STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION |
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CHAIN INSTALLER PERMIT APPLICATION / RELEASE OF LIABILITY
TR-0106 (REV. 09/2011)
The applicant hereby applies for a permit to install and remove tire chains on motor vehicles during the snow season on assigned State Routes.
Name
Mailing Address
Business Telephone No. |
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Driver’s License No. / CA I.D. No. |
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Birthdate |
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Business License No(s). |
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County |
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Chaining Area |
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If you have an existing permit or have submitted an application in another District, please provide the following:
PERMITNUMBER
VESTNUMBER
FOR OFFICIAL USE ONLY
Fee: |
$164.00 |
DATE: |
Vest: |
$ ____ |
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COLLECTED BY: |
Total fee
paid: $ ____
Any dishonored checks will be considered as a violation of the permit and will be an automatic one year suspension.
I have read, understand and agree to the CHAIN INSTALLER’S CONDUCT AND WORKMANSHIP CONDITIONS contained herein, and I agree to comply with all provisions and conditions of this Chain Installer Permit Application / Release of Liability and the Chain Installer Permit issued to me. Any failure to do so will result in suspension or revocation of my chain installer’s permit. I have also read, understand and agree to the INDEMNIFICATION and ASSUMPTION OF RISK AND RELEASE OF LIABILITY provisions contained herein.
INDEMNIFICATION: I hereby agree to indemnify and save harmless the State of California, its officers, directors, agents, employees, contractors, subcontractors and each of them (STATE) from and against any and all claims, demands, causes of action, damages, costs, expenses, actual attorney’s fees, judg- ments, losses and liabilities of every kind and nature whatsoever (CLAIMS) arising out of or in connec- tion with the issuance and/or use of this permit for: 1) bodily injury and/or death to persons including but not limited to myself, STATE, and the public; and 2) damages to property of anyone. Except as provided by law, the indemnification provisions stated above shall apply regardless of the existence or degree of negligence or fault of STATE.
ASSUMPTION OF RISK AND RELEASE OF LIABILITY: I understand that working as a chain installer carries with it certain risks including, but not limited to, serious bodily injury and/or death resulting from being struck by moving motor vehicles. To the maximum extent allowed by law, and in consideration for permission to work as a chain installer, I hereby knowingly and expressly assume all such risks, and I, on behalf of myself and my heirs and assigns, agree to, and I do hereby, release and hold harmless STATE, and waive all CLAIMS against STATE, for: 1) any and all loss, damages, injury and/or death arising out of or in connection with the issuance or use of this permit; and 2) any and all loss, damages, injury and/or death arising out of or related to my work as a chain installer. The assumption of risk and release of liability provisions stated above shall apply only to STATE and, except as provided by law, shall apply regardless of the existence or degree of negligence or fault of STATE.
I UNDERSTAND THAT THE INTENT AND EFFECT OF THIS DOCUMENT IS TO RELEASE STATE FROM LIABILITY FOR ANY PERSONAL INJURIES OR DEATH THAT OCCUR TO ME WHILE WORK- ING AS A CHAIN INSTALLER, EVEN IF CAUSED BY STATE’S OWN NEGLIGENCE OR FAULT.
STATE OF CALIFORNIA• DEPARTMENT OF TRANSPORTATION |
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CHAIN INSTALLER PERMIT APPLICATION / RELEASE OF LIABILITY
TR-0106 (REV. 09/2011)
DEPARTMENT OF TRANSPORTATION ENCROACHMENT PERMIT
CHAIN INSTALLER’S CONDUCT AND WORKMANSHIP CONDITIONS
InaccordancewithSection670oftheStreetsandHighwaysCode,permissionisherebygrantedtoinstallandremovetirechainsforcompensationwithintheState’sHighwayrights-of-waywhenrequiredbytheDepartment, relatingtothesafeandorderlymovementoftraffic,forthesafeoperationofthehighways.ThepermitteeshalloperateincompliancewithSection670oftheStreetsandHighwaysCodeandallprovisionsofthisEncroachment PermitandtheChainInstallerPermitApplication/ReleaseofLiabilityhe/sheexecutedincludingtheConductandWorkmanshipConditionsstatedherein,andshallconformtoallotherapplicableStateandlocallaws.Ifthe county or other political subdivision within whichthe permittee intends to install chains requires thepermittee to have a businesslicensein orderto collect fees fordoingthiswork,such business license shall be obtained bythepermitteeandthelicensemustbepresentedbeforethisEncroachmentPermitwillbecomevalidforuse.ThisPermitmaybesuspendedorrevokedasprovidedintheseConductandWorkmanshipConditions,fornon- compliancewithanyoftheprovisionsofthisEncroachmentPermitortheChainInstallerPermitApplication/ReleaseofLiabilityexecutedtoobtainthispermit,atanytimebyanyDepartmentalrepresentativeortheCalifornia HighwayPatrol.Thepermitteeshallsurrender,upondemandbyanyDepartmentalrepresentativeortheCaliforniaHighwayPatrol, theirchaininstallerpermitandchaininstalleridentificationvest. Failuretocomplyshall be cause for denial of any future chain installer permits.
