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APPLICATION FOR ENCROACHMENT PERMIT <br /> 19 aq <br /> To the San Joaquin County <br /> Highway Departnicni <br /> Gentlemen <br /> The undertigntd hereby applies for punnibbion to excavate, construct and/or otherwise encroach on <br /> CUunty Iligh'+dy Eight of way by performing the folloN%ing work <br /> Install a ground nater monitoring well(s) <br /> (Applicant will describe here fully what he wtbhes to do using re-verse side if necessary) <br /> A mobil drilling rio using_ 1C^ hollow stem augers will drill 10" diameter boring(s ) to <br /> 65 feet below the surface , 4" ground water monitoring well (s ) will be constr'±cted from <br /> tYe bcrzng(s) . Grout inspection will be performed by San Joaquin Courty Health. The <br /> drilling will be performed under a drilling ermit obteired from San Joaquin County Health <br /> Prior to drilling underground alert will locate all underground utilities (See F71gLWe 1 and enclesc <br /> Space for sketch Submit detailed plans if available <br /> work order/permit packet). <br /> J` <br /> On County Highway County easement south side of Douglas Road and web. of Pacific Avem,e <br /> cCalifornia, <br /> (Applicant will state here accurately the location of the â–ºpork he der ,ires to do) <br /> and agrees to do the work in accordance with your rules and reguiattons and bub)ect to your inspection <br /> and approval <br /> Signature o Applicant George L. Converse <br /> Western Geo-Engineers <br /> (916) 662-4541 <br /> Phone Number T <br /> 1386 E. Beamer Street <br /> woodland, CA 95695 <br /> Po-t Office Address <br /> Permit issued <br /> 9 PW-24 19/941 <br />