractor By r. X-Conn Letter Date Special Requirements and/or Water Quality Testing Conducted? Yes ❑ No ❑ Constituents Tested for Well Seal Witnessed? Yes ❑ No ❑ By Date Seal Depth Well Site Approval GPS Coordinates N W Well Seal GPS Coordinates N W Final Letter Sent? Yes ❑ No ❑ Date Comments PERMIT IS VALID FOR SIX MONTHS FROM ISSUANCE Page 1 of 2 repro 1 1 84 O'!GCCUMENnridi\Weii Perm;'; ApulicallonI 8oc 22-Mqr-02 PUBLIC HEALTH DEPARTMENT Environmental Health Servicas 2156 Sierra Way • P.O. Box 1489 San Luis Obispo, CA 93406-1489 Phone: (805) 781-5544 FAX: (805) 781-4211 WELL PERMIT APPLICATION I Name of Well Owner ��, , ,.� -r�J _ .; f �; ��� _ r—iA,� Mailing Address -=, j 7 ► �`_ Name of Drilling Contractor OFFICE USE Permit No.. �[ 7 �;�,► Application Approved' ❑ . Date By: ::� Li 1 S Phone No. j; 0''7j f C-57 License No. Drilling Company Name �` '1 q Business Address C f =1�411 Phone No. 7 Proposed Well Site Address .,,Z 1 r;, f J.� r r w 11 r i 1 Area of County Assessor's Parcel No. 1-- ��;, ,, �n.a_ Township j _ Range j ? "bection P Parcel Size (acres) In Coastal Zone? GPS Coordinates -- - N `ni (dote: The "Well Permit Plot Plan" shall be attached to this application and indicate within a two hundred foot radius around the proposed well the following items: A) Property lines, B) Sewage disposal and/or sewer lines, C) Animal enclosures and/or any other concentrated sources of pollution, D) All intermittent or perennial, natural or artificial water bodies or water courses, E) Surface water drainage pattern of the site, F) Existing wells, G) Access roads. The proposed site shall be designated with a flagged surveyor's stake labeled "Well Site." Drilling shall not commence until this application is approved- _ Well Type Purpose of Well Construction Domestic Private Soil Testing Destruction ❑ Domestic Public ❑ Cathodic Repair/Modify El Irrigation ❑ Industrial Inactivation ❑ Monitorin Test Well Drilling Method ❑ Rotary E ol Cable To ❑ Reverse Rotary ❑ Other ❑ Air Rotary ❑ Proposed Depth Casing Diameter 7 it Annular Seal Depth 0 -:5 f Do you anticipate drilling into a water bearing formation that has the potential to degrade a higher quality aquifer? Yes ❑ No If yes, please explain Is there any known potential to encounter a water bearing formation where levels of water quality constituents such as nitrate, selenium, hydrogen sulfide, boron, organics; etc., are a concern? Yes ❑ NoV If yes, please explain I hereby agree to comply with all applicable laws and regulations of the County of San Luis Obispo and the State of California pertaining to well construction, destruction, repair or modification. Within fifteen days after completion of the well, I will furnish Environmental Health Services with a completed we (log. his application becomes a valid permit following sign off by Environmental Health Services. Signed Date_'" � . � �t-7 .� Applicant OFFICE USE ONLY Received By _ �_ �� Date L� ? .S Cj Fee Paid $ G_o Check #-'"" Well Site Approved Yes U No ❑ By Date jl:: Site Letter X-Conn Letter Special Requirements and/or Comments for Drilling Contractor Water Quality Testing Conducted? Yes ❑ No ❑ Well Seal Witnessed? Yes ❑ No ❑ By Well Site Approval GPS Coordinates Well Seal GPS Coordinates Constituents Tested for _ Date N N Seal Depth W W Final Letter Sent? Yes ❑ No ❑ Date Comments PERMIT IS VALID FOR SIX I!A©IVTI•dS FROM ISSUANCE repro 1194 Page 1 of 2 OADOCUMENTInchfflpn Permit A, plicstion1.dcc 22-Mar-02 STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION ENCROACHMENT PERMIT TR-0120 (REV. 6/2000) In compliance with (Check one): ® Your application of May 1, 2003 El Utility Notice No. Of ❑ Agreement No. of L1 R/W Contract No. of TO: Conoco -Phillips c/o SECOR International, Inc. Attn: Chris Prevost 3437 Empresa Drive, Suite A San Luis Obispo, CA 93401 Phone: (805) 546-0455 Your Reference No. 77CP.66293.01.0005 I_ I 0503 6SV 0297 Dist/CoMte/PM 05-SLO-1-16.92/16.92 Date June 23, 2003 Fee Paid Deposit $ 400.00 $ Performance Bond Amount (1) Payment Bond Amount (2) $ $ Bond Company (1) I Bond Number(2) , PERMITTEE And subject to the following, PERMISSION IS HEREBY GRANTED to: Install ground water monitoring well, MW-6, in the two way left turn lane for 363 Santa Rosa Street as shown on the attached plans and as directed by the permit provisions in State Route 1 right of way at postmile 16.92 in the County and City of San Luis Obispo. Perwittee shall contact State Inspector Samir Bakar, telephone number (805) 549-3151,or Harry Afshar, telephone number (805) 549-3210, 48 hours prior to