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WELUPUMP PERMIT <br />SAw JoAanl Cow" Ewvoww mj(TAL HEALTH DEPARTNUIT <br />1888 EAST HAa.LTow AvEmm-STocKTON CA 95205 - (209) 4ss3420 <br />NON-REFUNDABLE PERMIT CALL(209) 953 97 <br />FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />JON ADO"sa SW Comer Navy Dave 3 San Joaquin River <br />CnWzv Stockton, 95203 <br />CFAM STREFT 8.4-0 m LJ14502019 <br />PARcv_spa 10.28 LA_wo (JSp An— <br />ATM It <br />OW"M NAY! <br />ow+orAaoREsa <br />CrrriaTATEIZ1P <br />CONTRACTOR Kleinfelder, Inc. <br />(209) 948-1345 <br />C0KmACTOR AooRcss 2001 Arch Airport Road, Suite 100 <br />CnWSTAT9IZW Stockton, CA 95206 <br />StAcdrTRACT011 Woodward Drilling Comapny, Inc. <br />pHom .707) 3744300 <br />suacovmACTvt Amiens 550 River Road <br />C"STATNZO Rio Vista, CA 94571 <br />LKU" X car r. C-01 n D4)9 00W <br />wmw, 710079 ExmATwl DATr 07/312019 <br />OEooRA9WC AL IIIonMATrm: Coordnabe X Y <br />_ Townahip _ Rwmp smean <br />er g n Don»sYr/Privals D Yripalbr�Agrklldral n kxuwW <br />WMor Quamy Ma*orkq X Sol it kvChwadmitzoon <br />WARNTen <br />Of woRu NOW Wog Reoleeemw,l WON WeNOlhv <br />Mondoreip WN(e 0 d Wele Sol Boring(s) <br />_ <br />l of kNY1p K Gealadntcal <br />0ut-0(S4rvicrr Wei W -0( -Service WN Rartawel 1 Crow-Corrrcron Repek <br />New Pump PWM R. town«x Pvnp R.S»k <br />Ralee Wel Cooky <br />ArLLL CQftATmxT*N <br />Dr*" Method X Mud Rotary Air Rotary Aupw Cable Tod Push Pont Omar <br />Rropo«d Wes Depth 55 It Excerwfon 4' In dlen»w open Botbm Gravel Packld.rd Slav im dlrrrY <br />C"AxI rCnrp in diaewW Conductor Ca" Depth R <br />Well Caewq Diernew _ in Thicknaedf au*ASTM Sdmd SWI n Plnle n slMrin9 SOW Orfw _ — <br />Grout Seel Depr+ R N Neel Gernert! (94 b bWW10 gar walm) n Sand Gamont_ _ sack MW7 g l Wale <br />BeneonMa (20% so9d9) a OIhw — <br />3rmn PleewrwM llll d X Pupped 'i Fmo Fad a RelardrN I Mneleraior (rmvm) <br />PEDESTAL Mrtailed liy Driller ❑ Pump Cdnbadw n OIhv ConnNa Pedeetd Dkrnrraloru Wldlh A Length R Thick in Chnory Box almm Plpa <br />P ten. SubmarakrM Turbm _ 00m HP Pump Set R Standing Walar Level A <br />1 HERESY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br />JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE M <br />CURRENT AND ACTAlE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br />WORKERS COMPENSATION LAWS. <br />M�MUM 21 HO RAD �E NOT T_IC(� REQUIRED FQit11�{,S�P�ECTIO/NS -PLEASE CALL (209) 903-7697 <br />sman C �! i Kul/ T-&dZ J.L�CIl�9+�' DATE <br />, Ac -pled Sy <br />GroutkWeclion 4 <br />Pump kypeCODn By <br />Sol Boring kr9ection By <br />COMMENTS k <br />I■ ■■ ■ ■■■ ■■ ■■■■ <br />'s'■■■■MEE ON <br />mill ■■■■■■':■1: ■■■':■■. <br />■ ■■■ ■ 19! <br />■No <br />■■■■■■■■ ■ ■■■■■■■ ,., <br />■■ 0m lion ■ ■ ■■■ �. <br />lip"41tt�.�r��-a9rsiW <br />��������la,� aryr��■■■ rwifAi 1�11 17 <br />rl <br />nrnr��RM �ti1•�t�tlitli•�■ ■ ■ <br />■ ■■i■ ■■■■■ �rnrnM, it <br />t Ty <br />I■ g` ■■■■■■■■m■■■■s MIN NT <br />u��r�.n------ar•■�r�■�� r•�ia� <br />DEPARTMENT US ONLY <br />DOW <br />011110 <br />Delm� <br />Area �/sfk.,1 Employ" <br />0 SPECIAL Well Permtt <br />C WArVER Rscetvad <br />Conevucbd ll Depth <br />D043416 <br />~2 <br />Well Kv <br />