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cleprn ------
<br />l rt•E CIF SII•TIC w,>ak NEW IN$1AtLAt1ON I i REPAIRIADDITION i I Ol5
<br />IMIatt114n VV41 serve Ptoodence --- Com ro'CUl — Othw
<br />N,n+tNe 01 M— 1MN•-- NumtMH o1 bedrooms ..
<br />rhs,sclw ul ecli to a depth of 3 feet
<br />SE)111C TANK 0 TyparMig
<br />PKG TRCATMLNT ►tT rl
<br />Dialwa to naMeal
<br />LEACHING LINE Ll foo. A L"th W kris
<br />FIIf EN RfD E.1 O+tawo so noveM.
<br />_.__--------- Capacity--_'
<br />1I t lNo sepl,C system pwm,ttyd a ""L"'c
<br />avaaable w+Ihn 700 teet.n
<br />T
<br />\Vatw utile depth
<br />No. COMPAWIMOrts
<br />Method of Dlsposai _ 1
<br />Wen - fdundal.On Property L,rle - O�
<br />e _ Total Nngth/axe /
<br />well Foundation Pluperty Lww
<br />r
<br />SELPAGE PIT6 I t D♦i.rh~ --- —'-- Number --
<br />SUMPS LI Uw»,ata tir wreel Woo ------ Foundation
<br />D'SPOSAI PONDS 11
<br />I hereby cwlwr that I I+aH Y f -m aus apdKa(ar. and that 1M wp► w" W done rt 1CCpdan^,e with San JoaquinCounty 0ldwynCes, stale I&-$'nd
<br />,i
<br />ruts$ and '*9Qt4twM of ins San Joaqu•n C— ly I shall rwt
<br />"Low owner a $+;.mead slfera • a.flnatwo'An.t,ss tr+e l0aowr+p "I contty that In the parlor.f Cale or the work f, 1,6 pwng f Sub.t o issued,
<br />1Mr,pa„y any petpn n ouch ma,w. ea 10 bec.+rnabubo"C' to
<br />tlnca of M ayWs to ylrt"ho t -o twi Ew1d'1 Wu ampbY Delp^� DNct O�watlma t rs�co ��enw
<br />urtdra the fotoww,p I candy %list in the yart,.
<br />tan owe of CGttl Ornta ..
<br />The ep^441t st can t sa 4".Od m•pattana Compete drew+np on reverse � /Z6
<br />/ y Trw r 10 Date: fa//
<br />F1 PARTMENT USE ONLY
<br />F Date—
<br />AppL�ar.on Accepted by
<br />/- '
<br />7t~eL Dii:�//ct� Finalinapectan D Date
<br />M Groat r.a{sctan by///�.J �
<br />Ad111ttorW CortYnrnu
<br />Appl l,'ent - m«turn ail rnP1«w to: saw Joaquin flwaty Public Wealth Service"
<br />Emrtroaratal Henith permit/Servlcna t•�,
<br />eeI M Sam Joaquin. P U ltos 7000. Stka. CA 95701
<br />iii
<br />Ftf AMpUhI AMOUNT RlMlfltt) R'c"'o
<br />Dl/! 1Y DATE /y'�IfRM1T NO
<br />{ 1 of
<br />t✓ .l. :7 cI �� �
<br />to tsN lmfY ••�). /
<br />_—
<br />SAN JOAQUIN COUNTY PUBLIC fiEALTH SERVICES
<br />ENVIRONMENTAL HEALTH DIVISION
<br />445 N SAN JOAQUIN, PRONE (209)468—
<br />P O BOX 2009, STOCKTON, CA 9520
<br />V I
<br />PERMIT exPIRI'0 I YFJ1R FROM DATE IS:iCLa .
<br />(cc)mplete in Triplicate) "'tr '992
<br />Applicetiun 1E eerehy sada to San Joaquin county for it permit to construct and/or SnKi ,«t dor k 'heerrei���eribed. This
<br />1662 / cions of San
<br />Application Is .wle in comwitance with San Joaquin county UrJinance No. 544 and
<br />PER'wltf/SERVICES
<br />Joaquin County Debut Health tlerrlces• - ZI
<br />(� Lot Stu/Aerenge '�1L
<br />r..- Citylk
<br />51. �i Y`
<br />Job A�drsss ., (,J 1pl.L.l.1 .----
<br />If 4241
<br />P
<br />n�i
<br />: sci
<br />Ownw'e Name. rT-�/--
<br />' �s'� '
<br />�:�t=:i �r ,f.( ✓fie. • ✓,(� t ��t'o-, � 1 L, 1-;�_S1� Pnone
<br />And,ett 1CL!_�i�(k, i..,i=�C +"`'- cense no
<br />Conb$CiaL,�lk�IrhCL' J;�YIvf .Li__.
