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NOTE DIRECTIONS DIMENSIONS AND LOCATIONS AR E APPROXIMATE
e
SCALE IN FEET
0 1200 2400
SITE LOCATION
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
4800
FIGURE
1
4 176
SOURCE BbU ampu l 2011 H W c OUltl El 11- yto 11 -dcwl l nol c__ Roct91 Projoltt shy
LEGEND
D D LJ
CROSS SECTION FOR SLOPE STABILITY ANALYSIS
424 1
4208
II I
I
bull middot1276
4 2 7
NOTE 0RECTIOHS DIMENSIOHS AHO LOCATIONS AApoundAPPROX1MATpound
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
4340
N
A FIGURE
2A
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0 0
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-$- 8-30
D D LJ
BORJNG TO = TOTAL DEPTH IN
CROSS SE FEET FOR SLOPE
LEGEND
-$- DEPTH IN FEET
D D CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE OIRpoundCTIONS OIMENSIONS AHO LOCATIONS AAE APPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING REClAMATION AND GROUNDWATER RECHARGE PROJECT
lAKESIDE CALIFORNIA
N
400 A FIGURE
20
SOURCEk middot V-lt11
LEGEND
D D
LJ CROSS SECTION FOR SLOPE
STABIUTY ANALYSIS
I
I
I
HOTpound OIFtECTIONS 0MENSIONS AND LOCATIONS AAE APPROXJMATE
SCALE IN FEET
I 00 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
N
A FIGURE
2E
SOUIICE tt--oS Gtoltn- l roo Protbullushyc-pou Orlohrv bull bull 10
LEGEND
OEPTH IN FEET
0 0 CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE DIRECTIONS 0 1MEIISIONSANO lOCATIONS AAE
SCAlE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
FIGURE
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LEGEND
D D LJ
BORING TO= TOTAL DEPTH IN FEET
CROSS SECTI STABIUTY SLOPE
NOTE DIRECTION$ OIMENSIONS A HD L OCATIOHS AAE APPROXJMATE
PROJECT NO DATE
106200005 5111
100 200 400
N
A SCALE IN FEET
BORING LOCATIONS FIGURE
EL MONTE VALLE AND RECLAMATION
LAKESIDE PROJECT 2H
LEGEND
DEPTH IN FEET
D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
484 I
I
4$3 3
bull1708
middot17 4
7
middot
NOTE DIRECTIONS OIMENSIONSAhiO LOCATIONS AAEAPPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
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0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
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SCALE IN FEET
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EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
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EL MONTE VALLEY MINING REClAMATION AND GROUNDWATER RECHARGE PROJECT
lAKESIDE CALIFORNIA
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LAKESIDE CALIFORNIA
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EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
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PROJECT NO DATE
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100 200 400
N
A SCALE IN FEET
BORING LOCATIONS FIGURE
EL MONTE VALLE AND RECLAMATION
LAKESIDE PROJECT 2H
LEGEND
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D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
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100 200
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EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
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BORING TO bull TOTAL DEPTH I
CROSS S N FEET
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I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
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D D CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE OIRpoundCTIONS OIMENSIONS AHO LOCATIONS AAE APPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING REClAMATION AND GROUNDWATER RECHARGE PROJECT
lAKESIDE CALIFORNIA
N
400 A FIGURE
20
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LEGEND
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STABIUTY ANALYSIS
I
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SCALE IN FEET
I 00 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
N
A FIGURE
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LEGEND
OEPTH IN FEET
0 0 CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE DIRECTIONS 0 1MEIISIONSANO lOCATIONS AAE
SCAlE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
FIGURE
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NOTE DIRECTION$ OIMENSIONS A HD L OCATIOHS AAE APPROXJMATE
PROJECT NO DATE
106200005 5111
100 200 400
N
A SCALE IN FEET
BORING LOCATIONS FIGURE
EL MONTE VALLE AND RECLAMATION
LAKESIDE PROJECT 2H
