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Permit No C G\.Lt^OO 220
CITY OF CAMPBELL ENCROACHMENT PERMIT
2
DEPT.OF PUBLIC WORKS (for working within the public X-Ref.File
70 North First Street right-of-way) Application Date NODerrlbet 21,2014.
Campbell,CA 95008 Application Expiration Date
(408)866-2150 Issued I2 C4 Ail-
Ph. APN 305-43-OO}•
Fx. (408)376-0958 Permit Expiration Date it/2-Lt 115
APPLICATION-Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code,Section 11.04. (Application expires in six
(6) months if the permit is not issued. Application Fee is non-refundable.)
A. Work Address or Tract No.: 507 Rincon Avenue.Campbell,CA 95008.
Utility Trench Location: From the middle of street to property line.Trench will be 40'long,3'wide,5-10'deep.
B. Nature of Work: Replace damaged 4"VCP lateral with new 4"PVC lateral and install new P.L.cleanout
C. Attach four(4)copies of an engineered plan showing the location and extent of the work,and four(4)copies of the preliminary Engineer's
Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. When approved
by the City Engineer,said plan becomes a part of this permit.
D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction;the General Permit Conditions
listed on the reverse side;and the Special Provisions for this permit,listed below. Failure to abide by these conditions and provisions may result
in job shutdown and/or forfeiture of Faithful Performance Sureties and cash deposits. (See General Permit Conditions 1 and 2.)
E. The Contractor must have this permit and approved plans at the site and must notify the Public Works Department at least two days before
starting work. Notice must be given to Public Works at least 24 hours before restarting any work.
Name of Applicant: Jorge L.Picado(On behalf of West Valley Sanitation District). Telephone: (408)385-3009
Address: 100 E.Sunnyoaks Avenue.Campbell,California 95008.
E-Mail Address: jpicado@westvalleysan.org 24-HOUR EMERGENCY PHONE NUMBER: (408)828-1949
Is this work being done by the property owners at their own residence? r YES r NO
The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell,its officers,agents,and employees free,safe
and harmless from any claim or demand for damages resulting from the work covered by this permit.
The Applicant/Permittee hereby acknowledges that they have read and understand both the front and back of this permit and they will inform their
contractor(s) of the information. Applicant is advised that upon issuance of this permit, property owner, or property owner's successors, shall be
responsible for any and all damages arising out of the condition of any privet mprovements in the public right-of-way.
Accepted: Tor ye Pithdo �O behalf of W V.S.P) It.9.4eadB'. Novembef Ai, 2414-
(Applicant Permittee) (sign) Date
Pac,I'c U/ldergrofrnd Cor Irvc'ion bill May-%i November-2i, 2DI¢
(Contractor) (Print Name) Date
SPECIAL PROVISIONS;
1. Street shall not be open cut for underground installations. Minimum cuts may be allowed for connections or exploration holes. Such cuts may be
specifically approved by the Inspector prior to cutting.
2. Pavement may be cut for underground installations and must be restored in accordance with the Standard Details Trench Restoration Method
"A",unless otherwise approved by the Engineer.
3. Work to be staked by a licensed Land Surveyor or Civil Engineer and two(2)copies of the cut sheets sent to the Public Works Department
before starting work.
4. Per Section 4216 of the Government Code this permit is not valid for excavations until Underground Service Alert(USA)has been notified and
the inquiry identification number has been entered hereon. USA Phone: 1-800-227-2600. USA TICKET NO.
5. Prior to any work,the property owner shall execute an Agreement for Private Improvements in the Public Right-of-Way,which shall be recorded.
6. Public Notification Requirements:
7.
SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES AMOUNT RECEIPT fYQ.
PERMIT APPLICATION FEE $ 345 5
PLAN CHECK DEPOSIT $
SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $
CONSTRUCTION CASH DEPOSIT $
PLAN CHECK&INSPECTION FEE $ jJ�}t-
EMERGENCY PERMIT FEE $ /
APPROVED FOR ISSUANCE V I Z4 l(1
For City Engineer Date
Permit Expires 12 Months After Date of Issuance
GENERAL PERMIT CONDITIONS
. A Construction Cash Deposit is required. Charges will be made against this deposit if there is an emergency call-out,overtime inspection or when City
ordered barricading is required. Any such costs in excess of the deposit will be billed to the Permittee.