Prior to issuance of a permit, all chain installer applicants shall attend a mandatory chain installer orientation class, pass a written test, and demonstrate knowledge of snow tire identification and proficiency in tire chain installation.Failuretoattendthemandatorychaininstallerorientationclass,shallresultinpermanentrevocation.Thenumberofpermitsavailableforissuanceislimited.Firstconsiderationshallbegiventopriorapplicants ofthepreviouswinterseason,providingtheirpermitswerenotsuspendedformorethan30daysorrevokedduringthepreviouswinterseason.
Anypermitssuspendedneartheendofthewinterseason,and/orifthesuspensionisfoundtobeineffectiveatthetimesoorderedintheopinionoftheDistrictPermitEngineer,maybeappliedtothenextwinterseasonifso statedintheletterofsuspensiontothepermitee.
Appeals of any punitive action taken against a chain installer permittee, shall be submitted in writing within 5 business days to the District Permit Engineer at:
____________________________________________________________________________________________________________________________________________________________________________________
Awrittendecisionshallberenderedwithin10businessdaysfromthereceiptofthewrittenappeal.TheDistrictPermitEngineer’swrittendecisionmaybeappealedinwritingwithin5businessdays,totheDistrictDirector in which the permit was issued. The District Director’s decision shall be rendered in writing within 10 working days from the receipt of the appeal, and this decision is final. (There are no further administrative rights of appeal.)
Penalties noted in this permit are minimums. Severe penalties may be imposed for any infraction of Permit Conditions if warranted by the circumstances, or by the permittee’s conduct.
AllpermitfeespaidtotheDepartmentofTransportationarenonrefundable
1.When installing, removing, repairing or modifying tire chains, the permittee shall display a sign (measuring a minimum of 12” x 24” up to a maximum of 18” x 36”) advising motorists in advance of their fee for providing theseservices,andtheirvestnumber.Thelettersshallbeaminimumoffourincheshighwithaminimumbrushstrokeof5/8”.Apermitteefailingtodisplaythissign,and/ordisplayofanyothertypeofadvertisingsignother than this required sign will be issued a warning, and shall cease work until the unauthorized display is removed.
2.Thepermitteeshallbeinpossessionofareceiptbookandshallissueonewhenrequestedbyamotorist.Thereceiptshallshowthepermittee’sname,vestnumber,thetypeofworkperformed(installing,removing,repairing, modifyingtirechains),andthefee chargedforthework.A permitteefailingtoissueareceipt forservices providedwhenrequested, shallbesuspendedfor7days.
3.This Permit is non-transferable, only the person to whom it was issued is to perform the services authorized herein, and shall have it in their possession at all times when performing said services. This Permit shall be presentedforinspectionupondemandbyanydepartmentalrepresentative,theCaliforniaHighwayPatrol,oranylocallawenforcementpersonnel.Awarningwillbeissuedtoanypermitteefoundtobeworkingwithouttheir permitintheirimmediatepossession,theyshallceaseworkimmediately,andsurrendertheiridentifyingvest,untiltheirpermitcanbeproducedtoregaintheiridentifyingvest.
4.Anypersonfoundworkingunderapermitnotissuedtothem,andanypermitteeallowingsuchuse,shallimmediatelysurrenderthepermit.And,neitherindividualwillbeeligibleforissuanceofachaininstallerpermitfor aminimumofoneyear.
5.Acolored vest containing the permittee’s identifying number will be issued along with this permit.THIS VEST ISTHE PROPERTYOFTHE DEPARTMENT.The vest shall be worn in plain sight in a legible manner at alltimesbythepermitteewhileperformingtheservicesspecifiedherein.Apermitteefoundtobeworkingwithouttheirvestbeingclearlylegible,shallbeissuedawarning,andshallceaseallworkuntiltheirvestandidentifying numberaremadeclearlyvisible.
