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WELLIPUMP PERMIT <br />SAM JoAam COumy EwAmommurAL HEALTH Dmana T 1 no EAST HAULTON AMNS - STOCKmw CA e/2611, - (209) 4411-U20 <br />NON-REFUNDABLE PERMIT CALL_�209) 9ti3-TE97 FOR INSPEC ^ EXPIRES 1 YEAR FROM DATe IssUED <br />Jon ADDRESS 1628 E. 10th Street (Van Buren Elementary !J!E g 205 <br />CROSS STREET S. Bieghle Street APN v •Z 0 , O PAKeu sad LAw Use APftxATKws <br />OMNI[, NA" _ Stockton Unified School District _ p (209) 933-7000 <br />I0 M x ADORE.ss 701 N. Madison Street —R CRYISTATarApStockton, CA 95202 <br />'COwTRAcTOn Woodward Drilling Co., Ina pww (707) 374-4300 <br />c,m,cT'OR ADM" -55e Rfiro CtnISTATsrDP <br />IC Ir10�� (95.1) 7j0sU iD <br />SLIaCosrtRACToe --- — <br />SuocowreAcTnR AooRm 1548 N. Maple Street cr"4TATv2* Corona, CA 92880-1783 <br />uctIN.e O(C-67 C -at D-00 c OMwr Nu..eE 710079 EX MAWNDATE <br />Domeffne We.L SAm tm: 6 OwmvW Mmerd CoMorm Bockm (439 1) (4392) i Armenia (4393) <br />krymmum DarramwPlbab O krlpalbNAp wmk W ? Iridusaisl c 101hwr oudW MoNbhtp a Sol <br />Puw W.wByrara <br />Ndw we sears Oe MAeravbmNave comind"No ear wrrr- <br />TYPE OF Wpm u New VM Rapbow wd Well Nil AlblelbNModlabn Mier _ <br />Monilwtp Wsl(s'—_ E of wsis Sol Bork x) ._ •eIbei cc Gwbdw d 3 •1 b~ <br />Ou1-0rSsn4ri WN Out-OFServim WM Rawwd Crose-Conriedon Rapd* <br />New R Raise Wel Caft <br />1WLLCowTRwppN <br />Driinq Method Mud Rolmy Air Rotary N Auger C" -od 0 Push Poke OMrr <br />Proposed Wel Depar 20 l Excavabon S Yrdt in dianrhr 0 Open Bopom Gravei PaciaGravel Sin b dWT*W <br />Conductor Caft __ in dam w I Conductor Caaft D@A __ It <br />Wel Csslny DNKTWW in THWussrAw NASTM Shced O Shat Plaalk Sisk*" SUN � OMtar_.. _ <br />Grout Seel �M Neat Ca nwrt 194 b W911410 par me" Sand Cemery sock MW get wMr <br />t2ox sold') OMIT <br />cTrout PYeement Mw11od ❑Pulped Fms Fal OMNN %RBI i . I Amslwawr (risk) <br />( i ntalsd By ❑ Drier o Pmv Centaelor o Otte _ i <br />CawreY Pods" DIKNIINa w VAM l LanMMI _. It l ji in Chrlety Box . ' Stow P <br />Parr Sabmars"o TurbW* 0 OMrer HP Pump SN R SWAN Wow Laval m <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WfTH SAN <br />JOACILIIN COUNTY ORDINANCES, STATE LAWS. AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REOLNRED LICENSE 13 <br />CURRENT AND ACTNE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br />WORKERS COMPENSATION LAWS. <br />WtN) S.UM 48 HOUR ADVANCE NOTICE REQUIi:cD FO SPECTIOnNS -PLEASE CALL (209) 953-7 7 <br />Sloliu C.. c.�7'iC.i-s - G -C. � !�- T1n[��L�+�L� DATE '-�° � l? <br />GaDNTY <br />��,rN RDUNM RTMEN� <br />:,cai_TN DEPP <br />A R HENT U E O Y <br />App knbon Accepted By - - A—VV� Empbyes IDB <br />Grout kwp-ibn By Gt o ��(�ah I _j <br />SPECIAL Wall Permit <br />Pip Inspection ey Dela l WAVER Received <br />Sol Borkp kupaction BIy� Deb Constructed Well Depth <br />COIMAENTS 01---- <br />00 419E r Awd 41" wall IPIrMP PERtar <br />