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APPLICATION <br /> .,gAN J0Ag1uI t et)b „ i PC BLIC HMT11 SEIIVICTS. _ <br /> El V IRONIMPAL nALTH DIVISION <br /> 3 Gp <br /> 445 N SAN JOAQUIN, PHOMrs (20J)46N=3420 <br /> P o NO%. 2000 0 STOG$T014 CA '95201 ` <br /> (Complete in Triplielktts) <br /> Ap,liEatilse fI6 tiilf61W�jWj fA fes, Joa�quih doutity for A pei�it to conbttutt and/or i>iatEl�thb work fftrein described. Thitl <br /> t�pliCititlu istlllr a ti liiult6 iritic W J�oyekui^n to Ordintlhc! Nos 549 the 1662 and the Aulds &Ad ftgulntions of $�n <br /> J'OKU11% County fiubl i i''Di/jo <br /> j 61 City Lot size/Acree.ge <br /> Job A6 .. , .. <br /> ,: :OvLnt6r's Niw► <br /> ddresa 7qqPhtSne <br /> G`ttntfBtttN Adtfr'tj53 <br /> lriSL Nx 212A__0h6n <br /> act'-.TYPE 67f WELL/PUfyIP }- ' NEW WELL w ..N1ELL REPLACEMENT .E7,., DESTRUCTION Ll Out of Service well 0 <br /> "'pltfaNE INd1'AL ® ► SYSTEM WAIA L1 t1460 ® tbnitorins Well 0 <br /> �s�TAN�fr�n Nf`AAf`Sfi �SEI;'�#'eA�lft• � �`" l;Iv�l:l�`LII1f1ti5,,.�.��. bl5f}OSAL kb! 900 LIRE �f <br /> rixIfi�I,TIi��Vtilf. :; p:UULLi19t1rVll�S �.�. <br /> sft- AAA <br /> iNrl Nt3t b US ." gip Wf:�LL` p{I:I"�d• - ogeA ¢ 4'�1N'StRUC710N,SPICIOICA 16146'• �i <br /> C1 Ind�istrist n ❑ Opeh A6ito�rl E7 Mer6teCA. bill. elf Well ilkeiirefiaih bli. of iNdH Cluing <br /> ]ett111;u�tPrWiill fii6Ai Peak , 0 Ttiey Typo of ceflho _ ► �_! Specifititloi�s — <br /> } Pubilo : :s Ih other ��>��iy belta � bapth of Grout S`A#1 type of CtF6u1 J <br /> I f irrigirtian r�6�th Afterfi M :: $uriecii Seuf i"114116d ay <br /> Rap&Work b6Ai 4 0 � Ty"6)t�tilf�s <br /> 147 "� Ff,1t. �" - Stets Mirk Done <br /> . �p ElliiillE Naterist A pa6�th " 1 <br /> W#N olatfuttamt fJ wail blitflteter'_i"" <br /> _ ti <br /> ` b161itfl latr PAW-L&I'A' i 4a <br /> TYPE OF,SEPI t1 WditK: NEW INSTALLATION I 1 REPAIR/A04ITtON f I Ot STRUCTIOWI INO 3tlp16C tyltiiii 1Errialrled if publit stlw9r It' m S <br /> AV#Hibli within 2(fC ie1t:1 <br /> F <br /> Im"6111#t16A®Gill i81Vii" Aflftf#hC#..= I;olt6ftSell►IAI" i "'fjifiaF Y t' ; <br /> k Nutt if Of ti�Iltt: Nutilile of WrobPtitl <br /> rrhilAfat bf#epi8 fi dip1R fel r6ft' i .. _ t <br /> .'�., �.� _.� et tibia dd6th <br /> rl boitibe�trtilintA ��� � <br /> Sf:P IC XfaK F, b 0111% cAp� <br /> th <br /> Pett# f SATMile 0a.C ..��_ � .�' � `�� �x 1� 1u <br /> .,w.., �n filt�I of f)lipb#�f �� <br /> K x, ' j' IS1lliAlf[ to f►liP6�tt „iNell ' f otleietlof� PrA�iMyurti' ` <br /> 7.:jg.. .i _ 1 `rn Y DF. ;..rM1 c.R'. S""k'.`.`•Ti�a'-1 a_ . <br /> tACwtu� llNfr' f fdtl. L8�d1 63f hf1Ai , .- r . a 9'riiife �tilt'I�fla ,.r : <br /> flLtEf1'11 IIIEI ��`i f I#ifilll:i#6 11afireitt' I W6fl f .f buhdefid I�rtipflfiir Llfir>F I ° <br /> v' fes.ii ji YF. A. .* '+1•.. .++ i. .. t <br /> L ,. a1 ; t..,M2r.F �lUFflef 'A1. n <br /> ()Athf L" Sits <br /> F SUfutpS, (t biet✓rfle id 1wi6r�it� . Wolf .. _ - Fburtie#ian. *6040W Line <br /> i)iSPOAL MN65: D <br /> 1 hereby eariify that i it✓yvi prod#fed 111i#AaPlltetHSll AMthAt Afie Wdrk,Will be ddho 1r1 i6ewdlfied tAflth-Sei jae4uitt ebuhty wdWneft Rite lam..end 4, <br /> rules end rsdutAtlbfyf b!th6 f35h'J6Af dIh t,bllN <br /> Hdttittl owrtlltt <br /> at flf:ifto Adllfit'i WDAMUf6 61liftilfii the fC1$bi+49h$: ii! 6#ttity thi6�ih the partBtMAMe&of thU'gva k toi*hleh thi#toliNt is issued. I shell not { <br /> e;►►ploy`iby �f�1�i�4��!1A Auch MAhAst Iola biliedM4 objeet 16 W6rki"Ifi't aomptlnshiloh ISWI Of Cel�f RIA.`.abiVueeitt#'f IifriFld of Aut>-col+tr#sting a'�gntytQrtl <br /> aeititit6sr ifie.to118vW19d:''-'I CA?tflyt that 10 tha Mtgt3f'IItAhda.6f thi W6rlt fbf'whith that pothiit It liitieil,1 AN Wholay j4!fl65hr Iubliet 16*oArnin's compents <br /> tion tafire 61 tAIiftStrlii." <br /> T1+#apt'll 4 uitetl It swildin#.:'CfStr olms etrevyillQ 6r fa ig <br /> oil 6. a..�" "• `7 <br /> Snedtoo U$E My <br /> 21 <br /> At#i <br /> plt - <br /> Applirrit6Dti Att16Pt1I8 by� , -. <br /> Pit 6t rou ihtil6h by,. r bile..�. 1 Flri#I Inipbotio $y Ohio <br /> 7 / I. <br /> Additiano C M#0111hte: <br /> 5 Applicant L [teturn Ali cb0i'et a cleft Joadui•n collet$ Pubiid mkith botiI606. ..•. <br /> � �'�- �?� � Eigvirlxl,merltai tte3xfth`PePAiit15#>t�ictirl <br /> 445 N bin Jb&4uiff i p 0 Boit 2C0l3; t3ticil� t2A 85�b1 <br /> CASH, . <br /> FEE CEIyp OY WE PERMIT'NO: <br /> INFO :AINDUN bIJE AIIAOUfJfi�ItttilltttEiT fIE „ . <br /> ttH}12f IllEv.11461 <br /> Err 1440 DD <br />