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APPLICATION l"OR IrllCROACHMF14T PERMIT <br /> F� <br /> l.lalc_ 7cuu .t19&L <br /> To the. Sun .lnnquin County <br /> Highway Uepartmcnt <br /> Gentlemen: <br /> Tho undersigned hereby applies for pennission to excavate, constnlct and/or otherwise encroach on <br /> County Highwuy right of way by perfurntiar the folloveing work: <br /> Install a ground Mater monitoring well- ) <br /> (Applicant will describe here fully what he wishes to do using reverse side if necessary? <br /> A mobil drilling rig usin 1C" hcllow stem augers will drill 10" di.amete; boring(s) to <br /> 65 feet. below 'he surface, 4" ground water monitoring well(s) will be constructed from <br /> ' the boring(s). Grout inspection will be performed by San Joaquin County tiealtli. The <br /> drilling will, be erformed under a drillinq permit obtained from San Joaquin County Health. ; <br /> Prior to drilling underground alert will locate all underground utilities (s=e Figure 1 arra enc' d <br /> Space for sketch Submit detailed plans if e•+ailuble. <br /> tioric crier/perrlit packet). <br /> t <br /> i <br /> On County Highway Coiriy.'oasemenl_south' sidowof:Doug <br /> Road and"Fres,l of pacific nyegii <br /> (Applicant will state here accurately the location of the work he desires to do) <br /> and agrees to do the work in accordance with your rules and regula[ioas and subject to your inspection <br /> and approval C <br /> Signature o Applicant George t.. Converse <br /> Western Gen-Engineers <br /> (916) 662-4541 <br /> Thune,Number <br /> 13£16 E. Beamer SLreeL <br /> / Woodland, CA 95695 <br /> Pu:i Office Address <br /> Pennil issued: ® rw.24 is/aai <br />