Laserfiche WebLink
i6` v-Z1� <br />lJ <br />-c <br />WELL DESTRUCTION PERMIT <br />PUEILIC WATFA SYSTEM ❑ Ys ❑ No <br />SAN JOAam Courry ENVMOrawrtAL HEALTH DaIT 1 W Est Hordbn Avenue - STOCKTON CA 962064232 - RM 465-5420 <br />NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />JOB i If 15 ( 1,1 , f •M 1=r <br />carr/z. Lfx2 CA 95242 <br />CPO" 3 -WE- q*-,_anae <br />PARMSolt(,,i (&W UKAPKICATTON0 <br />Brat arlor�a csln <br />OWNIIRAOOREse�52 WeN Woodbrldae Fbad <br />CTrr15TATE/b Lod C 1 952{2 <br />RrONE <br />CONTRACTOR Wrwru,.eA []rearkg - ler <br />CONTRACTOR AaoRoe 5Fn AivA. Rtmert <br />7n7�i711'�f1r1 <br />CmrIStATU2r R4� 1Acta CA 94571 <br />Cil WILL DRa11Na LrcnwE NKNNIX t CS7.710079 <br />EwwATM DATE 07-31-17 <br />PuWoRATm CoNrRAcTON WOode•ard DTRRna CO.. Inc <br />PNONE 707-374.4WO <br />PflMRORATION CONTRACTOR AOOR[es SSn Q:.+�Q�+.`r <br />Cm•ISrATE/b EjlfLi�.� OAF71 <br />fM C-57 Wei DMN lbrw <br />Number j10azO EpfrE6On DM -nv12 <br />BIrseu of Alcohol, Tobacco and Firearms - U"m of High FVioeires Lkerwe <br />Number _._ E)*skn DEN __ <br />CHP Hawdors MMeriel TrasparY6m for E*Wm License <br />Number EVirafbn Dale <br />Sen Jonquil County SMrIN4Cororw 60osim Appilexion and Poo License <br />Number Evirallon DON <br />Cam mie Occ pNiosf Sm" Hoom - Bls or Lloarw <br />Number En*akm DON <br />agmmKrg"umwmm ❑ Dry ❑ R.prcerrrt Well O Caved In <br />O PR WMI llac4ea 13 Taal Nola <br />Detected . Suapected Wert Waver Cartr nkwd4ra. - — <br />-- -- <br />Adfaortpr"atyw1Wconlendis"nOddpnQ <br />Iowan sat + Wtrar wrtanwwrmN at ad)aoert propenY <br />EKSTM W21.1. CONIUMMMM DUALS ❑ open Boom 1p Orr4 Pea <br />O 1Axaeed O Dow <br />Wet Leg copy atrdwd O Yes Q No Orout feel O No O Y« <br />R beige Pond eurlwe ") HoW DIstrAW ...- Mra <br />Wet O Y� O No Dpthd CaNuewr Csaq ___ _ <br />R by DMRwwr of Cawrrewr Caskq tdrEa <br />Wei c8*q DWx~ J y d„ 4slws TOW apt ! 1 u R DIM le WANT <br />t,. (� R DpM of Ceeaq <br />Drcr.l, Trrw G t Yu•illerl <br />sew" MalerW from 110 R bps b _Q_ It bps FMer Materlal 10.3 Stand <br />Slim lam 110 A bps to 0 R bps <br />Wel 1 9 b be lies by <br />Mom __ _- R bps w _ R bps <br />Me Knfh i- Number of oua Every �R and : or _� <br />Cut <br />E*W*Nes a DMosaq cord O wNh pw ocdm eery <br />R O wWafi p W M <br />O Down&rp card and boars O %0 ptnpollM awY <br />R O wiflo14 prapotM <br />0 cow, <br />Sealing MaMM Neal Comet 04 D bm!Sdgat Wow SEM Coomi ti <br />rTaadr nrir 7 pal vnNr 6erMortM PeRNs <br />"Vwtb (2D% collie) Ma1ubaser Spec % W&M % Name <br />Specs on Fie Specs Subm tod <br />Recenwnt McUwd Pu l;NKl Free FM Otw <br />Sed Corn;kMon Complain with Mu boom Cap it bps <br />Co mpUN Ic Evhtlnp & rime* Ped <br />I HEREBY CERTIFY THAT I HAVE PREPARED TH93 APPLICATION AND THAT THE WORK WILL RE DONe IN AcxJHuk^ c --c wnIM sAw <br />JOAQUIN COUNTY ORDOLM#CES, STATE LAWS, AND RILES AND REGULATIONS, I ALSO CERTIFY THAT MY REQUIRED LICENSE If <br />CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM M COMPLIANCE WITH ALL <br />WORKERS COMPENIATION LAWS. <br />DTICS REQUIRED FOR INSPECTIONS <br />6?Os <br />U'hY <br />DEPARTMENT USE ONLY (LTi <br />Apptorlom Aornpind By �r DON --1=-b�� ice- _ ATM _Q =JC� <br />Dowumon krpectbn Br . L 4-]v- 7uSlh�( oar .. F S., IN <br />coMMENTs 11A';?,1&' <br />r` _ I n� I "07" I `.�ww' I �Rwaamw I DOM I d �.. I Mawfe I 1 Mhll W <br />P, <br />EEM 45-06 <br />07 y - WELL DESTmcnoN PEIMMT <br />19ao7 <br />/� <br />r C - <br />