Soil Bor Permit App
GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS Department of Planning & Natural Resources Division of Environmental Protection WATER GUT HOMES 1118 CHRISTIANSTED, ST. CROIX, USVI 00820-5065 (340)773-0565 APPLICATION FOR SOIL BORING PERMIT In compliance with Title 12, Chapter 5, Virgin Islands Code, the undersigned: Name of Driller & License Number Mailing Address Telephone Number hereby applies for a permit to: Install a soil boring on the property: (Name of Property Owner) (Estate, Lot Number and Island) . (Property Tax Number) (Telephone Number) The soil boring will be drilled to the approximate depth of___feet and willbe diameter. (Purpose of soil boring) The attached sketch (property map from Cadastral Survey) shows location of proposed soil boring relative to existing buildings or other physical features, the location of existing wells on the property or nearby adjacent properties and the location of all known sources of contamination in the vicinity. …
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GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS Department of Planning & Natural Resources Division of Environmental Protection WATER GUT HOMES 1118 CHRISTIANSTED, ST. CROIX, USVI 00820-5065 (340)773-0565 APPLICATION FOR SOIL BORING PERMIT In compliance with Title 12, Chapter 5, Virgin Islands Code, the undersigned: Name of Driller & License Number Mailing Address Telephone Number hereby applies for a permit to: Install a soil boring on the property: (Name of Property Owner) (Estate, Lot Number and Island) . (Property Tax Number) (Telephone Number) The soil boring will be drilled to the approximate depth of___feet and willbe diameter. (Purpose of soil boring) The attached sketch (property map from Cadastral Survey) shows location of proposed soil boring relative to existing buildings or other physical features, the location of existing wells on the property or nearby adjacent properties and the location of all known sources of contamination in the vicinity. APPLICATION FOR SOI BORING PERMIT To prevent contamination of subsurface soils and the ground water aquifer, the soil boring will be sealed upon completion of drilling activities. The soil boring will be tremie-grouted with a cement-bentonite mixture to the surface. A log showing the various strata or formations intersected by the soil boring, depth to first water encountered, static water level, etc., will be forwarded to the Division of Environmental Protection within 30 days after completion of drilling operations. Fee of $10.00 is attached. (If check, please make payable to the Government of the Virgin Islands). Signature of Property Owner Date Signature of Driller } Driller’s License No. FOR DEPARTMENT USE ONLY: DATE: APPROVED: DISAPPROVED: REMARKS AND/OR SPECIAL CONDITIONS: SIGNATURE OF INSPECTOR: DRILLING PERMIT NO. (if Approved):