LEGEND
DEPTH IN FEET
D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
484 I
I
4$3 3
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middot17 4
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NOTE DIRECTIONS OIMENSIONSAhiO LOCATIONS AAEAPPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
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a ]
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)
pound 0
-2 cQ
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D D LJ
BORJNG TO = TOTAL DEPTH IN
CROSS SE FEET FOR SLOPE
LEGEND
-$- DEPTH IN FEET
D D CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE OIRpoundCTIONS OIMENSIONS AHO LOCATIONS AAE APPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING REClAMATION AND GROUNDWATER RECHARGE PROJECT
lAKESIDE CALIFORNIA
N
400 A FIGURE
20
SOURCEk middot V-lt11
LEGEND
D D
LJ CROSS SECTION FOR SLOPE
STABIUTY ANALYSIS
I
I
I
HOTpound OIFtECTIONS 0MENSIONS AND LOCATIONS AAE APPROXJMATE
SCALE IN FEET
I 00 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
N
A FIGURE
2E
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LEGEND
OEPTH IN FEET
0 0 CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE DIRECTIONS 0 1MEIISIONSANO lOCATIONS AAE
SCAlE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
FIGURE
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D D LJ
BORING TO= TOTAL DEPTH IN FEET
CROSS SECTI STABIUTY SLOPE
NOTE DIRECTION$ OIMENSIONS A HD L OCATIOHS AAE APPROXJMATE
PROJECT NO DATE
106200005 5111
100 200 400
N
A SCALE IN FEET
BORING LOCATIONS FIGURE
EL MONTE VALLE AND RECLAMATION
LAKESIDE PROJECT 2H
LEGEND
DEPTH IN FEET
D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
484 I
I
4$3 3
bull1708
middot17 4
7
middot
NOTE DIRECTIONS OIMENSIONSAhiO LOCATIONS AAEAPPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
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a ]
CL (
)
pound 0
-2 cQ
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APN 29- oo
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eurogt- -2-1-
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LEGEND
-$- DEPTH IN FEET
D D CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE OIRpoundCTIONS OIMENSIONS AHO LOCATIONS AAE APPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING REClAMATION AND GROUNDWATER RECHARGE PROJECT
lAKESIDE CALIFORNIA
N
400 A FIGURE
20
SOURCEk middot V-lt11
LEGEND
D D
LJ CROSS SECTION FOR SLOPE
STABIUTY ANALYSIS
I
I
I
HOTpound OIFtECTIONS 0MENSIONS AND LOCATIONS AAE APPROXJMATE
SCALE IN FEET
I 00 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
N
A FIGURE
2E
SOUIICE tt--oS Gtoltn- l roo Protbullushyc-pou Orlohrv bull bull 10
LEGEND
OEPTH IN FEET
0 0 CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE DIRECTIONS 0 1MEIISIONSANO lOCATIONS AAE
SCAlE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
FIGURE
2F
UJ
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0 0
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LEGEND
D D LJ
BORING TO= TOTAL DEPTH IN FEET
CROSS SECTI STABIUTY SLOPE
NOTE DIRECTION$ OIMENSIONS A HD L OCATIOHS AAE APPROXJMATE
PROJECT NO DATE
106200005 5111
100 200 400
N
A SCALE IN FEET
BORING LOCATIONS FIGURE
EL MONTE VALLE AND RECLAMATION
LAKESIDE PROJECT 2H
LEGEND
DEPTH IN FEET
D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
484 I
I
4$3 3
bull1708
middot17 4
7
middot
NOTE DIRECTIONS OIMENSIONSAhiO LOCATIONS AAEAPPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
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pound 0
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LEGEND
D D
LJ CROSS SECTION FOR SLOPE
STABIUTY ANALYSIS
I
I
I
HOTpound OIFtECTIONS 0MENSIONS AND LOCATIONS AAE APPROXJMATE
SCALE IN FEET
I 00 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
N
A FIGURE
2E
SOUIICE tt--oS Gtoltn- l roo Protbullushyc-pou Orlohrv bull bull 10
LEGEND
OEPTH IN FEET
0 0 CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE DIRECTIONS 0 1MEIISIONSANO lOCATIONS AAE
SCAlE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
FIGURE
2F
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D D LJ
BORING TO= TOTAL DEPTH IN FEET
CROSS SECTI STABIUTY SLOPE
NOTE DIRECTION$ OIMENSIONS A HD L OCATIOHS AAE APPROXJMATE
PROJECT NO DATE
106200005 5111
100 200 400
N
A SCALE IN FEET
BORING LOCATIONS FIGURE
EL MONTE VALLE AND RECLAMATION
LAKESIDE PROJECT 2H
LEGEND
DEPTH IN FEET
D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