2. A one-year maintenance period and surety are required. Such period will begin on date of written acceptance by the City.
3. Refund or the cash deposit balance and refund or cancellation of the Faithful Performance Surety will be initiated by the written acceptance of the work
by the City.
4. Submit project schedule 10(ten)days prior to proposed start of work.Special provisions may be required for work within City facilities and
downtown Campbell.
5. The Permittee must request in writing a final inspection and acceptance of the work upon completion. Acceptance by the City will be made in writing
to the Permittee.
6. Maintain safe pedestrian and vehicular crossings and free access to private driveways,bus stops,fire hydrants,and water valves.
7. A Construction Traffic Control Plan and a Construction Schedule are required for all lane closures,detours,and street closures.This plan must be
reviewed and approved prior to any lane closures.
8. A Construction Traffic Control Plan shall conform to the Caltrans Manual of Traffic Controls for Construction and Maintenance Work Zones,dated
1990,available at Caltrans.Traffic control equipment shall Include Type II flashing arrow signs if required.
9. Replace as directed by the City Engineer any damaged or removed improvements in accordance with City Standards and Specifications at the sole
expense of the Permittee.
10. Sawcut for all PCC or AC removals. All PCC removals shall be to the nearest scoremark and shall be doweled to existing improvements.
11. Prior approval of inspector is required for any work done after normal working hours,on weekends or holidays and may require reimbursement of
inspection costs at the current overtime rate.
12. Adequate signing and barricading is required on the job site. Failure to provide such signing and barricading may result in the City's providing signing
and barricades and charging the cost(including all labor and materials)against the cash deposit.
13. Compaction testing of subgrade,base rock,and asphalt concrete by Permittee is required unless otherwise stated by the City Engineer.
14. The Contractor or Permittee will have a supervisory representative available for contact on the project at all times during construction. Contractor or
Permittee shall provide a phone number at which they can be contacted outside the hours of 8:00 a.m.to 4:00 p.m.
15. No storage of materials or equipment will be allowed near the edge of pavement,the traveled way,or within the shoulderline which would create a
hazardous condition to the public.
16. This permit shall not be construed as authorization for excavation and grading on private property adjacent to the work or any other work for which a
separate permit may be required,nor does it relieve the Permittee of any obligation to obtain any other permit required by law.
17. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency.
18. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon.
19. Call back(call out)due to emeregencies regarding this permit shall be at the current overtime rate with a three(3)hour minimum charge per
occurrence.
20. Pursuant to Chapter 14.02 of the Campbell Municipal Code,applicant shall not cause to be discharged any material into the municipal storm drain
system other than storm water. Applicant shall adhere to the BEST MANAGEMENT PRACTICES established by the Santa Clara Valley Urban Runoff
Pollution Prevention Program.
21. If the public interest requires a modification of,or a departure from the plans and specifications,the City shall have the authority to require or approve
any modification or departure and to specify the manner in which the same is to be made for City-owned or maintained facilities.
22. Permitttee must provide advance notification to all parties that may be affected by the permit activities. Notification shall be reviewed by the City prior
to distribution and include dates of work and a contact name and phone number.
Applicant shall be responsible for ensuring that all those providing services under the applicant are aware and understand all of the above conditions.
1 r9e Picado Con behalf O1, (.deaf Vmlle. SaniValion 11is*rr'c1') . November -2), 20/4
Applicant Date:
Ppieaia Ltnderymund Congo/efion (Bi// Marrow) Alovemker.21, 2014.
Contractor (Print Name) Date:
J:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf
Rev.02/14
West Valley Sanitation District
2014-2015 Sanitary Sewer Repairs
WORK ORDER NO. 8
Issued To: Pacific Underground Inc. Issue Date: November 21, 2014
Issued By: West Valley Sanitation District
Type and Location of Repair: ❑ Main 0 Lateral ❑ Both O Other
Various repairs within Los Gatos, Saratoga, and Campbell.