commencing work to arrange a pre -job meeting in accordance with Provision 6 of the attached General Provisions. When work has been interrupted for more than five (5) working days, an additional 24-hour notification is required before restarting work unless a pre -arranged agreement has been made with the Department's representative. Page 1 of 9 THIS PERMIT IS NOT A PROPERTY RIGHT AND DOES NOT TRANSFER WITH THE PROPERTY T< The following attachments are also Included as part of this permit (Check applicable): ® Yes ❑ No General Provisions ❑ Yes ® No Utility Maintenance Provisions ® Yes ❑ No Special Provisions 1 A NEW OWNER. In addition to fee, th actual costs for: ❑ Yes ® No ® Yes ❑ No ® Yes ❑ No permiftee will be billed Review Inspection Field Work ❑ Yes ® No A Cal -OSHA permit required prior to beginning work; ❑ Yes ® No As -Built Plans Submittal Route Slip for Locally Advertised Projects (if any Caltrans effort expended) ❑ Yes ® No Storm Water Pollution Protection Plan Th ' f i Yes ® No ern ormat on in the environmental documentation has been reviewed and is considered prior to approval of this permit. This permit is void unless the work is complete before June 23, 2004 This permit is to be strictly construed and no other work other than specifically mentioned is hereby authorized. Na project worts shall be commenced until all other necessary ermits and environmental clearances have been obtained. cc: Attachments: APPROVED: Permit File Weekly Traffic Update Samir Bakar (Insp) Public Affairs Project Notification Harry Afshar. Std. Plans T10-T13 R. GreggAlbright, District Director Jim Gracia Form DC-CEM-3101 BY Jim Tkach For Steven A. Senet, District Permit Enoineer FM 91 1436 Conoco -Phillips 0503 6SV 0297 05-SLO-1-16.92/16.92 Page 2 of 9 PLANS AND SPECIFICATIONS All work shall be done in accordance with the attached plans, the latest editions of Caltrans' Standard Specifications and Standard Plans, the attached Encroachment Permit General Provisions, and the following provisions. If conflicts arise between Special Provisions, Plans, Caltrans Standard Plans, Standard Specifications, or other Caltrans standards, the Caltrans Inspector shall make the final determination regarding selection or interpretation of standards and/or specifications. State Standards and Specifications shall apply to all work within the State right of way unless directed otherwise by the State Inspector. WORK HOURS All work on this permit shall be performed on weekdays between the hours of 9:00 AM and 3:00 PM, excluding holidays, unless stated otherwise for traffic control. Lane closures shall only permitted on Monday through Thursday between the hours of 7:00 PM and 7:00 AM and on Friday between the hours of 12:00 am (midnight) and 7:00 AM. Deviations from these hours must be approved in advance by the State Inspector. Designated legal holidays are: January 1 st, the third Monday in January, Lincoln's Birthday, the third Monday in February, Cesar Chavez's Day, the last Monday in May, July 4th, the first Monday in September, the second Monday in October, November 1 Ith, Thanksgiving Day, the Friday after Thanksgiving Day, and December 25th. When a designated legal holiday falls on a Sunday, the following Monday shall be a designated legal holiday. When November 1 Ith falls on a Saturday, Friday, November IOth, shall be a designated legal holiday. CONDITIONS OF APPROVAL/SPECIAL REQUIREMENTS Traffic control must be placed for northbound and southbound traffic on State Route 1. Permittee shall obtain a separate Encroachment Permit for any sampling gathering activities from the monitoring well after the expiration date of this permit. NOTIFICATIONS Temporary Lane Closures Notification of temporary lane closures or traffic detours shall be given to the State Inspector for his approval using copies of the attached form entitled, WEEKLY TRAFFIC UPDATE. Notification shall be submitted to the State Inspector by 12:00 PM (noon) Wednesday, prior to the week of the proposed closure or detour. Notifications submitted after the aforementioned deadline cannot be approved for the upcoming week. All traffic control requiring the temporary closure of lanes or detour of traffic shall be approved in advance by the State Inspector. Conoco -Phillips 0503 6SV 0297 05-S LO-1-16.92/ 16.92 Page 3 of 9 Special Notifications If construction activities such as road closures or traffic detours may result in significant traffic congestion, Permittee shall be responsible for coordinating advance notification to local newspapers, television and