484 I
I
4$3 3
bull1708
middot17 4
7
middot
NOTE DIRECTIONS OIMENSIONSAhiO LOCATIONS AAEAPPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
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LEGEND
OEPTH IN FEET
0 0 CROSS SECTION FOR SLOPE L_j STABIUTY ANALYSIS
NOTE DIRECTIONS 0 1MEIISIONSANO lOCATIONS AAE
SCAlE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATION AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
400
FIGURE
2F
UJ
() a gt g N
0 0
_ UJ
- 1-zo 0 OUJ
0
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LEGEND
D D LJ
BORING TO= TOTAL DEPTH IN FEET
CROSS SECTI STABIUTY SLOPE
NOTE DIRECTION$ OIMENSIONS A HD L OCATIOHS AAE APPROXJMATE
PROJECT NO DATE
106200005 5111
100 200 400
N
A SCALE IN FEET
BORING LOCATIONS FIGURE
EL MONTE VALLE AND RECLAMATION
LAKESIDE PROJECT 2H
LEGEND
DEPTH IN FEET
D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
484 I
I
4$3 3
bull1708
middot17 4
7
middot
NOTE DIRECTIONS OIMENSIONSAhiO LOCATIONS AAEAPPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
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a ]
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)
pound 0
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LEGEND
D D LJ
BORING TO= TOTAL DEPTH IN FEET
CROSS SECTI STABIUTY SLOPE
NOTE DIRECTION$ OIMENSIONS A HD L OCATIOHS AAE APPROXJMATE
PROJECT NO DATE
106200005 5111
100 200 400
N
A SCALE IN FEET
BORING LOCATIONS FIGURE
EL MONTE VALLE AND RECLAMATION
LAKESIDE PROJECT 2H
LEGEND
DEPTH IN FEET
D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
484 I
I
4$3 3
bull1708
middot17 4
7
middot
NOTE DIRECTIONS OIMENSIONSAhiO LOCATIONS AAEAPPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
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e-- 4 Jo
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A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
LEGEND
D D LJ
BORING TO= TOTAL DEPTH IN FEET
CROSS SECTI STABIUTY SLOPE
NOTE DIRECTION$ OIMENSIONS A HD L OCATIOHS AAE APPROXJMATE
PROJECT NO DATE
106200005 5111
100 200 400
N
A SCALE IN FEET
BORING LOCATIONS FIGURE
EL MONTE VALLE AND RECLAMATION
LAKESIDE PROJECT 2H
LEGEND
DEPTH IN FEET
D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
484 I
I
4$3 3
bull1708
middot17 4
7
middot
NOTE DIRECTIONS OIMENSIONSAhiO LOCATIONS AAEAPPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
LEGEND
DEPTH IN FEET
D D CROSS SECTlON FOR SLOPE LJ STABILJTY ANALYSIS
484 I
I
4$3 3
bull1708
middot17 4
7
middot
NOTE DIRECTIONS OIMENSIONSAhiO LOCATIONS AAEAPPROXIMATE
SCALE IN FEET
100 200
BORING LOCATIONS
EL MONTE VALLEY MINING RECLAMATlON AND GROUNDWATER RECHARGE PROJECT
LAKESIDE CALIFORNIA
N
400 A FIGURE
21
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
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e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
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A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
LEGEND
B-30 fOooiD$
D D
LJ
BORING TO bull TOTAL DEPTH I
CROSS S N FEET
SLOPE
I
middot
PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
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F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
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PERMIT LMON 107648 APN 392-050-43 392-060-29 392-150-17 391-061-01 391-071-04 393-011-01 390-040-51
COUNTY OF SAN DIEGO EST NONE DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION MONITORING WELL PROGRAM
GEOTECHNICAL BORING CONSTRUCTION PERMIT
SITE NAME EL MONTE VALLEY
SITE ADDRESS 13950 14403 15480 EL MONTE RD 10815 ASHWOOD ST 13315
14999 WILLOW RD LAKESIDE CA 92040
PERMIT FOR 30 GEOTECHNICAL BORINGS
PERMIT APPROVAL DATE FEBRUARY 172011
PERMIT EXPIRES ON JUNE 17 2011
RESPONSIBLE PARTY HELIX WATER DISTRICT
PERMIT CONDITIONS
1 All borings must be sealed from the bottom of the boring to the ground surface with an approved sealing material as specified in California Well Standards Bulletin 74-90 Part Ill Section 19D Drill cuttings are not an acceptable fill material
2 All borings must be properly destroyed within 24 hours of drilling
3 Placement of any sealing material at a depth greater than 30 feet must be done using the tremie method
