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2519
,. .NOTE'"" t' i. With proper, validatinri rthis form constitutes an encroachment permit ., z Jr' I` i #For the construction of/'0.1plic or private curbs, driveways, pavements, sidewalks,parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS f . Subdivision Improvement Permit— Class III DATE: -October 1. 1996 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION La Ouinta Post Office. 51-350 Ave. Navarro CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) (Street address or Description of Location) PURPOSE OF CONSTRUCTION Tmm�etsery eerklna lnt Pnr Sketch (attach construction plans if appropriate) .r ' � N*- I Bost Office DESCRIPTION OF CONSTRUCTION a DIMENSION OF INSTALLATION OR REMOVAL f 60' of frontasu curb/scatter SIZE OF EXCAVATION, IF NEEDED N/A sidewalk APPROXIMATE TIME WHEN WORK WILL BEGIN 10/2/96 APPROXIMATE TIME OF COMPLETION 10/90/96 ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) _ In consideration of the granting of this permit, the applicant hereby agrees to: SEE ATTACM CONDITIONS M ATTACHBD DRAWING w+ Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four (24) he Comply with all applicable City Ordinances, the terms and condi La Quinta and to pay for any additional replacement necessary 709. postal Service L-00 r Name of Applicant (please print) Business Address Telephone No. ASC Coaetrwtiou Co. 3130 Utional. N.N.• Ban Disko. CA (619) 239-3428 Name of Contractor and Job Foreman Business Address Telephone No. 2,54763 Contractor's License No. Ranefir Ina. Co. Applicant's Insurance Company FEES: Subdivision Improvement Permit —Class III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ 40. Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by 10. $ 50. Date City Business License No. Policy Numt of U ( OCT 3 1996 PERMIT VALIDATION PERMIT NO. 2519 DATE APPROVED 10/1/96 EXPIRATION DATE • 11/1/96 DATE,ISSUED 10//11//96 By Administrative Authority Recorded by 11 Telephone: (619) 777-7075 NOTE: J " a With proper,validation, this form constitutgs an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction of public or private curbs, driveways, -pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS �Q raj / Subdivision Improvement Permit - Class II I DATE: l ((J ® Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION L-14 Ql)lr�'f�l PST 2?FF/C� . �l 35� A VfN/a-. WAVARI& (Street address or Description of Location) PURPAASE O CONSTR CTION _rf"1p. P�9�v! LO T Sketch (attach construction plans if appropriate) ©� is 6 ,, DESCRIPTION OF CONSTRUCTION DIMEttAsION OF INSTALLATION OR REMOVAL C3:•rl(��l (vim 06• L&v"ri¢GE <16 . SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN /400/0 APPROXIMATE TIME OF COMPLETION .30. ESTIMATED CONSTRUCTION COST $ (Including removal of all'obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to: Indemnify, • defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and ah penalties, liabilities or loss resulting from claims or court action and arising out of. any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of Le Quinta and to pay for any additional replacement necessary as the result of this work. ( Signature Applicant of ant `!^OS /1 SERV I CS . Name of Applicant (please print). _ Business Address Telephone No. .A 13 C CoNstRu ctla- r a Zje- 31 zv AJA7io,V,9L _A67 5/ 23V-3 V2_R Ime of Contractor and Job Foreman Elusinessre telephone No. -7/_ , Contractor's Li ?e -No. 7 City Business License No 7 Gu�fo7 Applicant Insurance Company GEN. L_IASILITy Polic FEES: Subdivision Improvement Permit -Class III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit - Class IV: See attached schedule Inspection Fee $ I PERMIT VALIDATION Per Fee I C2 PERMIT NO Penalty Cash Deposit -Surety Bond if required. TOTAL: $ Receipt No.. Received by Date Recorded by DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (619) 777-7075 ' � �'��-'�llf/ ��,� SS IL, - GGA � � °J , , , .l.N 4 4�"rm - R.�w� -_ ., - , I TjMT&, . - - . , * , % . ,,�;,q!� ..� 5,o .. i -L w , " � ; " Wi �k ta ,c .'' . �," I : .,. .. % W�M. " �K- 't", _yMmi�%N, i .� , � .,!i"T .:.: -, I 1�1 . ., v :1.1 .. . MIA... , ", ,. , ., - * � � . . . . Lo , . , I ", :,� .. . . , 1�_. '. "i;. s-, ji�..I.t,-Iii-.;�,"�t,.���!,!":.t,::�.,. . U, f 4; 1 e., - 11 '� - � '. �; " * , ! ;�.,.,:�l�,'�";',., - � :. ..... . , I "'.. - I #_� 0 � .. ... ; -,j! ,�. 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Ill. , . . ,"Q-,' . . --1 _A,�,.O�i,(,'� .1 11 j , _ .. 11 1, t' . . . �l lg� , -I, , li I., 'W"r I ti;" I I * ,- - I '1'11� - v 1, " - � ; , , I , ,4' . ,, ;, I . I . - - *' , . " � z * 'f. " . x. ..- AJ.j..'- i �,,;, I Z-�'- � �;. " I "".1ki , I .., I ,- I 1� .. , J i., ., , " .; ,,C` - . -l-"�_,4'l\;,_ " ; . ,. I I Cl The following General and Speciil Provisions are attached to and made a part of Permit No. 25-1 GENERAL PROVISIONS The following shall always apply: ENROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City of La Quinta right of way ONLY. Whenever construction extends within private property, it is the responsibility of the permittee for his contractors to secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work. TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tracklaying construction equipment shall not be permitted to operate on any paved surface unless fitted with smooth -faced street pads. All mechanical outriggers shall be fitted with rubber street shoes to protect the paving during excavations. Rubber -tired equipment only shall be used in backfill operations in paved areas. If the existing pavement is scarred, spalled, or broken during the term of this contract, or if the pavement is marred, City of La Quinta shall request that these portions of road be resurfaced over their entire width. Resurfacing "shall consist of one coat of two inches (2") of A.C. surfacing plus appropriate seal cost as specified above. PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City Engineer or La Quinta City Public Works inspectors. Suitable detours and detour signs shall be placed and maintained for the duration of the project. The City shall be notified.24 hours in advance of any traffic detours or delineations. CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete pipe, steel culvert and concrete structures encountered during excavation which necessitate removal shall be replaced in kind. In the event it becomes necessary to remove or cut existing drainage structures, City of La Quinta shall be notified prior to commencement of this work. Drainage structures and open drains shall be kept free of debris at all times for proper drainage. RIGHT OF WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed from the right of way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction. Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall' be removed prior to paving. Water tanker shall be used, as required, to sprinkle the job site to keep down dust conditions and shall be used immediately after backfill. DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City of La Quinta roads, it shall be the responsibility of the permittee (contractor) to control this water and to provide off-street barricades when necessary. CLOSING STREETS:. No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limited access for the adjoining property owners and emergency vehicles. In the event it is felt by the permittee that he must close a street for any length of time, permittee shall contact this office to obtain the necessary permission. SPECIAL PROVISIONS The following shall apply when indicated: RI NOTIFICATION: Permittee shall notify the City at (619)777-7075 at least 48 hours in advance of starting construction. R2 UTILM CLEARANCE: (Substructures) Prior to making any excavation within the City of La Quinta right of way authorized by permit, the permittee shall contact all concerned utility companies relative to the location of existing substructures. Damage to existing substructures resulting from operations conducted under this permit shall be the sole responsibility of the permittee. R3 UTH= CLEARANCE: (Surface Structures) No work shall be done under this permit until all utilities are clear of the proposed work site. The permittee shall notify all concerned utility companies of the proposed work. R4 PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be surfaced with inches of A.C. paving placed on inches of class aggregate subbase course having an "R" value of not less than and in conformance with City of La Quinta Road Improvement Standards and Specifications, Ordinance #461. R5 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of 1/4 inch to one foot (1'). R6 GRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by a licensed engineer. R7 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter (_feet) shall be removed. Curb and/or curb and gutter shall be saw cut prior to removal.. Depressed curb, matching concrete gutter and concrete driveway approach shall be constructed in conformance with City of La Quinta Standard //207. R8 DRIVEWAYS: A.C. driveways shall be constructed as not to alter existing drainage pattern. Surfacing between the property line and the existing road,paving shall be 2 1/2 inches of A.C. paving placed on of class aggregate base. Driveway construction shall conform to attached drawing. R9 SIGHT CLEARANCE: Sight clearance of 600 feet in all directions shall be assured and maintained at all times. RIO SOH. STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall commply with the manufacturer's specifications. ir. R11 COORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or City of La Quints may conduct in this area during the period of this permit. Work shall be coordinated with the State or City of La Quinta forces to preclude delay or interference with State of City of La Quinta projects. R12 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the centerline of all streets or property lines when involved shall be completely tied out so they may readily and correctly be replace&by a licensed civil engineer or surveyor at the expense of the permittee. A complete set of notes showing the ties to these monuments shall be furnished to the City Engineer prior to the removal of any monuments. This office shall be notified upon completion or replacement of all survey monuments for proper project clearance. R13 PAVEMENT CUTTING: Pavement will be mechanically saw cut to a straight to a straight edge prior to excavation. Method of pavement cutting shall be approved through the office of the City Engineer. (Under no circumstances shall excavating equipment be used to excavate prior to cutting of pavement.) Excavation material shall be placed in such a position as to best facilitate the general flow traffic. Prior to final paving operations, any damage to pavement straight edges shall be corrected. R14 LIMIT OF EXCAVATIONS: Excavations shall be limited to 1000 linear feet of open trench before backfill operations must begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of the traveling public. The Public Works Inspector shall determine the suitability of excavation barricading in each case. No excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction material is actually on the work site. R15 BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongy or saturated material) which is encountered during excavation shall not be used for backfill, but shall be supplemented or replaced by an approved sand or gravel. ' R16 BACKFILL. SAND: Backfill shall be approved transit -mix sand or equivalent and shall be'placed in lifts of not greater than three feet (3') and vibrated using vibrotamper or equivalent equipment. Alternate methods may be substituted, but in any case, a relative compaction of 95 percent shall be attained with the structural section of the roadway. R17 BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench before flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care is to be exercised that the backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed so that the resulting compaction shall be not less than 90 percent or equivalent to the surrounding ground, whichever is the greater compaction. Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain the water. Where jetting is used, the jets shall be of sufficient length to reach the bottom of each layer and the water supply shall be continuous. R18 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made at intervals of not more than 1000 feet and a minimum of one (1) test on each road. One (1) copy of each test shall be forwarded to the City Engineer for approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated January 1973. R19 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line. One (1) copy of each test shall be forwarded to the City Engineer for approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated January 1973. R20 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch consisting of 2 inches of SC -800 shall be placed on a prepared subgrade. The SC -800 temporary paving shall be placed after a maximum of 3000 linear feet of trench has been excavated and backfill operations completed, but in no case shall the placement of the temporary pavement exceed a five (5) day limit. R21 PERMANENT PAVEMENT REPAIR: After backfill and compaction have been completed, a temporary patch consisting of two inches (2") of SC -800 shall be placed immediately. A permanent patch of inches A.C. surfacing placed on a inch class base shall be placed no later than days after completion of temporary road repair. R22 FOG SEAL: A fog seal coat consisting of an application of asphaltic emulsion shall be applied over all patch areas as determined by the City Engineer. R23 STREET RESTRIPING: Where street striping is still visible on streets to be excavated, such striping shall be replaced upon completion of permanent repairs. R24 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta road right of way shall be accomplished by a licensed, bonded and insured tree service, and handled safely without interference or hazard to the traveling public. It shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at its new location. Trees to be removed shall be in sections which can be handled safely without interference or hazard to highway traffic. The entire width of the tree stump shall be removed and disposed of so that no debris remains in view of the highway. The stump hole shall be backfilled and thoroughly compacted as specified in the following paragraph. Where is becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500 feet at any one time. Adequate signs, flagmen'and or barricades shall be provided to protect the traveling public at all times. Large holes resulting from tree removal shall be backfilled and compacted to not less than 90 percent or equivalent to the surrounding ground, whichever is the greater compaction as determined by the impact or field method. Compaction tests shall comply with Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated January 1973. SPECIAL CONDITIONS --PERMIT NO. 2519 --- ABC Construction Company, Inc. --- In addition to the standard permit conditions, the following shall apply: 1. All work shall be performed in accordance with the latest edition of the Standard. Specifications For Public Works Construction. 2. Permittee shall be responsible for providing continuous dust and_ erosion control. 3. Streets shall 'be kept clean. They shall be completely cleaned at the end of each working day and more frequently if required.' 4. : Contractor shall comply with the local noise ordinance. Operation; and maintenance of equipment within one half mile of human occupancy shall be performed only during the following time periods:. October 1 st to April 30 May 1 st to September 30-.'' Monday -Friday 7:00 a.m. to 5:30p.m. Saturday 8:OO a.m: to 5:OOp.m. Monday -Friday 6:00 a.m. to 7:OOp.m. Saturday 8:00 a.m. to 5:OOp.m. Work shall be prohibited on legal holidays including Sundays. 5. Permittee/contractor shall assume responsibility for repair of any pavement damage to any public or private street and for any damage to other City streets or facilities as a result of work performed under this permit. 6. Advance warning signs and traffic control shall be installed and maintained in accordance with Cal Trans ''Standards or the Work Area Traffic Control Handbook (WATCH. Manual). It shall be the permittee's responsibility to detour and barricade this site. 7. Street closures shall not be' -permitted. A minimum of one travel lane on paved surface shall be maintained with flagmen at all'times. 8. Prior .to excavating, the permittee shall contact Underground Service Alert at 1(800) 422-4133. 9. Should 'additional work, materials, or modifications of the work be required in order to meet city standards, safety requirements, signage requirements, or to fit actual field conditions, 'the work shall -be performed by the permittee as directed by and to the satisfaction of the City Engineer at no cost to the City of La Quinta. 2. Special Conditions - Permit No. 2519 Page 1 of 2 SPECIAL CONDITIONS ---PERMIT NO. 2519 (continued) 10. All work shall'be coordinated with the City's inspector and others working within the area as directed by and to. the satisfaction of the City 'Engineer. 11. All backfill and subgrade soil shall be compacted to 90% relative dry density, all. ` backfill soil within the top 2' of finish pavement surface shall be compacted to 95% relative dry density, all base material shall be compacted to 95% relative dry density.. 12. All excavations at or near the travel way .shall be backfilled and paved at the end of every workday as directed by and to the satisfaction of the City Engineer for the protection of the traveling public. 