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--to--�411( SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> FOR OFFICE USE: ' 1601 E. Hazelton Ave:, .Stockton, Calif. <br /> F - Telephone:1 p (209) 466-6781 <br /> APPLICATION FOR WELL CONSTRUCTION OR PUMP PERMIT Permit No. � <br /> THIS PERMIT EXPIRES 1 YEAR FROM DATE ISSUED Date Issued ✓ _ .�fl� <br /> 'pn <br /> (Complete Ir Triplicate) <br /> Application is lere-.by— ,made to the San Joaquin Local Health District for a permit to construct <br /> and/or install the work herein described. This application is made in compliance,with San Joaquin <br /> County Ordinance No: <br />