6.Lossofapermittee’spermitoridentificationvestshallbeimmediatelyreportedtotheDepartment’sdistrictofficethatissuedthepermit.Applicationforaduplicatepermitoridentificationvestmaybemadeduringnormal businesshours.Aduplicatepermitwillbeissueduponpaymentoftheadministrativefee(equaltoonehourmultipliedbytheStandardHourlyRate).Areplacementvestwillbeissueduponpaymentoftheadministrativefee plus the cost of the vest itself.
7.ApermitteemayonlyparkasinglevehiclewithintheState’shighwayrights-of-wayintheareadesignatedbytheDepartmentortheCaliforniaHighwayPatrol,andonlyduringthetimethepermitteeisengagedinactivities authorizedbythispermit.ParkingonStateconventionalhighwaysinsimilarlydesignatedareasshallconformwiththeapplicableprovisionoftheVehicleCode.Ifapermittee’svehicleisparkedinalocationormannerthat interferesorimpedeswithhighwaytraffic,snowremovalequipment,orparkedonanyfreewayramportaper,thepermitteeshallbesuspendedfor7days.
8.Permitteesarenotallowedinthelanesmaintainedforthroughtraffic.Apermitteeshallremainintheareadesignatedforinstallationorremovaloftirechains.Anyinterference,stopping,orcontrollingoftrafficbyflagging, signs,armmovements,thewavingofsignsorlights,etc.,impedingtheorderlymovementoftrafficcausedbyapermitteeshall resultinasuspensionfor7days.
9.Vending or renting of tire chains, tire chain accessories, or other items or products upon any State highway rights-of-way by a permittee is strictly prohibited. A permittee offering to sell or rent tire chains or other items, orwhoacceptsmoneyforthesaleorrentaloftirechainsorotheritems,shallimmediatelysurrenderhis/herpermitandidentificationvestandshallbeineligibleforissuanceofachaininstallerpermitforaminimumofone year.Suchapermitteemaybesubjecttoprosecutionforviolationofthelaw(StreetsandHighwaysCodeSection731)prohibitingvendingonStatehighways.
10.Permitteesshallconducttheirbusinessinaprofessionalandcourteousmanner.Apermitteefoundtodisplaypoorworkmanshipininstallingchains,givingmisleadingstatementsconcerningthenecessityforaltering chains, misrepresenting any conditions or requirements regarding chain regulations, or causing complaints relative to his/her conduct shall be issued a warning. These violations may result in suspension or revocation ofpermitprivileges,dependingonthecircumstancesoftheincidentandtheconductofthepermittee.Apermitteepresentinganyformofthreatofviolencetowardanypersonorpropertywhileinvolvedintheactivitiesrelated to this permit shall immediately surrender his/her permit and identification vest and he/she shall be permanently ineligible for issuance of a chain installer permit.
11.Permittees shall wear yellow, orange or lime colored raingear (rain suit or jacket and class E pants). Personal protectivesafety clothing shall meet the Performance Class 3 requirements of theANSI/ISEA107-2004 entitled"AmericanNationalStandardforSafetyApparelandHeadwear".Apermitteefoundworkingwithoutproperraingearwillbeissuedawarning,andshallimmediatelyceasework,surrenderhis/herpermit,andidentification vest.Workmayresumewhenthepermitteeisequippedwiththeproperraingearandhasregainedtheirpermitandidentificationvest.
12.Permitteesshallonlyworkinestablishedchaininstallingareas.Apermitteefoundworkinginanareaotherthantheestablishedareawillbesuspendedforthewinterseasonandshallimmediatelysurrenderhis/herpermit andidentificationvest.
13.Permitteesshallbe18yearsofageorolder.Apermitteefoundtohaveobtainedhis/herpermitbyfalsifyingtheirageshallimmediatelysurrendertheirpermitandidentificationvest.And,shallnotbeeligibleforissuance ofachaininstallerpermitforaperiodofone-yearextendingbeyondthedatetheyattain18yearsofage.
14.A permittee maintaining an open fire or littering on the highway right of way shall be issued a warning.
15.A permittee may apply for a second chain installer permit in another district, provided there is no established waiting list.
16.Unlesssurrendered,suspendedorrevokedasprovidedinthePermitpackageconditions,apermitshallexpireonJune30in theyearfollowingitsissuance.
17.Apermitteeshallnotuseanyworklightsinamannerthatwouldimpactmotoristsonthehighwayorthesnowclearingequipmentoperators.
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ADA NOTICE |
Forindividualswithsensorydisabilities,thisdocumentisavailableinalternateformats.Forinformationcall(916)654-6410orTDD(916)654-3880orwriteRecordsandFormsManagement, |
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1120NStreet,MS-89,Sacramento,CA95814. |
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