13. All landscaping, irrigation, decorative rock, decorative concrete, lighting etc. shall be. replaced to' its original condition. 14. Access and' egress to all local properties shall be maintained at all times., 15. Permanent pavement replacement. section shall be one inch greater than existing. Special Conditions - Permit No. 2519 Page 2 of 2 Project U.S Post Office Parking Lot Job No. Encroachment Permit #2519 Client U.S Post Office Contractor ABC Construction Project Mgr DAIL)WONSTRUCTION REPORT DATE 10/8/96 WEATHER TEMPERATURE WIND HUMIDITY DAY S M T W TH F S Time 9:30 Representing City of La Quinta x To 32 32-50 50-70 70-85 Brite Clear Overcast Rain Snow 1 x Time 9:30 Representing City of La Quinta Representing To 32 32-50 50-70 70-85 85 up x Still Moder High Report No. x Dry Moder Humid x VERAGE FIELD FORCE Name of Contractor ABC Construction Non -Manual Manual 6 Remarks 1 VISITORS Time 9:30 Representing City of La Quinta Representing Remarks M. Fuller EQUIPMENT AT THE SITE Case 850G dozer, Ford'545A skiploader, John Deere 570B blade, roller, water truck CONSTRUCTION ACTIVITIES U.S. post office parking lot construction 9:30 Arrived on site; contractor is placing concrete into curb and gutter forms; forms were inspected and are consistent with Type A-6 standard 6" curb detail; contractor intends to use filler paper at expansion joints at top of curb on each side of driveway approach and through sidewalk to be consistent with existing driveway approaches adjacent to property; Contractor is. using Superior Ready -mix concrete; 560-C-3250, 4" slump; stronger than required by standards. UlStrlbutlon: 1. Project Manager 2. Field Office 3. File 4. Client By: Marcus Fuller F:\pwdept\staff\fuller\inspections\961008a Page I of I Pages Title Assistant Engineer I 7 SUPERIOR READ NCRETE;' L.P. .1508W. M&ION ROAD • ESCONDIDO, CA 92029 ' PHO(619) 343-7460 • (619) 745-0556 Weighed at 25 1 V- S• 72470 Varner Road Thousand Palms, CA 92276 DELIVERY 11940215KET 1 WEIGHMASTER CERTIFICATE I THIS IS TO CERTIFY that the following described( rn.ditywas weighed, measured, or counted byaweighmaster, whosesignature i on this certificate, who is a recognized authority of accuracy, as rescribed by Chapter 7 (commencing with section 12700) of Division 5j of the California Business and Professions Code, . ' administered by the Division of Measurement Standards of the California Department of Food and Agriculture. DATE CUSTOMER NO. ORDER NO.___„__ - _CUSTOMER P.O. OR JOB _NO.. PLANT NO._ DELIVERY TICKET,NO. Wit; 10/ES/136001075 I 76 7002344 ,CUSTOMER NAME - j 11 R C CONSTRUCTION Ctr)MPANY, INC. aSPECIAL INSTRUCTIONS A THE P( Slr OFFICE L ,JOB ADDRESS 53:1��.F7 ,DESIGN ^�I `RO LK�(LBS,)� % y'�ROCK_(LBS.), LBS. SAND �-I— 1LES. CEMENT y(SACt(� WATERY ADD MIX (LBS.)_ D 6F'Lu / l� J j ,WEIGHMASTER ""- �- _TRUCK jy —DRIVER_. j�T� �, �f7J� DEPUTY MAR�yJ;I6OVER CUBIC YARDS TOTAL C/ SCRIP N PRODUCTCODE UNIT PRICE' r TAX AMOUNT j.,kJbO PE 1E t-L(�tPtr G)NL,r_TE _D16r_N .08.00 r In the event of delivery beyond curb line, this company will not assume liability for damage to sidewalk, driveway, utility lines, )'TOTAL THIS'ORDER meters, septic systems, or any other property. Materials hereby sold become property of purchaser at point of origin. The STAND-BY TIME THIS TICKET { purchaser shall in no event accept deliveries of materials not in accord with the agreement of the parties,l but such materials PREVIOUS STAND-BY shall be refused by the purchaser and returned to the seller with a written statement of the reason for the refusal-therk�of,. No cancellation accepted after concrete has been loaded in carrier's trucks at our plant. Customer is to provide for and assuu e responsibility for area or container for clean out of concrete truck chute. Any discharge to watercourses, street gutters or stormdrains is a violation of law. Concrete is a structural building material warranteed only to meet ASTM standards. Some t imperfections and popouts may occur for which supplier is not responsible. I �'� �- -- OUT L UNUSUAL INCIDENT OF NOTE ON THIS DELIVERYPLANT M RECEIVE_ D IN GOOD CONDITION BY: 4.00 SLUMP 70 06: I N y2X •WATER ADDED AT CUSTOMER'S" SIGNATURE CUSTOMER ON JOB - UNLOADING CAUTIONI Cement powder or freshly mixed concrete, grout or mortar may cause skin injury. Avoid REOUES7 GALLONS contact with skin and wash exposed skin areas promptly with water. If any cement powder or mixture • ESTIMATED SLUMPAT UNLOADING DEPART START gets into the eyes, rinse immediately and repeatedly with water and get prompt medical attention. Keep children away from cement powder and all freshly mixed cement products. ANY WATER ADDED TO MIX ON THE JOB WILL BE AT THE PURCHASER'S RISK INCHES •�' . ! _� ARRIVAL -� FINISH;'; NOT RESPONSIBLE FOR ULTIMATE QUALITY OF CONCRETE IF ANY INGREDIENTS ARE ADDED -WAITING AND/OR UNLOADING AFTER LEAVING PLANT. 4 be READY Stand-by and/or dumping timelin excess of minutes per yard will charged. V` TIME HOUR TO UPJLOA'D" '• .i'a+!*r � r� / "- �,. ' DELIVERY DAILIWONSTRUCTION REPORT DATE 10/10/96 WEATHER Project U.S Post Office Parking Lot Job No. Encroachment Permit #2519 TEMPERATURE Client U.S Post Office Contractor ABC Construction WIND Project Mgr HUMIDITY DAY S I M T W I TH F S Time 8:10/4:00 Representing City of La Quinta Representing I x 50-70 70-85 Brite Clear Overcast Rain Snow 1 x Time 8:10/4:00 Representing City of La Quinta Representing To 32 32-50 50-70 70-85 85 up x Still Moder High Report No. x Dry Moder Humid x VERAGE FIELD FORCE Name of Contractor ABC Construction Non -Manual. Manual 6 Remarks 1 VISITORS Time 8:10/4:00 Representing City of La Quinta Representing Remarks M. Fuller EQUIPMENT AT THE SITE Case 850G dozer, Ford 545A skiploader, John Deere 570B blade, roller, water truck CONSTRUCTION ACTIVITIES U.S. post office parking lot construction 8:10 Arrived on site; contractor is placing concrete within parking lot area via a concrete pump truck. (Western Concrete Pumping); expect contractor to install concrete for sidewalk and driveway approach - later this morning; sidewalk.and driveway approach grades were checked for depth, cross -slope, and compaction; 4:00 returned to job site; parking lot and sidewalk area construction are complete; Superior Ready Mix Concrete used; 560-A-3250 concrete delivered; uau wuuvu. 