radio stations, and emergency response providers with both the State Inspector and the Caltrans Public Information Officer, telephone (805) 549-3237. Public notice may include press releases and/or traffic signing. Permittee shall complete and submit the attached form entitled PUBLIC AFFAIRS PROJECT NOTIFICATION to the Caltrans Public Affairs Office prior to 12:00 PM the Wednesday prior to the approved closure or event. Additional information or clarification may be required in the form of a written description of the activities in a format that is suitable for a press release. The form may be delivered by fax to (805) 549-3638. Horizontal and Vertical Requirements for Extra -Legal Load Vehicles Permittee shall provide written notification to the Caltrans Permit Inspector or Caltrans Representative, of anticipated horizontal or vertical lane restrictions which will affecting extra -legal loads up to 16' wide and 18' high, or ramp closures/reopenings that may affect extra -legal loads traveling through the project area. Said notification shall be delivered to the inspector no fewer than fifteen days prior to proposed change. Permittee shall immediately notify the Caltrans Permit Inspector or Caltrans Representative as soon as the restriction is no longer present. Notice of Materials Used Permittee shall fiurnish a completed Form DC-CEM-3101 "Notice of Materials Used," to State's representative for the approval of highway related material to be used prior to its installation. "NO PARKING" zones shall be posted a minimum of 48 hours in advance of proposed parking lane closure. TRAFFIC CONTROL AND PUBLIC SAFETY Work shall not interfere with traffic and no equipment shall be parked on or operated from the traveled way unless approved by the Caltrans representative. When a lane closure is authorized, it shall be done in accordance with the applicable Caltrans' Standard Plans for traffic control. Where required by the plan, the use of a flashing arrowboard is MANDATORY. If a lane closure is authorized, work shall be confined to one lane; equipment and/or material shall not encroach beyond the painted lane line. All traffic control devices and personnel shall be provided by the Permittee and all expenses incurred from this operation shall be borne by the Permittee. Not withstanding closures noted in the traffic control plans, the full width of the traveled way shall be open for use by public traffic on Saturdays, Sundays, after 3:00 PM on Fridays, designated legal holidays, the day preceding designated legal holidays, and when construction operations are not actively in progress. On multilane roadways, a minimum of one paved traffic lane, not less than 3.6 meters wide, shall be open for use by public traffic in each direction of travel. Conoco -Phillips 0503 6SV 0297 05-SLO-1-16.92/ 16.92 Page 4 of 9 On 2-lane, two-way roadways a minimum of one paved traffic lane, not less than 3.6 meters wide, shall be open for use by public traffic. When construction operations are not actively in progress, not less than 2 of these lanes shall be open to public traffic. If approved by the State Inspector, one lane may be closed during construction and public traffic stopped for periods not to exceed 5 minutes. After each closure, all accumulated traffic shall be allowed to pass through the work before another closure is made. Lane closures shall not exceed 0.5 mile in length. If the State Inspector determines that the traffic queues or traffic delays are excessive, all traffic lane restrictions shall be removed. All traffic lanes shall be opened for traffic as soon as practical and shall be safe for the traveling public as directed by the State Inspector. Minor deviations from the requirements of this section concerning hours of work may be permitted upon the written request of the Permittee if, in the opinion of the Inspector, public traffic will be better served and the work expedited. The Permittee shall not adopt these deviations until the Inspector has approved them in writing. Suspended Loads Suspended loads or equipment shall not be moved nor positioned over public traffic or pedestrians. Pedestrian Safe When the work area encroaches upon a sidewalk, walkway, or crosswalk area, special consideration must be given to pedestrian safety. Protective barricades, fencing, handrails and bridges, together with warning and guidance devices and signs must be utilized so that the passageway for pedestrians, especially the blind and other physically handicapped, is safe and well defined as shown on the approved permit