<br />NEW WELL WELL HEPLACEAIENT C: DE5TRUC TION Ll Out of itoserriee Well 0
<br />monitoring Well L7
<br />TYPE Of WELL/PUMP • OT ER C:
<br />PUMP INSTALIATIO � SYSTEM REPAIR :.
<br />PROP LINE
<br />pee SEWER LINLS � DISPOSAL FLD.
<br />DISTANCE i0 NEAREST TANK lY L� PITSISUMPS
<br />_
<br />FOUNDATION �... AGRICULTURE WEII OTHER WFIL
<br />FOUNDATION
<br />INTENDED USE TY►E Of WELL PROBLEM AREA CONSTRUCTION SPECIFICATIONS_ 3 n
<br />---- D.a of WON Excavation fLlj' •+ Out of WON Cooing -
<br />T...
<br />` Bottom (-1 Maniacs _
<br />1, Ir.ouUral LJ pare^ t r. $peedcatw)nsif�' Ir r /1 I�nl
<br />Caw•J hli��.
<br />e'T"
<br />I QumeshcrPnvats G,aysi Pac► I: Tracy Type of
<br />Depth of G•oui Seal Tvpe of GrtwtL'f
<br />t I O[thw i Della
<br />lu .wwoe Depth 1 ENtom Surface Seal Installed W
<br />hielaY.,
<br />N P Sou Wort Done - -
<br />Rep,, vVuu Dune lJ Type of Pump ESeallrA material a Depth
<br />.yell Doei,uctar• Q Was Dwratal ---^ Piller Material L Depth -
<br />cleprn ------
<br />l rt•E CIF SII•TIC w,>ak NEW IN$1AtLAt1ON I i REPAIRIADDITION i I Ol5
<br />IMIatt114n VV41 serve Ptoodence --- Com ro'CUl — Othw
<br />N,n+tNe 01 M— 1MN•-- NumtMH o1 bedrooms ..
<br />rhs,sclw ul ecli to a depth of 3 feet
<br />SE)111C TANK 0 TyparMig
<br />PKG TRCATMLNT ►tT rl
<br />Dialwa to naMeal
<br />LEACHING LINE Ll foo. A L"th W kris
<br />FIIf EN RfD E.1 O+tawo so noveM.
<br />_.__--------- Capacity--_'
<br />1I t lNo sepl,C system pwm,ttyd a ""L"'c
<br />avaaable w+Ihn 700 teet.n
<br />T
<br />\Vatw utile depth
<br />No. COMPAWIMOrts
<br />Method of Dlsposai _ 1
<br />Wen - fdundal.On Property L,rle - O�
<br />e _ Total Nngth/axe /
<br />well Foundation Pluperty Lww
<br />r
<br />SELPAGE PIT6 I t D♦i.rh~ --- —'-- Number --
<br />SUMPS LI Uw»,ata tir wreel Woo ------ Foundation
<br />D'SPOSAI PONDS 11
<br />I hereby cwlwr that I I+aH Y f -m aus apdKa(ar. and that 1M wp► w" W done rt 1CCpdan^,e with San JoaquinCounty 0ldwynCes, stale I&-$'nd
<br />,i
<br />ruts$ and '*9Qt4twM of ins San Joaqu•n C— ly I shall rwt
<br />"Low owner a $+;.mead slfera • a.flnatwo'An.t,ss tr+e l0aowr+p "I contty that In the parlor.f Cale or the work f, 1,6 pwng f Sub.t o issued,
<br />1Mr,pa„y any petpn n ouch ma,w. ea 10 bec.+rnabubo"C' to
<br />tlnca of M ayWs to ylrt"ho t -o twi Ew1d'1 Wu ampbY Delp^� DNct O�watlma t rs�co ��enw
<br />urtdra the fotoww,p I candy %list in the yart,.
<br />tan owe of CGttl Ornta ..
<br />The ep^441t st can t sa 4".Od m•pattana Compete drew+np on reverse � /Z6
<br />/ y Trw r 10 Date: fa//
<br />F1 PARTMENT USE ONLY
<br />F Date—
<br />AppL�ar.on Accepted by
<br />/- '
<br />7t~eL Dii:�//ct� Finalinapectan D Date
<br />M Groat r.a{sctan by///�.J �
<br />Ad111ttorW CortYnrnu
<br />Appl l,'ent - m«turn ail rnP1«w to: saw Joaquin flwaty Public Wealth Service"
<br />Emrtroaratal Henith permit/Servlcna t•�,
<br />eeI M Sam Joaquin. P U ltos 7000. Stka. CA 95701
<br />iii
<br />Ftf AMpUhI AMOUNT RlMlfltt) R'c"'o
<br />Dl/! 1Y DATE /y'�IfRM1T NO
<br />{ 1 of
<br />t✓ .l. :7 cI �� �
<br />to tsN lmfY ••�). /
<br />_—
<br />
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