1. rwJccr rvrmmger 2. Field Office 3. File 4. Client F:\pwdept\staff\fuller\inspections\961010a Page I of I Pages By: Marcus Fuller Title Assistant Engineer I SUPERIOR READY MIX CONCRETE, L.P. .,r. 1508 W. MON ROAD • ��SN$IDO, CA 92029 PHO (619) 343-7460 • (61'9).745-0556 b: _ Weighed at 2470 Varner Road + Thousand Palms, CA 92276 DELIVERY TI KET �� 14115 WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a weighmaster, whose signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with section 12700) of Division 5 of the California Business and Professions Code, administered by the Division of Measurement Standards of the California Department of Food and Agriculture. _DATE CUSTOMER_NO. ORDER NO. CUSTOMER P.O. OR JOB NO. PLANT NO., DELIVERY TICKET NO, 13; 1799 70 11211/10/96 0101.075 700 2436 CUSTOME_R_NAME. SPECIAL INSTRUCTIONS__2.". y,-. , .LVt.�_, A D C CONSTRUCTION COMPANY, T NC. JOB ADDRESS JOB 94-4_5-16 51- ;321 AVENIDA BERMUDAS DESIGN ROCK (LBS.), _35"ROCK (LBS.)t .LBS. SAND _ _ LBS. CEMENT _SACK MIX (LBS.)_ J_N 1__WATER_1____,ADO D16PL-1 WEIGHMASTER DRIVER ' _TRUCK DEPUTY 472 DON NOL.L_ CUBIC YARDS TOTAL C/Y RIPTI', PRODUCT CODE UNIT PRICE TAX AMOUNT 9. bf(j J 1.04. bib/ .?abO C'LASS "A" !. ONtCRI::TE V16PL Q { � 1 • � 1 YARDS TOGO 0.001 In the event of delivery beyond curb line, this company will not assume liability for damage to sidewalk, driveway, utility lines, TOTAL THIS ORDER meters, septic systems, or any other property. Materials hereby sold become property of purchaser at point of origin. The STAND-BY TIME THIS TICKET purchaser shall in no event accept deliveries of materials not in accord with the agreement of the parties, but such materials PREVIOUS STAND-BY shall be refused by the purchaser and returned to the -seller with a written statement of the.reason for the refusal thereof. No cancellation accepted after concrete has been loaded in carrier's trucks at our plant. Customer is to provide for and assume responsibility for area or container for clean out of concrete truck chute. Any discharge to watercourses, street gutters or TOTAL AMOUNTI stormdrains is a violation of law. Concrete is a structural building material warranteed only to meet ASTM standards. Some imperfections and popouts may occur for which supplier is not responsible. ,. •r r :+' PLANT OUT -� - 1: UNUSUALINCIDENT OF NOTE ON THIS DELIVERYMAXIMUM %j� 00 !� I .RECEIVED IN GOOD CONDITION BY: l4. SLUMP [[[[ L717 _ I N WATER ADDEDT CU,STOMER'S X D,� 7.} F1 1 il' ` CUSTOMER SIGNATURE - ON JOB / UNLOADING;"'��'" 1 mixed concrete, grout or mortar may cause skin injury. Avoid CAUTIONI Cement powder or freshly, REQUEST GALLONS / contact with skin and wash exposed skin areas promptly with water. If any cement powder or mixture o ESTIMATED SLUMP AT UNLOADING DEPART START gets into the eyes, rinse immediately and repeatedly with water and get prompt medical attention. Keep from cement and all. freshly mixed cement .11 6 _ children away powder products. ANY WATER ADDED TO MIX ON THE JOB WILL BE AT THE PURCHASER'S RISK ; INCHES ( r•.';� ARRIVAL .F �' FINISH - NOT RESPONSIBLE FOR ULTIMATE QUALITY OF CONCRETE IF ANY INGREDIENTS ARE ADDED • WAITING AND/OR UNLOADING AFTER LEAVING PLANT. 11 . +' . i :4 _ i READY , C"�"'*'"'I j�{, t� Stand-by and/or dumping time in excess of 4 minutes per yard will be charged. TIME HOUR TO UNLOAD + DELIVERY I Cu 4' Project U.S Post Office Parking Lot Job No. Encroachment Permit #2519 Client U.S Post Office Contractor ABC Construction Project Mgr DAILY CONSTRUCTION REPORT WEATHER TEMPERATURE HUMIDITY DATE 10/3/96 DA'i S I M I T I W I TH F S Time 3:45 Representing City of La Quinta Representing To 32 X 150-7.0 70-85 Brite Clear Overcast Rain Snow 1 x Time 3:45 Representing City of La Quinta Representing To 32 32-50 150-7.0 70-85 85 up X Still Moder High Report No. x. Dry Moder Humid x VERAGE FIELD FORCE Name of Contractor ABC Construction Non -Manual. Manual 5 Remarks 1 VISITORS Time 3:45 Representing City of La Quinta Representing Remarks M. Fuller EQUIPMENT AT THE SITE Case 850G dozer, Ford 545A skiploader, John Deere 570B blade, roller, water truck CONSTRUCTION ACTIVITIES U.S. post office parking lot construction 3:45 Arrived on site; contractor is preparing subgrade throughout parking lot area and within the right-of- way for the future curb and gutter and sidewalk; contractor is cutting 18" below grade throughout sidewalk and driveway approach area; contractor intends to install 12" of class H base underneath the sidewalk and driveway approach; compaction tests scheduled tomorrow. 2. Field Office 3. File 4. Client F:\pwdept\stafflfuller\inspections\961003c By: Marcus Fuller Page 1 of �_ Pages Title Assistant Engineer I FROM : VACATION INN PRLM DESERT PHONE NO. : 619 340 4441 Oct. 08 1996 12:55PM P2 RS:i4N6 MATERIALS' LABS COMPACTION TESTING (Nuclear Method ASTM D-2922) Test No. Elevation: IlS.Pps Mat'I:A - l s oeatiora: Citi i� !.; . e.Y,, 4, ►nom 1 iJ<-_r Density Count Test No.: Station: Elevation: Mot' I: Location.;. Test'No.. Station: MoistWe=Gorr®ction Mdt'I: Location: Mode & Oeptn �j Station: h Mat'I: Location: Wet Den4y,-FgF' )31. 1 Dry Density; Pi✓F % Moisture ` 'St6ndard'•Derrs, (MAX.) 3 •SpecifiedDens. � �'' �js ... .. . Test No.: fl Station: _ ^'' .;L ti Elevation:• Test NO.: Location: Test No,: Station: Elevation: Mat'I: Station: Elevation: Mat'I: %�1,.'n±„'�.5�;• �4, "gyp r�',�'�l+y`L:N"J i�vffj 'l•,.,'i'J!>�a�Fnr` y��i` .. . PROJli&Nd > ..•...e. '� r,,,. 