plan, or as directed by the State representative. Pedestrian walkways and canopies within State right of way shall comply with the requirements of the applicable local agency or with the latest edition of the Uniform Building Code, whichever contains the higher standards. GENERAL REQUIREMENTS Pro_ieet/Work Site All disturbed areas shall be restored to original or better condition. Any change in the existing drainage pattern, whether occasioned by increase or diversion, and the cost of damage, repair or restoration of the State highway right of way shall be the responsibility of the Permittee. All personnel shall wear hard hats and orange vests, shirts, or jackets as appropriate. No equipment or material stockpiles may be stored within the Caltrans right of way without the written consent of the State Inspector. Conoco -Phillips 0503 6SV 0297 05 - S LO-1-16.92/ 16.92 Page 5 of 9 No earth or construction materials are to be dragged or scraped across the highway pavement. No excavated earth shall be placed or allowed to remain at a location where it can be tracked on the highway traveled way, public or private approach by the Permittee's construction equipment, or by traffic entering or leaving the highway traveled way. The Permittee shall immediately remove excavated earth or mud so tracked onto the highway pavement or public or private approach. Asphalt concrete grindings, excavated asphalt concrete, spoils and other objectionable material resulting from Permittee's operations shall be disposed of outside the highway right of way in accordance with Section7- 1.13, "Disposal of Material Outside the Highway Right of Way," of the Caltrans Standard Specifications, and shall be the Permittee's sole responsibility. No excavation shall be left open overnight without written permission from the Caltrans representative unless otherwise specified herein. Material Testing Material testing and quality control shall conform to the State Construction Manual and to the .State Material Testing Manual. Testing shall be performed by a certified material -testing consultant acceptable to the State and paid for by the Permittee. Material testing and quality control tests shall be performed as required by the State's Inspector and the results thereof shall be made immediately available. All required construction compliance tests shall be performed with the California Test Methods and shall be in accordance with the latest edition of Caltrans Independent Assurance Program Manual. All tests shall also be performed by a Caltrans certified laboratory and all laboratory reports shall be furnished to the Department's representative at no cost to the State. Backfill Requirements All backfilling and compaction shall conform to the applicable sections of the Department's Standard Specifications. Backfilling using ponding or jetting methods are prohibited. Cement slurry backfill containing. 110 kg of cement per cubic meter (2 sacks of cement per cubic yard) shall be used under all paved surfaces or as directed by the State Inspector. Backfill within the roadbed and structure backfill shall be a minimum of 95% relative compaction. Relative compaction of 95% for roadbed backfill shall be obtained for a minimum depth of 0.2 in below the grading plane or 0.8 in below the finished grade for the width of the traveled way plus one meter on each side thereof, which ever is greater. Embankment compaction beyond the roadbed or outside of structure backfill shall be a minimum of 90% relative compaction unless stated otherwise in the Caltrans Standard Specifications or Caltrans Highway Design Manual. Culverts with less than 600-mm (2 feet) of cover shall be backfilled as directed by the State Inspector with minor concrete or Class 4 concrete conforming to the provisions in Section 90, "Portland Cement Concrete," and backfilling conforming to Sections 63 through 66 of the Caltrans Standard Specifications. Concrete CuriuE All newly placed concrete shall be cured in accordance with the provisions of Section 90-7, "Curing Concrete," of Caltrans' Standard Specifications. Conoco -Phillips 0503 6SV 0297 05-5 LO-1-16.92/ 16.92 Page 6 of 9 Exis#ink Trees and Vegetation This permit does not authorize the removal, severing of roots or trimming of vegetation. If work of this nature is required it must be approved of in advance by the Inspector in writing. Replacement planting may be required as a mitigation measure. Excavations should be done outside of drip line to reduce tree damage and integrity of trees. If excavations must be made