Laserfiche WebLink
4PPLICATION FOR WELQPUMP PERMP � <br />SAI;-- JAOUIN COUNTY PUBLIC HEALTH SE, `ES <br />E ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, STOCKTO,N, CA 95202 <br />(209) 468-3420 <br />NOR -REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE „ISSUER <br />(CEmpime Ill TElpltrali} 11 <br />AMICATIRN M IWM GY MAGE TO TIIE LAN JOAOUIFI COUNTY FOR A PEMOT 10 CONSTRIXT ANIIFOR INSTALL THF WOISE DFeCPTGFO. TIOS APMICAVPDR le W,bE M COMMIaNCE WRIT eAN <br />JDAOLRN COON" DEVROwMFM TITLE. COMM" B-1 T 16, ] AND TILE eTANDA/VG OF RM JOAOUW COUNTYTOIILIC /MALT11 lEFR/ICE1, FNVIROIILI[Mµ NEALTH ORReOM, <br />JOG AITOR OMPI AM& ffer C. JG_ Q d L _ PARCR PRUATNR <br />DwNFM1'eNAME ✓: J U s ✓/� /IPxTNAIpt�`^ '7%3Y1- S./fl/��li?•' nIDNE>r7zo)'-lar <br />CONTRACTOR T L c/.J G [.Q AOO/EE1 E i'� - .3-7 q :l wn 010, 710 C, ? ? ITRi `s •3� �/- )/ d U <br />GVIICONYWYOR ADMINS I� SiY3'71 <br />Rc[ ITIeN[ <br />TVF'EoFWELummm ❑ NEWwnt. ❑ ro AcimvrwEtl Q "w"awFlnwttL. IF :I �OTrKR Pa Essv.C� �,�d✓T <br />Q RoFTAtLATON ❑ WELL evelnu FQPAm I3 CROsacow4ecr MP -APR'] " Q VAPOR EXTRACTION WELL F <br />0N..0nse.ra WF or r"Ifim H.P. DtPTNNMPtEr FT. �� FIRST WAT[RIEVEl O <br />�❑ OVr-Or-wmAct wilt ❑ 111011 UCAl Wrll F �(` '• ❑ ROIL "Win A <br />�OEGTwJCT1OM�L�•SS U/LG �/iill/ _ .. 17 l <br />IWEPIOEO iE TT7--TYT aF W COM IRiICIRLM erECtTICAII��O//MG 6 . } A <br />❑ ARX)STIEAL iJ OI`EN GOTTOM CRA. OF WELL FXL•AVAIOH R(d+ V 'mml-3,�IO dA, OF CONDUCTOR CASH d <br />❑ DOUFR0ICIT.1VArE 1) ORAVEI PACXYSIrE TYPFOTCARINOIertttlPVC /rl/e_ 1f- CIA. OF WRI CAGmA O <br />00MICMUNCR•At ❑ORTVEN DFPrHOF0ROUT%EAI.L3- , w fj S �r wfewiCATIOH A <br />11 RGROATIOWAO ❑ OTH[N GOUT IMAt awTAUEO $V " BONA" flnAm NAME E <br />❑ MONrTOFm1O CROW IMAIAIAMI), loYr ❑I/. CONCmt tDERTAIeYMMLj*QYw on. - a <br />A►PROM, OLPTN LOCILRIO CI MIN soXRTOVE INF ] <br />moPOEFR eONETRLICTronrOFTll1N0 METHOD! MVO ROTARr Am ROTARY AIroltin CAPPLE OTHER <br />I IIF^FRY CIRI WY ITIAr I IMVE MPA 1D PIRG APPUCATION ANO IIIAT 114 VMM WRj RE HONE IN ACCOFOANCE YMTII eAN JOAOIIIN COUMY Ow1mANCES, MAPF tAVM. AND Mitt@ ANR <br />FWOMMATONO OF THE RAN JOAOVIN COUITrY, HOME ONAFEO OR LICFNRFO AatW'l SMRAI" CEFITUCIN TIIE rGdOVNN09 Y Ct"PI Y TNAT M TTM PtlrOMANCE OF 111E VMPR roR WHICH <br />Itee PPRIUT IR IERUFD. 1 GIIML NOT EMPLOY PERRONR MMJECT TO WORRMAR•e COMFENEATrON LAV" CALIFORMA.' COMRACTOR•e ""mOR mrs-CONIRACTOIO "WATUFD CERTNMG <br />TIIF FM(OVMIIO: ' I CROIFY TIMT M 711E PERFORMANCE OF THE WOwI FOR NeRCN TIRG TEMIR M wSUM. I MALL EMPLOY PEREOIFt SLMJFCT TO WOI1wRAIra CMAPMATIOR IAWe OF <br />CA(Knniako iTsi APPUCANT WAIT CALL ], 110 a III ADVANCS F RFOU"tM mEFECTONE AT 120" 44,0414210. COI/"t DXIAVAIM AT LOWEPI AFEA ITOV70E <br />A e^-. D.1. F ! ! 0 97 <br />Pte r PUN $>.... M Mw1A1 bW • r. <br />1. RAMFR M RTREFTt OR AVAOR MAFEeT TO OR Ratpto lq TIM PN01fRrT•. 4, LOCAFIuN Or IIOUIM EFWAOF mero GAL GYSTFM OR PmOFp1[D <br />7. OVTLINF. OF T11F rNOMMY. OPV" OIMFNEI)MIN ANO NORTH bFFGCTION. 1 EXPANEICN W GEWAOF OIRIOM treTFME. <br />]. De:IFNaOI" OURINFR AND tOCATON OF ALL ERIET1110 AND wnroaro G. LOCATION OF W1LL1 YYRIIIN RAMUe NE OF OInMo EO 1N-IY M- <br />9TMPCTVM9. IHCLUDOM COVERED AREA$ SUCH At PATOG, DIIIVEWAVIL ANO WAIX1• ,� ON Tt1E PIFOPERTY OR Aoxn mO P omm, <br />1 <br />} ..... ..................,_............................... 1 <br />/.� TI[PARTY[Rr UtG ONIr _ I <br />A.eFewehn A. -f <br />O.s,. R,wP.w1IP. eY O.M P w, ENP.s.e. of <br />DFM <br />j1 ACCOIIIIIINO CWT;_ I AOR I rACR Il .III <br />Put), Health SerY- - Erftft. 173 (1/97) <br />PE Coors <br />FEE rwo AMOUNT RFFMTTEO CFMCtRrc7AGH I RWUVtD EY <br />• <br />I DATt <br />I fETRAIrIt''O''177VIC It REOMST NUYIGTp INVOIC11 <br />I# <br />Put), Health SerY- - Erftft. 173 (1/97) <br />