4 This work is not connected to any known unauthorized release of hazardous substances Any contamination found in the course of drilling and sampling must be reported to DEH All water and soil resulting from the activities covered by this permit must be managed stored and disposed of as specified in the SAM Manual in Section 5 II E- 4 (httpwwwsdcountvcagovdehlwqsammanual guidelineshtml) In addition drill cuttings must be properly handled and disposed in compliance with the Stormwater Best Management Practices of the local jurisdiction
5 Within 60 days of completing work submit a wellboring construction report including all well andor boring logs and laboratory data to the Well Permit Desk This report must include all items required by the SAM Manual Section 5 Pages 6 amp 7
6 This office must be given 48-hour notice of any drilling activity on this site and advanced notification of drilling cancellation Please contact the Well Permit Desk at 858) 505-6688
APPROVED BY LJ_f__ ___ _ 74JA4 DATE 2172011
NOTIFIED---------
DEHSAM-9075 (403)
EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
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EXPEDITE nical BofeBIJIIT A bullfMouN
AND VADOSE AND EXPLORA TO
0 7 b-
OFFICE UE QNL Y r PERMIT LMOf1 tP 7 L( SAM (Kmiddotmiddotbull10 DATE RECEIVED Z -1
FEE PAID middotJJ I(( I 1 __ -- cl CHECK 1 7- 7-- --gt gt
A RESPONSIBLE PARTY +elX Wtliet DStri ct E-mail _plusmnit (The person persons or company responsible for the construction maintenance and destruction of the proposed borings andor wells)
Mailing Address _3jS_ IArIEXSt+f yenie City Lo tAesA State Cit Zip 19 4-2 Contact Person 1VY Smii1o- Phone ((o(Cf) -OS85Ext Fax 4kto-g23
B SITE ASSESSMENT PROJECT NUMBER - IF APPLICABLE
C CONSULTING FIRM
Mailing Address 5110 Q Qamp City State CA Zip j2-l2
Registered Professional ampVlciS Q Registration 20 7 (RG RCEt6EG1PG)
Contact PersonJ1000liGbA+ib tog Ext IUL Fax 57(middotqb00
D DRILLING COMPANY Tri-County Drilling Inc C57 547737
Contact Name Tim Duddie or Dave Maske E-mail timdtcdrillingcom or dmasketcdrillingcom
Mailing Address 9631 Candida Street City San Diego State CA Zio 92126
Phone 858-271-0099 Ext Fax 858-271-0233
E CONSTRUCTION INFORMATION
TYPE OF WELLS MATERIALS TO BE USED PROPOSED CONSTRUCTION BORINGS TO BE CASING SEAUBORING Estimated groundwater depth _22_ ft CONSTRUCTED BACKFILL Estimated depth of boring 25-llOtt
Not Applicable _2L_ D Neat Cement Concrete Q to I D Groundwater - Type D Cement amp Bentonite surface seal D Vadose - Gauge D Sand-Cement
Annular seat to 3o Diameter -- --D Other Well Screen Size D Other Bentonite a toJL
- transition seal -- dl4gt) Filter Pack Borehole diameter NUMBER OF WELLS Filter Pack to -- --
TO BE DESTROYED Perforation to Drilling Method -- --D rz1 Auger Air Rotary NOTE
D Mud Rotary D Other Attach a well construction diagram
D Percussion for wells with multiple completions
I agree to comply with the requirements of the current Site Assessment and Mitigation Manual and with all ordinances and taws of the County of San Diego and the State of California pertaining to wellboring construction and destruction
DRILLERS SIGNATURE DATE P[t4
Within 60 days of completion I will furnish the Monitoring Well Permit Desk with a complete and accurate wellboring log will certify the design and construction or destruction of the wellborings in accordance with the permit application
RGIRCECEGSIGNATURE ____ _
DEHSAM-9060NI (Rev 1109) Page 1 of b County of San Diego Department of Environmental Health
1Sl
i
-middot
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
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F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 392-050-43-00 Site Name El Monte Valley Site Address 0816 AIAtreeel Street l 31 so et M M-t-e City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 1- TYPE OF WELLS Soil boring
2 ASSESSORS PARCEL NUMBER 392-060-29-00 Site Name El Monte Valley Site Address 3331 WiiiampN MOfltt- City Lakeside Zip 92040-
Rd
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
3 ASSESSORS PARCEL NLIMBER 392-150-17-00 Site Name El Monte Valley Site Address 13950 El Monte Road City Lakeside Zip 92040-
PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466 1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 2- TYPE OF WELLS Soil borings
4 ASSESSORS PARCEL NUMBER 391-061-01-00 Site Name El Monte Valley Site Address 4+t65- El Monte Rd City Lakeside Zip 92040-
3150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Ext Fax 619-466-1823 --Mailing Address 7811 University Ave City La Mesa State CA Zip
91942-