Street Address/City
(Provide scope of work and map(s) for work ordered.
If multiple locations or routine repair, attach list)
Callout Urgency: O High Emergency (4 Hr. response)
O Emergency (24 Hr response)
❑ Urgent (96 Hr response)
El Routine (14 calendar days)
WO Issued By: Alan Kam Time Issued: 10:30 a.m. November 21, 2014
WO Issued To: Bill Marrow Time/Date On-site:
Was Contractor's arrival time on-site within required response? Ii Yes O No
Basis for Reimbursement: (Show calculation for each repair location)
Replace each of the following 9 sewer laterals:
1. 18610 Harleigh Dr. Saratoga. 35' long, 6' deep 4" PVC lateral in a low traffic area.
2. 18640 Harleigh Dr. Saratoga. 35' long, 7' deep 4" PVC lateral in a low traffic area.
3. 20289 La Paloma Av. Saratoga. 42' long, 4' deep 4" PVC lateral in a low traffic area.
4. 413 Monterey Av. Los Gatos. 45' long, 6' deep 6" PVC lateral in a moderate traffic area
5. 830/832 Pollard Rd. Los Gatos. 41' long, 9' deep 4" PVC lateral in a moderate traffic area
6. 507 Rincon Av. Campbell. 42' long, 10' deep 4" PVC lateral in a moderate traffic area
7. 14866 Union Av. San Jose. 13' long, 6' deep 4" PVC lateral in a low traffic area
8. 13902 Upper Hill Rd. Saratoga. 35' long, 6' deep 4" PVC lateral in a low traffic area
9. 15150 Winchester Blvd. Los Gatos. 82' long, 9' deep 4" HDPE lateral in a moderate traffic area
The District still has to apply for the encroachment permits. New laterals will be compensated with Bid
Items 12, 13, 14, and 15. New connections to the main will be compensated with Bid Items 22 and
23. New cleanouts will be compensated with Bid Item "E". Pipe bursting laterals will be compensated
under "Time and Materials" basis.
507 W. RINCON AVENUE
LATERAL LOCATION: Between upstream manhole 3-007-07and the
downstream manhole 3-007-28.
CITY LOCATION: Campbell, California.
LATERAL DESCRIPTION: 42 feet long, 4" VCP and Cast Iron lateral
and 4" ABS cleanout.
The lateral connection to the main is 80 feet from the downstream
manhole. The lateral connects to a 10" VCP sewer mainline. The lateral is
10.5 feet deep at the connection to the main. The lateral was televised on
March 2010.
From the TV report we know the cleanout is 3.2 feet deep. The lateral
changes material from 4" ABS to Cast Iron right after the cleanout Wye. The
Cast Iron section of pipe is highly corroded. There is a moderate offset pipe
joint on the cast iron pipe located 9 feet if measured from the cleanout plug
(or, 5.8 feet if measured from the cleanout Wye). The lateral has a possibly
abandoned Wye connection 12 feet if measured from the cleanout plug (or,
8.8 feet if measured from the cleanout Wye). The pipe changes from 4" Cast
Iron to VCP material 14 feet if measured from the cleanout plug (or, 10.8
feet if measured from the cleanout Wye). The 4" VCP section of the lateral
has a severe offset pipe joint 18 feet if measured from the cleanout plug, (or,
14.8 feet if measured from the cleanout Wye). There is another offset pipe
joint 22 feet if measured from the cleanout plug, (or, 18.8 feet if measured
from the cleanout Wye). The lateral dives with 45 degrees elbow
approximately 32 feet if measured from the cleanout plug, (or, 28.8 feet if
measured from the cleanout Wye). The lateral has a last offset pipe joint just
before it reaches the mainline 41 feet if measured from the cleanout plug,
(or, 37.8 feet if measured from the cleanout Wye).
PROBLEMS:
1. The lateral changes material from 4" ABS to Cast Iron right after the
cleanout Wye.
2. The Cast Iron section of pipe is highly corroded.
3. Moderate offset pipe joint on the cast iron pipe located 9 feet if
measured from the cleanout plug (or, 5.8 feet if measured from the
cleanout Wye).