'CLIENT:' DATE: Ib' C TECHNICIAN: x 1.. Density -Std.: Moisture Std.: FORn NO. 1!0 r pia P1YNa19 7M/L185 Elevation: IlS.Pps Mat'I:A - l s oeatiora: Citi i� !.; . e.Y,, 4, ►nom 1 iJ<-_r Test No.: Station: Elevation: Mot' I: Location.;. Test'No.. Station: Elevation: Mdt'I: Location: ' Test No.; Station: Elevation: Mat'I: Location: Test NO.: Location: Test No,: Station: Elevation: Mat'I: Station: Elevation: Mat'I: %�1,.'n±„'�.5�;• �4, "gyp r�',�'�l+y`L:N"J i�vffj 'l•,.,'i'J!>�a�Fnr` y��i` .. . PROJli&Nd > ..•...e. '� r,,,. 'CLIENT:' DATE: Ib' C TECHNICIAN: x 1.. Density -Std.: Moisture Std.: FORn NO. 1!0 r pia P1YNa19 7M/L185 FROM : VACATION'INN PALM'DESERT •'OUT.'FiL.4N0�� PHONE NO. : 619 340 4441 PROJECT CLIENT -.H &C Smr�-o�� �•ca -_ TECHNICIAN DAILY REPORT Oct. 06 1996 12:55PM P3 nes �r.ir�ntF il��!Ar+1D' AILS ES" .. PROJECT NO.: NON-CONFORMANCE AREAS: • • -:- ;�:s>M.. ;., :r' ,...T, .SIG •-v,��.��<x,_ PATE: o SIGNATURE OF TECHNICIAN; ~''""�'.•— • � Fa.a No.,6t•Ptoia Priatan ]C4.7J6! .::T Met:-�. •yup ••...wi .•�:'t:-.� ':1:..._• �..; .:.::::.. ..... -T-..•�' R�:-PR •LIE E TATiVE SUPERINTENDENT; FOREMAIN1:- TIME IN: % =� TIME OUT: LUNCH/BREAKS/ETC.: MILEAGE: ,.:-VRo RESS: (AREAS WORKED, COMPLETED ETC -1 A a �. c hAe� �' 1 ^1 ,A 4mL- ; :S iK � J gyp'• n -pv AAC, AA r r NON-CONFORMANCE AREAS: • • -:- ;�:s>M.. ;., :r' ,...T, .SIG •-v,��.��<x,_ PATE: o SIGNATURE OF TECHNICIAN; ~''""�'.•— • � Fa.a No.,6t•Ptoia Priatan ]C4.7J6! ':1/05/1994 1'1:;,:4'9 5197777155 CITY OF LA QUINTA�"'� PAGE 02 Small Scale Construction/Demolition Pr oje 5 Acre ss)) Fugitive Dust (PM10) Mitigation a Date:. ; g�20 9 �. Jurisdiction: L+ ov"% ,,�} File #: cUlo -o 2 -� Part 11 - Project InfQ.rmatiQn 'ot 9& -,Q n 4 Please ',provide the information below as completely as possible even if it has already been provided on other forms related to this project Failure to provide complete information or proviuibri of inaccurate information may delay the processing of your Fugitive ,)Dust (PM10) Mitig rayon Plan (Plan). It is recommended that you submit your Plan concurrent with your graamp o. demolition permit application. Project proponent: Address: Day phone number- o13 Emergency phone number: {x, Grading contractor (Contact Person): oE, A,11� �� t Address: A. 5 ArI ro��oN �, 2� `v C.I. el 5� Day p.�one number: c1pc� 6f6+b-310 Emergency phone number. � Constc"I ►.rction site street address: ' \l ,t S w.pN A r LA 01N+A, Construction site location: (Please include an &5x 11 location map) r� Construction site assessor's parcel number (Tract #): Parcel ,(Tract) size: p, g Z Acres or Square feet 3 j,17 Anticfoated date of physical project initiation: $ oZ l 3 Anticipated date of project completion: „b Amici ited costs for dust suppression: (Attachment B - Must also be completed and mailed to the appropriate address when constw-'tion activities have been completed) , •/t�°N6v3-o80 -oiy O ECOVE AUG 2 0 1996 K� CATV of 111QiJii A PLANNNGDEPAMENT,: I All pr�;�ects greater than one half (1/2) acre are also subject to SCAQMD Rules 403 and 4 ,. 1. Y 4 01/05/1994 17:29 6197777155 CITY OF LA QUINTA ' PAGE 03 From Me inventory of fugitive dust control measures provided in Attachment A, please indicate which measures are to be implemented during the project by placing the letter beneath the fugitive' dust sources listed below. Please indicate at which phase the measure will be implemented, either at Rough Grading (RG), Finish Grading (FG), or Fina' Construction (FC). Demolition projects should only indicate measures in the Rough Grading (RG) column. After indicating what measures are to be implemented complete the "Details" section by describing how and when the measures are to be implemented r. IMAM 1 Details (e.Q_ Imageecv of application n■�••�yet and trpe of dust control Implements- •<< t `` Please be as soecmfie as possible) . Unpav "tRoads F 7 stormi piles o ES Paved Road Mmck-out f�7 k j 01/05/1994 17:;29, im 5197777155 Please he as specific as possible) Land Clearing or Earth -Moving CITY OF LA QUINTA t +e' Disturbed surface Areas' PAGE 04 i of- T� F. . Part -3 - As eeeem Bent s F i I certify that the information contained in this Fugitive Dust (PM 10) Mitigation Plan is true and accurate and that all measures. specified in Part 2 will be implemented during project construction. I authorize the City of La Qu i nta to enter the above mentiAned property for inspection and/or abatement purposes, and I agree to hold harmless the City and its representatives from liability for, any actions related to this project. I also agree to complete the record-keeping requirements included herein as Attachment B once the project?has been completed. HH or ve I have read the conditions of the Fugitive Dust (PM10) Mitigation Plan and the owner has authorized the implementation of all its provisions throughout project buildout. 4 not the same as above) A-0 a 61/65/1994 1:,,29 6197777155 CITY OF LA QUINTA ! 4 PAGE 05 For City Use Only Based;on all of the provisions contained in this Fugitive Dust (PM10) Mitigation Plan the Plan is: t, Approved Conditionally, approved (Conditions specified below) Denied (Explanation. attached) Signature of City Representative (Date) ` 77te following conditions of approval have been added. to the Plan by staff in order to ensure an adeiluate level of fugitive dost controL �fP 4 �lrJ� �-T-l�lt'�s� C.9.✓YJ 1 T7 a.✓S . s 4;1 1. I have read the above conditions of the Fugitive Dust (PM 10) Mitigation Plan and I agree to implement all provisions at the concentrations and frequencies identified. K \ je or uwner or. A il �r i- d t; h• ce J! V3y .5 s 4;1 1. I have read the above conditions of the Fugitive Dust (PM 10) Mitigation Plan and I agree to implement all provisions at the concentrations and frequencies identified. K \ je or uwner or. A il �r i- d t; h• ce CONDITIONS FOR FDCP APPLICATION: FDCP 96-6; BOSTON MARKET 78-752 HWY. 111; CUP 96-027; .82 AC.' 1. Applicant shall comply with all control measures as set forth in the approved- FDCP application, which shall include the following additional measures. 