NUMBER OF WELLS 12 TYPE OF WELLS Soil borings
DEHSAM-90601 (Rev 08-10) Page 2 of6 County of San Diego Department of Environmental Health
I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
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CL (
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pound 0
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I
F SITE INFORMATION
1 ASSESSORS PARCEL NUMBER 391-071-04-00 Site Name El Monte Valley Site Address yenAllow Road
l So e I Mte (lcl PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 4-
2 ASSESSORS PARCEL NUMBER 393-011-01-00 Site Name El Monte Valley Site Address 448115--EI Monte Road
1150 PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 3-
3 ASSESSORS PARCEL NUMBER 390-040-51-00 Site Name El Monte Valley Site Address ttAIIevmiddot Rosd
I tSf tamp PROPERTY OWNER Helix Water District Phone 619-466-0585 Mailing Address 7811 University Ave
91942-
NUMBER OF WELLS 6-
4 ASSESSORS PARCEL NUMBER __ Site Name __ Site Address __
PROPERTY OWNER __
City Lakeside Zip 92040-
Ext Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City Lakeside Zip 92040-
Ext __ Fax 619-466-1823 City La Mesa State CA Zip
TYPE OF WELLS Soil borings
City __ Zip __
Phone __ Ext __ Fax __ Mailing Address __ City __ State_
NUMBER OF WELLS __ TYPE OF WELLS __
DEHSAM-90601 (Rev 08-10) Page of b
Zip __
I
County of San Diego Department of Environmental Health
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
G FEES (in effect beginning September 1 2010 through June 30 2011)
ACTIVITY FEE SCHEDULE
Permitfor Well Installations Only $20000 for the first monitoring well (Groundwater Monitoring Wells Vadose
Vapor Extraction Wells)
Permit for Well Maintenance $9900 for first well maintenance inspection
Permit for any Combination of The first activity will be $20000 Well Installations Borings amp
Destructions Additional activities will be as follows (except UST backfill permit)
$16100 for each additional well $9900 for first well maintenance inspection
$ 3000 for each additional well maintenance inspection
$12300 for each well destruction $ 4900 for each additional boring
TOTAL COST OF PERMIT
DEHSAM-90601 (Rev 08-10) Page 4 of b
X
X
X
X
X X
AMOUNT
$20000
$9900
$20000 $ __
$16100 $ __
$9900 $ __
$ 3000 $ __
$12300 $ __
$ 4900 $ __
$162100
County of San Diego Department of Environmental Health
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
H QUESTIONNAIRE Please answer all applicable questions completely For well destructions complete only 1 below and submit any required supportive documentation
1 If wells are to be destroyed provide a description of method of destruction NA
2 What is the purpose of the wellboring investigation
D a Part of an ongoing site assessment case in which a government regulator is the lead agency If yes indicate which government regulator is the lead agency and the case number
DEH RWQCB DTSC
D b Part of a Phase I investigation for property ownership transfer or __
0 c Geotechnical investigation for proposed construction land stabilization or
D d Other
3 What procedures will be used to prevent the wellboring from providing an avenue to contamination during construction All drilling and sampling equipment will be cleaned prior to intrusive activity The borings will be sealed in accordance with SAM guidelines
4 What field procedures will be utilized to determine if contamination exists Soil will be visibly observed for contamination
5 What procedures will be used to determine whether samples will be sent for laboratory testing or archiving Visual observations
6 What constituents will be monitored and tested (Include EPA Laboratory Test Methods to be used) NA An environmental evaluation is not part of this study
7 How will samples be transported and preserved NA see above
8 What sampling methods will be used Sampling will be conducted using standard penetration samplers and California modified samplers
9 Are you proposing a variation from the methods andor procedures presented in the requirements for the construction or destruction of Vadose and Groundwater Monitoring Wells (Current SAM Manual Requirements) If yes specify these variations and include a well construction diagram and all required supporting documentation Refer to the SAM Manual Appendix B for monitoring well guidelines (wwwsdcdehorg) Yes D No 0