4. Possibly abandoned Wye connection 12 feet if measured from the
cleanout plug(or, 8.8 feet if measured from the cleanout Wye).
5. Pipe changes from 4" Cast Iron to VCP material 14 feet if measured
from the cleanout plug (or, 10.8 feet if measured from the cleanout
Wye).
6. The 4" VCP section of the lateral has a severe offset pipe joint 18 feet
if measured from the cleanout plug, (or, 14.8 feet if measured from
the cleanout Wye).
7. There is another offset pipe joint 22 feet if measured from the
cleanout plug, (or, 18.8 feet if measured from the cleanout Wye).
8. The lateral dives with 45 degrees elbow approximately 32 feet if
measured from the cleanout plug, (or, 28.8 feet if measured from the
cleanout Wye).
9. Moderate offset pipe joint just before it reaches the mainline 41 feet if
measured from the cleanout plug, (or, 37.8 feet if measured from the
cleanout Wye).
SUGGESTED REPAIR:
Since there are too many problems and stoppages on the 42 feet long
lateral, install a new 4" lateral and cleanout. Use 4" PVC SDR-26 pipe
and fittings. Lateral must be 5 feet deep at the cleanout. Install a new
G-5 cleanout box with metal lid. Cover must read "SEWER".
Reuse the mainline 10" by 4" Wye, or Install a new 4" diameter tap-
tite. Use only non-recycled 3/4" crushed rock for pipe bedding.
Backfill the rest of the trench with material approved on the
encroachment permit. Reconnect the lateral coming from the house
with two 4" PVC — 45 degrees elbows.
Note:
Distances provided on this report are approximate. Contractor is
responsible for accurately locating the area of repair.
® ".' 1 { . t 100 or r2OO15-��0 0625'..-.�.�w
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-•i :,r.{.,�, "- + 507 W Rincon Ave X if 491 1 'S 's,. 3'007-02
t7T/ x 521 Y.
��� l - ��
„n i'", „...„94s531,. Al QQ✓� � �; OdVCP L
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W 'R ` 3 007-03 dir :< t �r °_ Libir �a1�1�P.,. 1i' Z, x
3_007.x32 27�'11
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P Install new 4"PVC lateral and cleanout. +
Annotation Reuse mainline Wye,or install new t r
I Legend (Manhole 4) Y *
4-014-04 4"diameter tap-tile.Use one single slope 9 ,, 1 West Valley Sanitation District ? J
between the cleanout and the mainline 3,, ;. Fiscal Year 2014-2015 Sewer Repair Project fit.t
D p h +41
,\ ' rn * Work Order No.8,Location
�0*11 - -' t ,I.. Lateral Replacement at 507 W.Rincon Ave.
1.0•A / M; 4 z b �ti � Campbell,California 95008
P.
fa.o
135
►�},,,,r„ t PN 305-43-007
Lateral Graphic Report.of 13896 For wvsd
Main Line
Job Number 10-0378 Contract Media# Setup 11
Operator PANELLI Van Ref 59 Surveyed On 03/17/2010
Street 507 W.RINCON AVE. City CAMPBELL
Survey Purpose IN HOUSE REQUEST
Comments
Surface Weather Dry Direction Downstream
Use Sanitary Length 43.0 Ft Entry Point Clean Out
Shape Size by 4 ins Condition
Material ABS TRUSS Num Taps 0 Tap Loc 0 Pipe Det
Lining Year Laid Joint Type I Result
Q 1 t'or E .P' •t�
0.0 Ft
Neater level 0
0 Ft
3.2 Ft =>"T h.c: : TG WYE r'COHNLir"-ION
3.5 ff-. Maferiat, chcncjes +v Cas+ Iron
9.0 Ft Offset Joint i1
t
12.0 Ft Wye Service 12 o'clock
1/1:O
K -n V
O
14.0 Ft MATERIAL CHANGE [TO VCP]
18.0 Ft Offset Joint [SEVERE]
22.0 Ft Offset Joint [POSSIBLE CRACKED JOINT]
32 .+. La-leraG dives of 45°ankle.
