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Ul/170/�110U 5 LL:Ll 5,3Ubb/btlSL WD(. EXHLURATIDN PAGE 02/65 <br /> 11/17/2007 13:59 5305628052 <br /> DEC-27-20711:06 WDC EXPLORATION PAGE 02/04 <br /> SIA <br /> 1707 93ti 6649 P,92iO4 <br /> San Joaquin County <br /> Environmental Realth]Department <br /> 600 East Main Street, Stockton, CA 95202-3029 SITE <br /> (209)468-3449 Fltx: 209 468.3433 Web;www III'11TIGATION <br /> Well Permit Application UNIT IV <br /> norody mrdo o Son j <br /> 1VOf1.RECUIIDABLF PERMIT GUPIRCS 1 YEAR FROM DATE ISSUgo <br /> AD011Qat)pt1 fy toequo County for A Demtll to commufn <br /> Joaquin County Oprebtm+ent Tive.Chapt@r X71 f5.3 8nd the Standards sIM/or tnxta4 the•rortt dewrlbed. Thla�Pptlodian p mi�eompNance wth San <br /> 0f San Joagttln County E►%nhvro MtU)Meana <br /> MLL Loesaon Oeparvnen( <br /> �ea Streotr-fB �4` �!_ /_ Aen fseors <br /> PROP-C 4X153 Yueh+tj*rb'd—:Dry <br /> ._address ttiL_LL_ � i� � <br /> C.i;'!ConVader ��°�lddrts! fv�.� ��•{T J� __. <br /> onsulgn Bun � N <br /> CnvTt „e- --"A 7= Ce8J �j I.�, r�W �a Re► 7 <br /> �._AdOrv:ea C. � <br /> GIs Coorss:irlatos: '�`�t= " �ci -' wt"r°"• �_�9 <br /> 'L_ Y yrs b <br /> .TowngrNp <br /> I BORING (CI T.oeol` ose WDROPUNCM,"M7•AL*ER.OTKER• <br /> 8ORIN131Y I pDESTRiJC71QN tchont,a,,rpeaebw► <br /> a'OtheOther s 46Q OVERBORE. DIAMETER'._. <br /> ` — Q PREssvile GROUT <br /> COMMEWS. GROUT SPECIFICATION$ <br /> C <br /> MaEOF�iyELLI�InAL{,An�rypE c0 3 U �— <br /> fiQAOKITORMsa .[HOLLOW STEM ; DIA pF 80REf40t k'2 I <br /> a EXTRACTION fl AIR MAMKEWQAIVEN CASING UL1fFLE CASING$ 0 urtut Tl{EvEL v/I;l.t.CASING DIA: <br /> VAPOR tVl;T►rICKN683' -TYPEOFCASQM , 1` <br /> Q MUD RQrARY OEPT)i OF GROUT SP5I D she' ArPbt o OTMER; <br /> 0 AIP SPARGFJ OZONE Q AU^sN PDI)JT(GP e• �A&F TYPE TO BE USED: �jtp.UGERS R OH . <br /> CPT)t-eROUT SEAL�UrupEq Kyas No NOTE: XJMUM FREE-r-,Ac.I_DEPTH is 30') �— <br /> QSOIL BORING Q �AtIGEF <br /> Q OTHER` tai20UT SPE�IFtCATIOht$ <br /> _;tOTr4ER APMOx.Ia0RING -�- <br /> -�/�L GLIFDTRAFFICAUX er 1jSTOvEPtPE <br /> COMMRNTe !—:Y �! a� y� CONDUCTOR C ING PROPOSED <br /> ��S - T A ' / --iN YM,stat xPed'r#Ml1ns.6n comment sealon) <br /> 9is.a Sem .r .430 ,.. S <br /> ' <br /> NOTE: OFFSITE WRINGS REQUIRI:ACCESS AGREEMENT OR ENCROACHMEIN7 PERMITS. <br /> 48 WORKING HOURS NOTICE REOUIRED FOR IN9PECT70N5, .— c <br /> I hereby taRiy that I have prspae>el this appNca <br /> County Qtion and OW t*workwOl be done in*tCorttance with 5 en Joaquin <br /> 4rlit,ranyc R ao Regulations,,and all a <br /> pplicabte CalilorRFa State <br /> .9;0 row /' <br /> Prot Namo. �e�Comp !'Jr+� DC �~ . <br /> - <br /> O&P—LI 7 <br /> EPARTYENT USE ONLY <br /> SITE MAP IN UNIT IV FILE, ADDRESS; A;I& 7 r <br /> WORK PLAN DATED. L014,L2 <br /> 0 <br /> APplimtlon Arzcpled 4 -- <br /> Grout Inspetd7on By / Date" l QAte blued 7 0 �Arna <br /> o <br /> Ouytruetton Inspartlon 6y Dale Fkmt Ins"alon Ely <br /> ACCOUNT"O ONLY; A104 <br /> ACN <br /> PE 00069 FEE INFO AMOUNT REMITTED CHECK* <br /> ascro tar a►Te �r lwvelca <br /> SRO() 307 <br /> D10 29•na-0 1 <br /> C-57� WC -yt/A�R� E_�Letter of Autherizatlor,to sl9M ermir ' <br /> vyEg ' n lntnf dOc <br /> yr,�rzoo>• <br />