10 Are you proposing a variation in drilling and destruction of soil borings from the methods andor procedures specified in the current SAM manual If yes specify these variations and include a destruction diagram YesD No0 __
11 What procedures will be used to ensure that the drilling equipment will introduce no contamination Drilling equipment will be cleaned prior to drilling
DEHSAM-90601 (Rev 08-10) Pages of c County of San Diego Department of Environmental Health
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
12 What methods will be used to clean sampling equipment NA
13 What cleaning method will be used to clean casing and screen prior to installation NA
14 A Property Owner Consent (POC) agreement is required for all applications except for onsite open LOPSAM site assessment cases Caltrans properties and military properties
DEHSAM-90601 (Rev 08-10) Page fgtof b County of San Diego Department of Environmental Health
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
GARY W ERBECK DIRECTOR
QInunplusmntt nf DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222fFAX 619-338 middot231511-800middot2 53middot9933
wwwsdcountycagovdehllwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
40615 Aslmood Street I 3 9 t5 0 B ( lOV ( (2amp
Lakeside CA 92040
Assessors Parcel Number (APN
392-050-43-00
JACK MILlER ASSISTANT DIRECTOR
t __ ___()_ __ __ owner of the propertyproperties tisted above give my permission to
---NinyoampMoor-e__ T--n---middot County-Drilling __ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells D Destroy ___ monitoring wells 1amp1 Drill _1____ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Driling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellSborings installed or existing wells estroyed on middot property to ensure proper closure of the monitoring wellsborings
PrintName ____________ __ Title
Company --middotmiddotmiddot----t----e---1Lx-middot _+-______________ _
Mailing Address __ ]-J-M9---___)tV--- =gtJegtL)+- LM--=esot-=L7J-
DEHSAM-9503 (Rev
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
nunplusmn nf GARY W ERBECK
DIRECTOR DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112-9261
619-338middot2222FAX 619-338-231511middot800-253middot993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
JACK MillER ASSISTANT DIRECTOR
Proposedlocationsforsubsurtaceworn Property Address
13331 Aiillow Read
CA 92040
I
Assessors Parcel Number (APN)
392-060-29-00
owner of the propertyproperties listed above give my permission to
___ N_in-lt-y_o amp M_o_o_re_T_ri-_C_o u_n--ty_D_r_ill_ing __ (consulting company contractor) to conduct the following worn at the locations stated above
0 Install ___ monitoring wells 0 Destroy ___ monitoring wells middot IR] Drill ---2==--- soil borings
I understand that Francis 0 Moreland registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroy on t middot property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date z 11 llClj
Print Name ___ ____cd_v-____clo-s--V--_W__----------- nile Di of tno ileeo1
Company
Mailing Address __ 1__ -=-f)-- _ _J_n_-___1 _[v--=es=-middot t-J _CA_OI_ ( Oi__4-=-=-2=----
DEHSAM-9503 (Rev amp-07)
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
GARY W ERBECK DIRECTOR
npound DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot3 38middot222 2FAX 619middot338middot23151middot800middot2 53middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work Property Address
13950 El Monte Road
Lakeside CA 92040
Assessors Parcel Number (APN)
392-150-17-00
JACK MILLER ASSISTANT DIRECTOR
I __ owner of the propertyproperties listed above give my permission to
----Ncin-yo=ampMoocre2-Tn-middot C_ou-nty-D-rmcin_g __ (consulting company contractor) to conduct the following work at the locations stated above
Install ___ monitoring wells Destroy ___ monitoring wells IZ] Drill ---==--- soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the currant SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well destroY-ed o his property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name ----=--U--(--l iJ_s_middot Di qf
Company __ c=--f _____________ _
Mailing Address __ _C_A_____q----1 --l]__tt--=-2 __ Jr I I
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
GARY W ERBECK DIRECTOR
QIaunplusmntr of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619middot338middot2222FAX 619middot338middot23151middot800bull253middot9933
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