2. The full amount of security furnished for the approved FDCP ($2,000.00) shall be available to the City for any measure(s) deemed necessary by the City to achieve adequate dust.control, whether or not -such additional measures are included by the applicant for this application. Security shall be submitted prior to release of the grading/site disturbance permit. 3. Applicant shall. submit copies of all records/invoices related to cost accounting for the dust .control measures assumed during grading construction. Said records shall be submitted within 30 days after completion of all dust control measures as outlined in the plan, including any measures made part of the plan as a condition to its approval. Security may be withheld pending submittal of this information. All such invoices shall be provided, along with the required completion of the PM10 Program Report Form, which .can be obtained from the Public Works or Community Development Departments. I 4. Track -out or other accumulations of soil material(s) shall be prevented onto -any paved public streets outside of the areas proposed for grading. Any track -out or other accumulation of soil material(s) onto ANY paved areas, whether public or private, shall be wet -swept or water flushed by the end of the work day, and shall be kept damp during construction operation hours until so removed. No blowers or other dry sweep methods are permitted. 5. Any soils associated with import/export activities shall be sufficiently. stabilized (watered down) so as not to create dust during loading, transport and spreading. Minimum freeboard shall be as established by the Public Works Department. On and off-site storage piles shall either be stabilized, covered or watered down at sufficient intervals in order to maintain a sufficient moisture content at all times. 6. Enforcement of these conditions shall be. at the discretion of the assigned grading inspector, who shall monitor and field verify that the spirit and intent of the FDCP and its attached conditions are being complied with. Adjustments to application frequencies;. quantities and other aspects of this FDCP may be made by the inspector, at his/her discretion, in order to assure compliance. 7. Employee and other parking shall not be permitted on any unpaved area(s). •01/05/1994 17:29 6197777155 CITY OF LA QUINTA PAGE 06 • y t ATTACHMENT A - REASONABLY AVAILABLE CONTROL MEASURES The left columncontains the sources of fugitive dust which are intended for emission control under The Ciiy's dust control ordinance. The two right columns contain an inventory and description of reasonably available fugitive dust control measures for eacha of the sources. Please `use this information as a guide when preparing a Fugitive Dust (PM1 D) Mitigation Plan. . (Sots No) Reasonably Available Sou control Measu Commen (1) Iand :� Clearidg/ (A) Watering o Application of water by means of truck, hoses and/ or. sprinklers prior to any land clearing or earth Earth. movement will increase the moisture content thereby movl*4, increasing stability of material o Once the initial land clearing/earth movement activitics.are complete, a second round of watering can generate a thin ,• crust which stabilizes the disturbed.surface areas provided that it is not disturbed o Security fencing can be used to prevent .unwanted future disturbances of sites where a surface crust has been created (B) Chemical stabilization o Only effective in areas which are not subject to daily disturbances o Vendors can supply information on product application and required concentrations r; (C) Wind fencing o Three to five foot barriers adjacent to roadways or urban areas can be effective in reducing the amount of wind blown Y= r material leaving a site 't o Should be used in conjunction with other treasures +, (D) Cover haul vehicles o Entire surface area should be covered once vehicle is full .a�rY (E) Wheel washers o Should be placed where vehicles exit unpaved areas onto paved areas o System can be adjusted to spray entire vehicle, including'stored bulk material in haul vehicles Unpaved (F) Paving o Requires street sweeping/cleaning if subject to.material Roads accumulation. 5 �x a p Via? (G) Chemical Stabilization. o Vendors can supply information as to application methods and w{P 1, concentrations yIj o Not recommended for roads with high volumes or those used for d heavy equipment (I) Watering o In sufficient quantities to keep surface moist o Required application frequency will vary accordingrto soil type, weather conditions, and vehicular use 01/05/1994 17:rr29 .6137777155 CITY OF LA QUINTA PAGE 07 . i (Source No) Reasonably Available Souk ;, Control Measures Unpaved (1) Reduce speed limits Roads (ConVd) (J) Reduce vehicle trips o 15 mile per hour maximum Access restriction or redirecting traffic to paved roads in order to reduce vehicle trips by a minimum of 60 percent _......._.!----------------------- _—.._..---.... .... ,------..... ..-._..-..... ............................. :................... (3) s Storage(K) Wind sheltering o Choices include silos or enclosures Piles . ;> o Enclosures should consist of three sided barriers equal to height of F; material with no more than SO percent porosity ' (L) Wet suppression o Application methods include: spray bars, hoses and water trucks o Frequency of application will vary on site specific conditions a: (M) Chemical suppression o Best for use on storage piles subject to infrequent disturbances (l) Altering loadin/loadout .o Confine loadin/loadout procedures to leeward (downwind) side procedures of the material o Most effective when used in conjunction with wind sheltering ?i (0). Coverings o Tarps, plastic, or other material can be.used as tewporary . coverings o When used, these should be anchored to prevent wind from removing coverings ._...