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APPLICATION FOR ENCROACHMENT PERMIT <br /> t � i <br /> ARI <br /> Sun Joaquin County <br /> 4 , <br /> Ilighway Department <br /> - <br /> itlemen <br /> The underbigned hereby applies for permission to exca%ate, construct and/or otherwise encroach on <br /> County Highway right of way by performing the folloxing work <br /> Install a ground eater monitoring well(s ) <br /> (Applicant will describe here fully what he wishes to do using reverse side if necessary) <br /> Amobil drilling rig_ using 1C" hollow stem augers will drill 10" diameter borings) to <br /> 65 feet below the surface, 4" ground water monitoring uela(s) will be constructed fron <br /> t.te borang(s). Grout inspection will be performed by San Joaquin Courty Health. The <br /> drilling will be performed under a drilling permit obteired from San Joaquin County Health. <br /> prior to drilling underground alert will locate all underground utilities (See FYgime 1 and enclosed <br /> Space for sketch Submit detailed plans if available. <br /> sic Lcder/permit packet). <br /> cj <br /> r- G4 <br /> l <br /> ISE ATrKi F-0 <br /> c. I Tl <br /> r r <br /> r c- <br /> `� m <br /> z <br /> On County Highway County easement south side of Douglas Road and west of Pacific Avenue <br /> .F42,S,_Pacj„£,in AypnuP_ , Stockton: -Ql_a_forn-ta, <br /> (Applicant mill state here accurately the location of the worm he desires to do) <br /> and agrees to do the work in accordance with your rules and regulations and subject to your inspection <br /> and approval <br /> Signature o(Applicant George L. Converse <br /> Western Geo-En g s-n e e r s <br /> (916) 662-4541 <br /> Phone Number <br /> 1386 E. Beamer Street <br /> Woodland, CA 95695 <br /> Post Office Address <br /> Permit issued 4T9 —4 0—L--V ` <br /> 0 PW-24 19/64) <br />