14 403 el Mente Read 3 q 50 tl tv effie (2_amp
Lakeside CA 92040
391-061-01-00
I bl e()lt fA6hl d- owner of the propertyproperties listed above give my permission to
Trimiddot-=C=o=untyL=Drilfingz__ (consulting company contractor) to conduct the following work at the locations stated above
D Install __ monitoring wells 0 Destroy ___ monitoring wells IX] Drill _1_2_ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company and an authorized signer for Tri-County Drilling (drilling company have submiHed a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wallsborings installed or existing wells troye n this operty to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
GARY W ERBECK DIRECTOR
nunilJ Of DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
619-338middot2222FAX 619middot338middot2 3151middot800middot2 53-993 3
wwwsdcountycagovdehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number APN)
15909 IAIIew Reaa 3415o E-l 391-071-04-00
Lakeside CA 92040
I H-e )( W 0shc t owner of the propertyproperties listed above give my permission to
-Nin-yo=-=ampMocore Tn-middot -=Cco=untyL=Drilling___ (consulting company contractor) to conduct the following work at the locations stated above
D Install ___ monitoring wells 0 Destroy ___ monitoring wells IR] Drill _4 __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to welllboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing well estroyed on thi roperty to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ____ _
Print Name _____ ZA_v_l_U-=-5_V_middot _WBt--_D ________ Title o-f-
Company ____ ---CO Ts---hjmiddot_ct-----------------
DEHSAM-9503 (Rev 5-07)
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
GARY W EREECK DIRECTOR
Qlountu- of JEliegn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN DIEGO CA 92112middot9261
61 9-3 38-2222FAX 619middot338middot231511middot800middot253middot9933
wwwsdcountycagovdehnwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MillER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
4876 El Maffia Read i 3GJ So E 1 M OVI lt- M 393-011-01-00
Lakeside CA 92040
I Wcrt-e-( owner of the propertyproperties listed above give my permission to
__ Ni_nyo_amp_M_o ___ or--e_ T_n_middot-c_o_u_n_ty_D_n_middotll_in_g __ (consulting company contractor) to conduct the following work at the locations stated above
0 Install ___ monitoring wells D Destroy ___ monitoring wells iZ] Drill _____soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore consulting company) and an authorized signer for Tri-Countv Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to weiVboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring we Isborings installed or existing wells troye on th property to ensure proper closure of the monitoring wellsborings
Property Owner Signature Date ---cent9---J_AltH ____ _
Print Name Cu los () (16 Title
Company ld e 19lt 0B1vtd-Mailing Address 10 ) h )96middotL fw-e ve I M e$l1 I c j q I 2
q I I
DEHSAM-9503 (Rev 5-07)
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
GARYWERBECK DIRECTOR
illnunty npound j nn iepn DEPARTMENT OF ENVIRONMENTAL HEALTH
LAND AND WATER QUALITY DIVISION PO BOX 129261 SAN OIEGO CA 92112middot9261
619-338middot2222FAX 619-338middot231511middot800middot253-9933
wwwsdcountycagovldehlwq
PROPERTY OWNER CONSENT
Proposed locations for subsurface work
JACK MILLER ASSISTANT DIRECTOR
Property Address Assessors Parcel Number (APN)
16200 Willegtv Roed l 3 CJ 5o B- ( M on e Ramp 390-040-51-00 ------------------------------CA92040
I H eh X ]1tfd owner of the propertyproperties listed above give my permission to
-----N_i---ny---o_amp_M_oo_r_e_ T_n_middotc_o_u_nty_D_r_ill_inOltg ____ consulting company contractor) to conduct the following work at the locations stated above
0 Install _____ monitoring wells 0 Destroy ____ monitoring wells 1KJ Drill __ __ soil borings
I understand that Francis 0 Moreland (registered professional) of Ninyo amp Moore (consulting company) and an authorized signer for Tri-County Drilling (drilling company) have submitted a signed application to the Department of Environmental Health in which they have agreed to complete the above-stated work according the requirements of the current SAM Manual all ordinances and laws of the County of San Diego and the State of California pertaining to wellboring construction and destruction I have arranged with the Responsible Party the person who causes to have monitoring wellsborings installed or existing wells d stroy don thi property to ensure proper closure of the monitoring wellsborings
