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10 <br />WELLIPUMP PERMIT <br />SAN JOAouw C"m EwmowNEwrAL HEALTK DFPAItTYENT i bu EAST HAULTON AVENUE - STOGCTON CA 15205 - (209) 463-3420 <br />NON-REFUNDABLE PERMIT CALL (209) 963-7697 FOR INSPEC EXPIRES i YEAR FROM DATE ISSUED <br />1JOBA00111111e 535 W. Jefferson Street (Hazle/(tan Elementary School) rLr Stoll bxV95206 <br />CRou3TIM S. Lineoln Street APN I `{_. __ _0_ _I I _ _ PMCFL wlNa A►t+LICATONe <br />Ovm„ NAra Stockton Unified School District ! PNoai (209) 933-7000 <br />Oww„ pie 701 N. Madison Street c"vMTAmap Stockton, CA 95202 <br />CownuCTOR Woodward Drilling Co., Inc. PHOM (707) 374-4300 <br />Ca "cTxmammu 550 River Road _ gry�TATvb Rio Vista, CA 94571 <br />SCOwrxACron _(951 <br />tra710-1 160 <br />SuncewrxAcroot ADOREee 1548 N. Maple Street c ffym 83 <br />Lxm" AC -57 C-61 D -W I 0l1w_- NleraElt 710079 EVMTM <br />DoMEsme WI1L SAMPLPM:: GanKW MknnUeColbn BacMria (4391) (43V4 o Ar -9C (4393) <br />Uonrskffll rw D NrIONOWAWicukusl ❑ krduMrral 7 WkAar CrMMY I I' "' 1 D Sol SoFfbvCharm <br />Public Warr Syslem <br />L� v dffi a peer vhw Nene C.aw Wma r <br />TYPK OF WORK New W44 o RepleoeswM WON n Well OMw <br />Lion" wA(s)___ _ s O(rwls Soll llorll9(s) M M ei"'o` x Gta mdvk l 3 of bwmp <br />Dul-0ISwNu Well out -OI -Bain WN Rw w W Crou Com "m Repair <br />-Mft Me" i Mud Rorry Air Rotry X Au9w Cable Tod Push Point OMw <br />opoaed Wd DepM _ 20 It Excsv am 6 itch in dremeir 7 Open Baft, Gramrsi PsdVGrsrel Sua In drMw <br />Wal Gas Ing DWBTw*aWarle __ASTMSCMd—._ D SrePbac StMnless Sri OIhw <br />eGotS"I Dept �N M946bMp6-fapNwreSend Gre*---- Sa <br />ckRW79eiwei <br />(2D% sd <br />4_ <br />rout PiscerrreM Me41ad ❑ Pumped c, Free Fd Oscar f ReirdeM I Aamlarsior <br />❑ CSnCrNe Hdestsl DinMwione WIdl1 _ A Lerpin It Thick __ . In Cw" am Stow <br />Ipvmp, SubowslEle Twbim Oaw HP Pump sae l 1Aidsr Lsr ei n I <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br />JOAOUIN COUNTY ORDINANCES, STATE LAWS. AND RALES AND REGULATIONS. I ALSO CERTIFY THAT MY REOLMRED 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 />IAiNIMUM 48 HOUR ADVANCE NOTLCE R QU1R D FOR 9199 ECTIONS - PL7EA E CALL (209) 953-7697 <br />s+ow<o C.`31 tr= d77et!�- I �i1 L .,fes DAn 4 %� <br />Gmd ln� By <br />PmV inspedb^ By _ .. <br />Sol Boriy k-perlion BY A-45 6m a <br />COMMENTS <br />MEN T UO LY <br />I DW Ares,/ � Em lcr," 100 <br />Dere _ SPECIAL Well PYfmit <br />Der WAIVER Receiv9d <br />Dar Conetruc$W Well! Depth it <br />[HO tine war V1 V1e YI81 ~ pliebw <br />