__ . ;,- -------------------------------------------------------------------------------------------------------- i .................... (d) Paved (P) Wheel washers o Should be placed where vehicles exit unpaved arcaa onto paved Road areas Track-ouil o System can be adjusted to spray entire vehicle, incl,�ding stored bulk material in haul vehicles i (Q) Sweep/clean roadways o Either sweeping or water flushing may bc.used j. 4 (R) Cover haul vehicles o Entire surface area should be covered once vehicle is full _.--------................................................. -................................. =-----------------------•=------------------- Disturbed (S) Chemical stabilisation o Vendors can supply information on methods for application and Areas/ required concentrations Inactive �,` Constructlon Sites (T) Watering o Would require frequent applications unless a crust can be developed over the site (U) Wind fencing o Three to five foot barriers adjacent to roadways or urban areas can be effective in reducing the amount of wind blown material leaving a site o Should be used in conjunction with other measures+ (V) Vegetation o Establish as quickly as possible when active operations have i establishment ceased Yo ;: t Use of drought tolerant, native vegetation is encouraged 01/05/1994 17:)29 .6137777155 • a CITY OF LA QUINTA PAGE 08 ATTACHMENT B • COST INFORMATION Small Scale Construction Demolition Projects (5 acres or Less) Fugitive Dust (PM10) Mitigation Plan R Date.-` G qi Project proponent: Address: Jurisdiction: C.t-- Ow,." Project File pZ' 0Z-4 Day phone number. Emergency phone number: I A In they space provided below please list file costs associated with implementation of all dust control measures. 77:e information provided below should include all implementation costs (including labor) for dust control throughout the project. Not all measures listed below will apply co all projects. sr After pro'ect completion these records shall be transmitted to the Jurisdiction where the gnzdingldemolition permit was attained and to the Coachella Valley Association of Governments (CVAG) at the address provided below. PM 10 Cost Monitoring Coachella Valley Association of Governments 73-710 Fred Waring Drive, Suite 200 Palm Desert, CA 92260 di 7� 01/05/1994 11:29 6197777155 - CITY OF LA QUINTA PAGE -09 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 (619) -777-7000 May 1019941' FAX (619) 777-7101 .b L y� 1 TO: ALL ACTIVE AND PROSPECTIVE DEVELOPERS/BUILDERS r, IN THE CITY OF LA QUINTA ' RE: PM 10 PROGRAM REPORTING REQUIREMENTS FOR FUGITIVE DUST CONTROL PLANS eta Dear DevelopdCr/Builder: The CoachelWa Valley PM 10 Program has been in its implementation phase since December, 1992. Among the re,' 'uired control measures was the enactment by Valley cities of dust control ordinances which require ,builders to implement dust control actions during construction, demolition and paving activities. In conjunction with City staff members, we ask your help with the reporting `requirements. A significant aspect of the PM 10 Program is the need to report statistical information to the Federal Environmental Protection Agency via the South Coast AQMD and the State of California Air Resources Board. In response to this requirement, a Dust Control Reporting Form has been created, a copy of which is attached. It is requested that if any project, developers have amounts to report for any PM 10 mitigation, these forms must be filled out. This form is intended to supplement. Attachment "B" of the Fugitive Dustontrol Plan by providing specific cost figures related only to dust control measures. The South Coa"st AQMD has requested that the retroactive operative date be Janua'ryi 1, 1993, for .reporting uses. This means that each jurisdiction is requesteto review projects since that date !m g P t'Po,.. d where PM 10 c"ontrol measure expenses have been incurred by developers, whether or not they have been incorporated as part of a Dust Control Plan, and forward this data to CVAG as soon' as practical. 4 ; Your cooperation. in completing these forms as part of the grading permit procedure will help assure that the Coachella Valley and the development community. as a whole receive deserved credit for the . effort to attain Clean Air Act standards for PM 10. Very truly d-RRY 'HE Planning .& JH: WHN:bjs Attachment lopment Director LT1twN.011 50 MAILING ADDRESS - P.O. BOX 14 - LA QUINTA. CALIFORNIA 92253 y v. 01/05/1994 17:129 6197777155 CITY OF LA QUINTA PAGE 10 a PM10 Program Report Form �5`T7-� g�2�/9� A, Z."'' 08 i ftelem aLeloper Name: liars 'ol�l Addressa ,j22 Lr_ho r 9w\ 9Acki Phone: 114 Sg I - j Psojeat Site I I I (RQo►,;AA 8,A+ Si ibr. P=jOct Titlo Gco5+01Ib NNA" i i Address: N£Cw%3Ec- ' Tragi No.: Acreage: GrMA-1 S:ibCCatSaCfAr (if dif!Grant ) Hams: Address:'. Phon®: PID1S$S7 t' us HOS► It so *hov:maay? Type of Development/Project: c�amercyal� Single Family Mmlti lamily_ Demolition Ot-her Date of ProiecC/Phase Start-Qv:$oil Date o: Project/Phase Camoleticn: S a6 II. COST n"=U=ZOB If actual coats are not available, please estimate to the. best of your, ability. 1. SiATffit:. Amount: Total Cost: 2. &QST COSTS: i. WatSW Track: Number on Site: Total Cost.- Sourly Rate: Sours: 1 S. Stre,c Sweeper: Number on Site: Total Cast: x�a Sourly Rata: ? Sours 2 (� z Cb Temprararp Irrigatio0: Tota'_ Coat: D . Wind Teat in9= Licear Pt.: Total Cost: cost/pt.: Z. Chemical/Material Stabilization: Total casts Sq. { Cost per Sq. Ft. y. Pegee.;Ltion coat: materials— Total. cost:��_ Baiatenance: o. otbaar` i Typ Total Cost: Bourly Rat—'—L. -3. LaBcR mt�,-T: Bourly Rata: a O Total Cast: Hours: �.i 44.- BD197' �''TS= Total Case: ; III. TOT!!►L 0=TS s add items 1 - a for total cost. TOTAL cx=.- 109c PL. ZA Z RBTORN FORM AT CMOL2-ZON OF PROJECT CR ?LEAS8 OR ANNUALLY FROM T=" I DATS OF ?RWzCT/?QaSg STAR- Up. ,