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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sicehd.com <br />WELL & BORING PERMIT APPLICATION GUIDANCE <br />A WELL PERMIT MUST BE ISSUED PRIOR TO ANY DRILLING OR BORING ACTIVITIES <br />(San Joaquin County Ordinance Code, Title 9, Section 9-1115.3) <br />All drilling and boring activity to identify the presence, absence, or extent of soil or groundwater contamination is to be <br />permitted by submittal of the following completed documents and appropriate fees to the EHD. Drilling and boring <br />activities not associated with this type of investigation are permitted by EHD separately from this process. <br />ITEMS TO BE SUBMITTED: <br />Work Plan. The work plan should describe the site history and the purpose and scope of the proposed investigation. The <br />work plan must include drilling procedures, well and/or boring construction/destruction methods, disposal methods for soil <br />and/or wastewater generated, a site map and a safety plan. For EHD local oversight projects, the work plan must also <br />include sampling procedures and analytical testing methods. <br />Written Approval from the Lead Oversight Agency. Written approval for the work as proposed in the work plan from <br />the lead agency providing oversight for the investigation must be submitted to the EHD (i.e. Central Valley Regional Water <br />Quality Control Board, Department of Toxic Substances Control, etc.). <br />Master File Record Information Form. This form must be completed to identify the site owner name and address, the <br />facility name and address, and the billable party responsible for paying any additional charges associated with the <br />proposed activity. The form must be signed by the individual accepting responsibility for any additional charges. <br />Work Plan/Report Review Activities Fees. The initial work plan fee, as shown below, must be submitted with the work <br />plan to cover the cost of the following activities: work plan/report review, permit review and issuance, waste disposal <br />follow up, notifications and project documentation. A Report of Findings must be submitted to the EHD after all <br />assessment/investigative work has been completed. <br />Work Plan/Report Review Activities Initial* Fees <br />Type of Assessment Project Initial* Hourly Rate Fee <br />Environmental Assessment (no known release) $417.00 (3-hour initial* fee) <br />Other Lead Agency Oversight (CVRWQCB, DTSC, Fed EPA, etc.) $417.00 (3-hour initial* fee) <br />Local EHD Voluntary Cleanup Oversight $695.00 (5-hour initial* fee) <br />Hazardous Material Transmission Pipeline $695.00 (5-hour initial* fee) <br />*Any EHD staff time spent on the project over the initial minimum hourly fee submitted will be billed to <br />the party identified on the Master File Record form as responsible for additional charges. <br />Well & Boring Permit Application and Inspection Activities. A Well & Boring Permit Application form must be <br />completed and submitted with the appropriate fee for each separate parcel. The Application shall be signed by a C-57 <br />licensed contractor, or the C-57 licensed contractor shall authorize an agent's signature in writing. The Licensed <br />Contractor Declaration must be completed and will be used to expedite license and workers' compensation verification. <br />On-site drilling by third parties (not the property owner or operator) requires a letter of authorization from the property <br />owner granting permission to drill. <br />Off-site drilling in public easements or on property owned by another party requires a copy of the encroachment <br />permit or access agreement granting permission to drill on the property. <br />Well/Boring Permit Inspection Activities Initial* Fees <br />Type of Project Initial* Hourly Rate Fee <br />Soil Borings $139.00/boring (1-hour per boring) up to maximum initial* fee of $417.00 (3-hours) <br />Monitoring Wells $139.00/monitoring well (1-hour per mw) up to maximum initial* fee of $695.00 (5-hours) <br />*Any EHD staff time spent on the project over the initial minimum hourly fee submitted will be billed to the party <br />identified on the Master File Record form as responsible for additional charges. <br />Notes: <br />All EHD staff time is charged at the rate of $139 per hour. Make all checks payable to "EHD". <br />If contamination is identified as a result of this investigation, the appropriate agency will be sent a copy of the <br />hazardous waste discharge notification and the site will be so listed on the EHD database. <br />29-003 Well & Boring Permit Application Requirements <br />8/1/16