43 Ft
�-� 41 .f+ orke+ ]vin+ Ernvderafe
43.0 Ft .
VWSD Phone:408-378-2407 Fax:408-364-1821 Page 1 of 1
Lateral Survey pictures of 13896 for wvsd
Work Order 10-0378 Media Num Surveyed On 03/17/2010 Direction Downstream Setup 11
Street Name 507 W,RINCON AVE. City Name CAMPBELL ZIP Code Weather Dry
Location Street Main Line
Date: 3/17/2010 10:03 12 AM `.- Date: 3/17/2010 10'0438 AM
Distance: 9.0 Ft Distance: 18.0 Ft
Obs: Offset Joint Obs: Offset Joint
8,4 , ,Ft i7-y`
Comments: Comments:
, ?
SEVERE
r
i '
Date: 3/17/2010 10'0531 AM
Distance: 22.0 Ft .,firt
Obs: Offset Joint
fix.
,I 2, Ft
Comments:
POSSIBLE CRACKED
JOINT
WVSD 'ne:408-378-2407 Fax:408-364-1821
WVSD Lateral Maintenance History 11/7/2014
1:04:37 PM
Structure Number 13896
Address 507 W RINCON AVE Operation Power Rod
Service Status Repair Needed Crew Size None
Structure Type Conforming Spec Cleaning Schedule 1 Man
Maintenance History
Date Operation Lbs Debris Debris Severity Number
10/18/2014 Power Rod- Lateral 4 Roots Stoppage 14-1668
9/4/2013 Power Rod- Lateral 1 Roots Stoppage 13-1393
2/28/2013 Power Rod- Lateral 2 Roots Stoppage 13-0395
6/5/2012 Power Rod- Lateral 2 Roots Stoppage 12-0783
3/17/2010 CCTV-Lateral 0 Clean Clear 10-0378
3/14/2010 Power Rod- Lateral 1 Paper or Rags Stoppage 10-0372
9/24/2009 Power Rod- Lateral 5 Roots Mild 09-1242
3/31/2007 Power Rod- Lateral 5 Roots Stoppage 07-0491
8/11/2006 Power Rod- Lateral 4 Paper/Rags Stoppage 06-1021
8128/2005 Power Rod- Lateral 15 Paper/Rags Stoppage 05-0877
WVSD Lateral Work History Page: 1
MetroScan/Santa Clara(CA)
Owner :Pinschmidt Daniel B&Virginia C Trustee Parcel :305 43 007
CoOwner Bldg Id : 1
Site : 507 W Rincon Ave Campbell 95008 Land :$424,627
Mail : 114 Edelen Ave Los Gatos Ca 95030 Struct :$283,084
Xfered : 12/20/2007 Doc# : 19688434 _ Other .
Price Deed :Grant Deed Total :$707,711
LoanAmt Loan %Imprvd :40
Lender %Owned : 100
VestTyp :Trust\trustee IntTy Exempt ,
LandUse :06 Res,Condominium,Townhouse Type .•
Zoning :P-D TaxArea : 10005
SubPlat :Morgan Park Townhouses 09-10 Tax :$8,752.08
Legal :TR 6493 LOT 7 MLS Area :015
Census : Tract 5065.03 Block :2 Phone
MapGrid :853 D6 Owner
Total Rnrs : 8 Bldg SF :2,128 Units Year Built : 1979
Bedrooms :4 Lot SF :4,792 Patio :No EffYearBlt : 1979
Bathrooms :3.00 Useable SF :4,819 Porch :Yes Garage Sp : 1
Stories :2 Lot Acres : .11 Elevator Garage SF : 312
Dining Rill : Lot Dineen :61x79 Lease SF Bldg Cond : 7.0
Family Rm : Pool :No Office SF Bldg Class :7.0 .
Rec Room Fireplace Sprinkler Bldg Shape : Square
CntlHt/AC :Heat Only
OPi10E OY COUNTY ASSESSOR SANTA LLARA COUNTY, CALti0R NIA
ROOK PACE
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Information compiled from various sources, Real Estate Solutions makes no representations
or warranties as to the accuracy or completeness of information contained in this report.