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05/24/2006 14:36 7073745677 WOODWARD DRILLING CO PAGE 03/05 <br />05/23/2UUs TUE 1*;59 FAIL 160021004� <br />San Joaquin County ORInaw <br />Environmental Health Department SITE <br />304 Fast Webelr.Flveenue, 3rd Floor, Stockton, cA 95k'5 JU; 16 Pj I WTj�q ATI0N <br />(209) 468-3449 Fax: (209) 468-3433 Web: www.s gov,grWeh,d - UNIT IV <br />a <br />Well Permit Application J, t -r I;< U : ; ;'L <br />NDH PFUNAAJ3 PCRIIlIT E a EXPIR1 YEARI'�ZOl1d DATE ISSUfd i f'i DEF' ,",„ T,31 r7 .; T <br />Appllcailon 19 hereby made to San Jogquin County for 0 permit t0 aonsftud "of inatail ttre work 0,19c ad This applIca{ion int moot in compliance oth San <br />Joscidn County Devmopment Tft Chapter 9.1115.3 end the Standards of San Joaquin Cnunty ENronmental Hda$h Npartmerrt, <br />Atea <br />WELL Location I-N&P N, El Uarc �7cro®aetceat�cuy `Z arra �� ►0 01 'p 345016 <br />PROP'Owner,�/iddress <br />C -s7 <br />Oon_ sultant / Stb <br />verve p9�5�(r��/1o07 vr>e�7a7 �'�' �f3oo <br />GIS CoordingtjDn:X AAl. 3(y8 Y 3"/ 3, Tmm hip 77/.1 Rwge -9160C section A0 <br />WORK TO BE PFRFO 7i: <br />)(NEW WELL/ UORING (CPT, GEOPROBF, HYDROPUNCH, HAND,AUGCR, oTWFM U DESTRUCTION (dwose type be" <br />U SOIL BORING 0 �•_�� Q OVER -BORE DIAMETER <br />'OthAt /l% /Z /3 UI^"" U PRESSURI; GROUT <br />GROUT SPECIFICATIONS <br />COMMENTS: <br />TYPE AF)N£t,L 9L,1-AnON TYPE PQMM95MON SPECIFICA-DQN§ <br />.RMONITORING XtIOLLOW STEM DIA. OF BOREHOI lyl U MULTIPLJ. CASINGS U MULTI-LEyEL MLI. CASING DIA: Zl <br />Q EXTRACTION U AIR HAMMERA)RIVEN CASING THICKNESS - -d TYPE OF WING' U STEEL )(PVC Q OTHI3i: (r, <br />U VAPOR U MUD ROTARY DEPTH OF GROUT S TREMIE TYPE TO BE USED: AUGf ftS p HOSE r <br />p Air, SPARGE! OZONE p PUSH POINT (GP or CPT)GROLIT SEAL PUMPED: )(Yw a No (NOTE; MAXIMUM FREE ALL DEPTH IS 3(Y) c <br />p SQIL BORING 0 HAND AUGER GROUT SPECIFICATIONS <br />13 OTIi&R: h OTHER APPROX. SOPJNO DEPTH b0 SSOLTED TRAFFIC BOX cw n STOVE; PIPE <br />—L- <br />�c1 <br />C� <br />c, <br />CO CASINO PRO <br />-)rw-17 � 50•1 q0 <br />(If YES, W SP80F Gallons in corrvwt aaci <br />NOTE. OFFSITE BORINGS REQUIRE ACCESS AGREEMENT OR ENCROACHMENT PERMITS. <br />48 WORKING HOURS NOTICE REQUIRED FOR INSMCTiONS. <br />I hereby oartify that I have prnparod this appllcaMon and that the work will be sorts In accordance with San donauln <br />C�iilt70 <br />SITE MAP IN UNIT IV FILE, A <br />WORK PLAN DATED: <br />Erm 29-02.001 <br />wavo4 <br />