DEHSAM-9503 (Rev 5-07)
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
Page 1 Document Name untitled
AS08 39205043
ASSESSORS PROPERTY SYSTEM 392-050-43-00 SITEOOOOO ASHWOOD ST PD2LOT 898080 AC ML IN TIMBER RESERVEampIN LOTS 81amp82amp85amp86ampIN ZONE USE ACRES0008080
OWNRPANSHELIX WATER DISTRICT
TRA 82150 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-050-40-00 ORIGIN CUT001751 YR 90 0 pp REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105045 AM
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
Page 1 Document Name untitled
AS08 39206029
ASSESSORS PROPERTY SYSTEM 392-060-29-00 SITE TRA82150 PD2TIMBER RESERVE6568 AC ML IN UNMBD LOTSampIN LOTS 90amp93amp94amp99ampIN STATUSN ZONE USE ACRES0006568 S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND MAP000289 0 IMPS PRIOR PN392-060-12-00 ORIGIN CUT002474 YR 77 0 PP REDRAFT CUT YR
0 X PRIOR TRA82006 TRA CUT005115 YR85
Date 2152011 Time 105123 AM
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
TRA82150 STATUSN S-R
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN392-150-04-00
PRIOR TRA82006
Date 2152011 Time 105134 AM
MAP000289 ORIGIN CUT002475 YR77 REDRAFT CUT YR TRA CUT005115 YR85
--middot---
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
Page 1 Document Name untitled
AS08 39215017
ASSESSORS PROPERTY SYSTEM 392-150-17-00 SITE PD2LOT 1052781 AC ML IN TIMBER RESERVEampIN ZONE USE ACRES0002781
OWNRPANSHELIX WATER DISTRICT
TRA82150 STATUSN S R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP000289 0 IMPS PRIOR PN392-150-04-00 ORIGIN CUT002475 YR 77 0 PP REDRAFT CUT YR 0 X PRIOR TRA82006 TRA CUT005115 YR 85
Date 2152011 Time 105148 AM
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
Page 1 Document Name untitled -middotmiddot middot-middotmiddotmiddotmiddotmiddotmiddot- -middotmiddot-- -middotmiddot- -middot- -middot- -middotmiddot-middot -middot- -middot- -middot-middotmiddotmiddot-middotmiddotmiddotmiddot-middotmiddot--middot-middotmiddot-middot-middotmiddot-middotmiddot-middotmiddot-middotmiddot-middotmiddot --middot- -middotmiddot-
AS08 39106101
ASSESSORS PROPERTY SYSTEM 391-061-01-00 SITE PD2LOT 7548626 AC ML IN LOTS 73 amp 74 amp 76 amp IN ZONE USE ACRES0048626
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND MAP001146 0 IMPS PRIOR PN391-060-42-00 ORIGIN CUT003042 YR 66 0 PP REDRAFT CUT010013 YR 75 0 X PRIOR TRA TRA CUT YR
Date 2152011 Time 105200 AM
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
Page 1 Document Name untitled
AS08 39107104
ASSESSORS PROPERTY SYSTEM 391-071-04-00 SITE PD2LOT 778968 AC ML IN LOTS 70amp71amp76ampIN ZONE USE ACRES0008968
OWNRPANSHELIX WATER DISTRICT
TRA82006 STATUSN S-R
CODES 1 DOC0060137 DATE030773 ZIPOOOOO MAILPUBLIC AGENCY
0 LAND
0 IMPS 0 pp
0 X
MAPDB0170PG071 PRIOR PN391-071-01-00 ORIGIN CUT002477 YR77
REDRAFT CUT YR PRIOR TRA TRA CUT YR
Date 2152011 Time 105213 AM
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
Page 1 Document Name untitled
AS08 39004051
ASSESSORS PROPERTY SYSTEM 390-040-51-00 SITE TRA82006
STATUSN S-R
PD2LOT 8012963 AC ML IN LOTS 76amp77ampIN ZONE USE ACRES0012963
OWNRPANSHELIX WATER DISTRICT CODES 1 DOC0060137 DATE030773 ZIPOOOOO
MAILPUBLIC AGENCY 0 LAND 0 IMPS 0 PP 0 X
PRIOR PN390-040-27-00
PRIOR TRA
Date 2152011 Time 105222 AM
MAPDB0170PG071 ORIGIN CUT002476 YR77 REDRAFT CUT YR TRA CUT YR
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
N
-- PROJECT ALIGNMENT
SCALE IN FEET A LEGEND
0 1200 2400 4800
NOTE ALL DIRECTIONS DIMENSIONS AND LOCATIONS ARE APPROXIMATE
FIGURE
1
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
0 -
if
e r
a ]
CL (
)
pound 0
-2 cQ
lt(
+
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
APN 29- oo
2 bo-middot nj S middot B- B- 3
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
AfN
I B - 1 2
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
AfgtN 39 2- SO- 1--00
s- -shyB- 5
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
6-2
s-s
IQ - 1
B- 1 (o --1-
pound2rg
e-- 4 Jo
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
APf-J 3Cf I -Oi-- OQ
4 s $-
e-4
B-t-3
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
A P N 3 4 3 - o - o - oo
6 B- --4 0- 2-5
-lt
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30
l10- OL(O Sl -00
(o bolti s 6- l 0
eurogt- -2-1-
e -30