within the drip line of trees (or extending tree roots) along the right of way, the trenches shall be hand dug and the utility routed beneath or around root structure. Major tree roots must not be cut or damaged. Additionally, the exposed roots shall be wrapped and kept moist until the excavation is back filled with the native material. Requests for exceptions shall be accompanied by an Arborist' recommendation. Archaeological/Cultural Requirements In the event that cultural material is encountered during project construction, work shall cease until the unanticipated discovery is assessed by qualified archaeologist. District 5 Archaeologist Kelda Wilson telephone number (805) 542-4697 shall be notified of such a discovery. If archaeological resources or human remains are accidentally discovered during construction, work shall be halted within 50 meters (150 feet) of the find until it can be evaluated by a qualified professional archaeologist. Permittee shall notify Caltrans District Archaeologist Kelda Wilson (805-542-4697) about the discovery. If the find is determined to be significant, appropriate mitigation measures shall be formulated and implemented. Monitor_i_na Wells All discharge from the wells shall be removed from the State right of way, treated and disposed of according to current local and regional standards. No discharge shall be allowed into the State's surface drainage systems. Placement of the monitoring wells shall be determined so as to offer the least immediate and future conflict with pedestrian and vehicle traffic. All monitoring well vaults or enclosures shall be flush with the existing ground surface and shall have traffic rated covers. Monitoring wells located on the graded shoulder shall be constructed flush with the adjacent surface and shall also have a minimum 600mm wide minor concrete collar constructed around the monitoring well as directed by the State Inspector. Permittee shall be responsible for proper registration, through the Department of Water Resources, permitting through the local agencies, and abandonment, of any wells installed within the State right of way shall be in compliance with all applicable local and/or federal guidelines. Wells shall be for the monitoring only and any additional use, such as recovering hydrocarbons, shall be the subject of another permit. Conoco -Phillips 0503 6SV 0297 05-SLO-1-16.92/16.92 Page 7 of 9 At the completion of use, this well shall be plugged and abandoned in a manner approved by the County of San Luis Obispo Health Department and the Regional Water Quality Control Boards in compliance with the Department of Water Resources' standards. Caltrans shall be notified when the monitoring wells are properly abandoned. If the method of abandonment is not specified, the entire ground water monitoring structure shall be removed and backfilled with cement slurry backfill to within 150-mm of the finished grade. The remaining 150-mm shall be backfilled with asphalt concrete paving or Class 3 concrete colored to match the adjacent surfaces. Monitoring wells located on the graded shoulder shall be backfilled with approved materials or as directed by the State Inspector per Caltrans Standard Specification for backfill requirements. Permittee shall supply complimentary copies of all test results and reports that use data of information from wells, borings and / or sampling of areas within the Caltrans right of way. Reports shall include but not be limited to site investigation reports, groundwater monitoring reports and site closure reports. This includes a map accurately locating the well, borings and/or service lines in reference to a permanent landmark. The permit number "0503 6SV 0297" shall be printed on the cover of any documents for identification and sent to: Jim Tkach, (Permit Number) Caltrans District Hazardous Waste Coordinator 50 Higuera Street San Luis Obispo, CA 93401 If the well is located on the pavement, the well shall be cored or sawcut to produce a neat hole at least two inches larger than the soil bore diameter. The surfacing to remain in place shall not be disturbed or displaced by the drilling, cutting or removal methods employed. Any damage to the existing pavement shall be removed and replaced as directed by the State Inspector. Any installation of monitoring well in sidewalks, shall require the sidewalk be saw cut to the nearest score marks and replaced equal in dimension to that removed with score marks matching existing adjacent sidewalk or curb. New sidewalk, curb and gutter concrete shall be doweled