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98 Z A 081:01 MZ 'L 'AoN awil paA!;3;� <br />P � <br />WELLJPUMP PERMIT ) <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1888 F-ASTHA2ELTONANeNUE-STOCKTON CA 95205 _ I2n91 AA.R-velli <br />NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />JOB ADDRESS 'rq2 EightKile Rd //�� C tockton CA 95212 <br />cies, STREET A l p in e R d Ap' �V PARCEL SIZE • 1 I .vM USE APPLICATION <br />OWNERNAME Leland➢Beigel, , i loth( N) PHONE209-662-4399 <br />OMERAOMMSS 7922:. E Eight Mile Rd c.,15 --ZZ Qckton CA 95212 <br />COWMACTOR Purviance 'Drillers Inc PHONE 209-887-3554 <br />CONrRAcwR ADDRESS PO Box 64 cn jsTATFJZIPL in d e n, CA 9 5 2 3 6 <br />SuecoNntAcTOR <br />PHONE <br />SUBCONTRACTOR ADDRESS CITY/STATEMP <br />LICENSEX C-57 ^_ C-61 3 D-09 U Other Numsm Z EXP RAnON DATE <br />uo1KE3TIC WELL A-AIAPLING: 3 General Mineral(ColifOnn Bacteria (4391) C Dibromochlotopropane (4382) 2 Arsenic (4393) <br />INTENDED UsE I/ Domestic/Private O Irrigation/Agriauttural D Industrial O Water ouality Monitoring ❑ Sol Sampling/Characterization <br />O Public Water System <br />If oiftmnt horn owner. Water symem Name Cm[ad kerne or Phone Humber <br />TYPE OFWORK C New VJell G Replacement Well 0 W A Alferation/Modification D Other <br />2 Monitoring Weli(sj_itofwelh C SoilBoring(s) aonndng, ❑ Geolechnical aofoutings <br />Out-OPService Well D Out -01 -Service Well Renewal ❑ Crass -Connection Repair <br />Cl New Pump to Pump Replacement ❑ PumD Reoair n R.r—,nteu r.,.-,,.,. <br />Drilling Method ❑ Mud Rotary CTI Air Rotary D Auger 0 Cable Tool 0 Push Pant ❑ Olher <br />Proposed Well Depth ft Excavation in diameter D Open Bottom O Gravel Pack/Gravel Size in diameter <br />O Conductor Casing in diameter / Conductor Casing Depth it <br />Well Casing Diameter _ in Thiccnesa/Gauge/ASTM Sched D Steel O plastic U Stainless Steel 0 Other <br />Grout Seal Depth ft 0 Neat Cement (941b bay --10 ga/ wate() D Send Cement sack r,d.,r7 gal wale <br />U Bentonite (20% solids) D Other <br />Grout Placement MelhOd ❑ Pumped 0 Free Fag O Other 0 Retardant/Accelerator (name) <br />EDes Installed By D Driller 6 PumpConlraclor ❑ Other <br />11 Concrete Pedestal ODimensions: Widfh ft Length It Thick in ❑ Christy Box n Stove Plpe <br />Pumv • SubmembteCl Turbine ❑ Other HP Pump Sel ft Standing Water Level h <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br />JOAQWN COUNTY ORDINANCES, STATE LAWS. AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REC"RED LICENSE IS <br />CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br />WORKERS COMPENSATION LAWS. <br />MINIM 24 HO NCE NOT[CE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />SIQNED� TSorporate SecretaryArE//-]/7 <br />�y <br />bo <br />PAY yam' <br />ftcefyED <br />VOy 0 7 201 <br />W'iOEVO AQUpy CpU <br />krtyO Iklt ru 1 <br />�TMEArT <br />EH0430e 41A11116 <br />WrZLPLIMP PERurr <br />C <br />�0 <br />�M <br />'v IHaa <br />C= <br />0 <br />M II <br />i <br />t, -d VL9£L9960Z out sjallu4 eouei/und 80l: l 6 L L LO AoN <br />no <br />ON EWEN MEME <br />ME <br />■■■■■■■■MESON <br />®MEN <br />!!!■■!■!■MENEM <br />l <br />ME ME■MEEMla <br />MEN ■i'�_ lMEME■EM■■E■EE■r! <br />MEN MEN ■!■M■■M <br />MEN Miw.asl !■!!!M!!!■!■■E■!■ <br />■■■euE■MMlMMM■E■EE■■��WEAVE <br />■■■_=-MEM■EM®■■■ <br />ai■M■MM■MMlEE■■M■�rr <br />MIEME■EE■ESI <br />k <br />■E■:� ■E■■ <br />N■■■■!■M■■MEE■■■�MH■MOE■■■■E■■■■i■M■MEN <br />■M■■■■M■�.. <br />• MM491/Il/rf <br />EH0430e 41A11116 <br />WrZLPLIMP PERurr <br />C <br />�0 <br />�M <br />'v IHaa <br />C= <br />0 <br />M II <br />i <br />t, -d VL9£L9960Z out sjallu4 eouei/und 80l: l 6 L L LO AoN <br />