as follows unless local standards exceeds the following specifications or as directed by the State Inspector. New concrete shall be doweled into existing concrete with 300-mm minimum (12") #4 smooth bars equally embedded, at 600-min (24") centers and 150- mm (6") from concrete edge. One end of bar shall be greased or sleeved. Additional bars shall be placed, one in the curb and one in the gutter, if required. EXISTING FACILITIES Existing improvements shall be protected or relocated as required by the work authorized by this permit. If existing improvements including pavement markings and delineation are damaged or their operation impaired Conoco -Phillips 0503 6SV 0297 05-SLO-1-16.92/16.92 Page 8 of 9 by this work, they shall be replaced or restored to the satisfaction of the Caltrans representative. Such work shall be done immediately if requested by the Caltrans representative. IT SHALL BE THE PERMITTEE'S RESPONSIBILITY TO FULLY INVESTIGATE THE PROPOSED WORK AREA FOR POSSIBLE CONFLICTS WITH EXISTING UTILITIES AND FACILITIES, INCLUDING BUT NOT LIMITED TO SEWERS, ELECTRICAL CONDUCTORS, GAS LINES, WATER PIPES AND TRAFFIC SIGNAL FACILITIES. THE PERMITTEE AGREES TO ACCEPT ALL LIABILITY FOR DAMAGES DONE TO EXISTING FACILITIES CAUSED BY THE WORK AUTHORIZED UNDER THIS PERMIT. Caltrans does not subscribe to underground utility locating services. It is the Permittee's sole responsibility to investigate, locate, and mark existing Caltrans traffic signal equipment, loops, conduits, and street lighting facilities prior to work in or between signalized intersections and street lighting facilities. Existing utility boxes must be either relocated or adjusted to grade at the Permittee's expense. If it is apparent that impacting traffic signal conduits during construction will be unavoidable Permittee shall install temporary overhead wiring for the signal at Permittee's own expense. Permittee shall have on hand at all times all necessary equipment and personnel needed to provide traffic control at an intersection should the traffic signal malfunction. ' If a signal detector loop, including the portion leading to the adjacent pullbox is damaged by Permittee's operations the entire detector loop shall be replaced, in kind, within 24 hours of the occurrence. If an adjacent loop is damaged during the replacement, that loop shall also be replaced. The Caltrans Inspector shall be notified immediately when damage occurs. Arrangements for Caltrans Electrical operations staff shall be made to have the traffic signal controller reprogrammed. Any utility relocation shall be performed to the reasonable satisfaction of the affected utility companies, in compliance with the State's highway encroachment policy. WATER POLLUTION CONTROL The Permittee shall utilize best management practices (BMP's) that conform to the requirements of the most current edition of "Caltrans Storm Water Quality Handbooks, Construction Contractor's Guide and Specifications," to prevent the transport of pollutants and/or erosive soils to storm drains or to a body of water. The Permittee shall be solely responsible to prepare, in accord with good management practices, a Storm Water Pollution Prevention Plan, or Water Pollution Control Plan which will satisfy the Regional Water Quality Control Board if applicable. Permittee shall be responsible for reimbursement of fines levied against Caltrans due to Permittee's failure to comply with Regional Water Quality Control Board rules and regulations within the State's right of way. - Permittee shall provide and install erosion control measures as directed by the State Inspector or Caltrans Storm Water Coordinator. Permittee shall be responsible to mitigate for storm water siltation Conoco -Phillips 0503 6SV 0297 0 5 - S LO-1-16.92/ 16.92 Page 9 of 9 within or entering the State right of way as a result of the proposed construction. Erosion control measures may consist of, but not limited to; gravel bags, straw bales and silt fencing. PROJECT COMPLETION A portion of the permit fee consists of a $100.00 deposit required to cover estimated State construction inspection costs within the State's right of way. Permittee will be billed for costs exceeding the deposit, or refunded unused portion thereof after completion of the project. Immediately following completion of the work permitted herein, the Permittee shall fill out and mail the Notice of Completion attached to this permit. PLEASE USE THE ATTACHED ENVELOPE (PRE -PAID POSTAGE) TO SEND THE ATTACHED NOTICE OF COMPLETION AND QUESTIONNAIRE. THANK YOU!