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Dec-09-99 05 : 56P VIRONEINC _ 51026C3 P . 03 <br /> GEC-09-1999 16:49 FRCR�I:TWINING , INC. 559 268 0770 TO:5 96.3 P.0021003 <br /> WELL PERMIT APPLICATION FORM UNIT IV <br /> SAN JOAAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION ("PHS-EHD") <br /> 304 S.Weber, Thins Floor, Stockton, CA., 95202 <br /> (209) 468-3450 <br /> —1;"M 1 YEAR FWW DATE*Wen <br /> ieaaaaten 11M0,w %San j"qu!canary b a Del to a morW■dh)4 naoa M wWk osrxb.t TTkr 8004mu*n k waft im O0r'Ofeeae sbt <br /> Sm imayn Cama Oewoap. TIM,ChWaw 2-111 U and M blswRs 00M JON$&Caeer PUW K"JM$V Vl ey lff*WV f'A NNRR 04imm L <br /> 37 west Sonora Street S. Center St Stockton 95212 " AasO. %137-31-16 <br /> WELL Laseon Cteaa Stw CSV Pvaale <br /> pAcreRTYo.ne IB20E of w. LodgeloKAeDeaaa P.D,BoX 691985 {lY Stockton 2se 95212Ph'wo <br /> f.S7CeAoa= Vironex, Inc. Ad&*" 23726 Foley St-#7 C,y Hayward ra, 9432f1;y705927p,,, IS10-266-0966 <br /> Consuev/Sub cwmstiT+ining Laboratories 2527 Fresno St. a7t,1resno tir: pr,yr1559-268-7021 <br /> Ct4 CDaettataa:XSy,.35p rs, S3i_yy„gspTe.n+eo Ratpe sochb'1� <br /> 'b pYw V45LL 2 DORwG(CST'I KYOROPUwcn.n,wo•Aw"t OTMM-) a aesrmjr wN tIAMe OM wo-i <br /> ismms s a cvett.wm <br /> COeA tENrs: <br /> a MDNRORSNG a HOLLOW s M. - DLk OF luta C ASP.asx ft" a Poo WELL wDa olk- <br /> 0 E rrRACTION 0 A,R NA.o MORIVEM w1eGaG <br /> Daa 7ls =" OP aJAamo: a STM a PMc a Cns14 <br /> as VAPOR 0 wuo ROTARY DearN oe caouY - Tle/Ie1g TYPE Ta ec us®: a Aut>aRs aHosE <br /> a AtR 2PARCR D st s+a Jr0!R GROUT!FJ L Agmen: 0 Yat Ra (NOTE.MA)OMUM FRMFALL DEPTH IS 30') <br /> a SOU.SORN4 0 WC AUM APPROx.voPlp G OEM 5 ft _ 0 BWED TAAFP C BOX or 0 STOVE Pme <br /> a 0TMVt COMOUCTOR gSn1G PROPOScTJr (f res.Y R✓fo7o•lSorr ttltt): <br /> coareNtt: <br /> NOTE: OFFSITE BORINGS REQUIRE ACCESS OR ENCROACHMENT PERM(TSI <br /> trraer Ira t t Draww ff";;;m at'w TDst yr seat iii ea aetr in salon m so s4ftfeftm co"Y omwwlose, aro Rua <br /> wee R.MY9w't d M Baa Mlavin t,aynp. Mrrrawnw w ad,satl AWW3&*m"QK%m me bRsin¢ 9 Mfr an in IJr"fmn MKS of be v w* <br /> 11F twerdr IRR P~a aaxwc J alae Pw OnslDl Jw•+d a+mk w M MORJaa ws corApsi u mm Lew a1 c'N& nsa.• Canaswla%"w au► <br /> earautlre L Orrlrl a aeiu or 4Jbw a 7 arty OJe h IA Pu4uel p der emu M■ebe m po"w b astmod t sw aspiOr vwsnts swq w b <br /> avOIOONNi CDePWSATrpv Lase a CMYnMt• <br /> E APPLICANT MUST CALL 46 HRS Pl ADVAN E K09kRiOMW 7NSPMC7IONS- <br /> reI�,,, <br /> SEE SITE MAP IN UNIT IV WORK PLAN. DATED 1211199 <br /> OIPDRJLIJfr V8a ONLY q <br /> AIOeCAeOrt AOAfYO I1' I:� A CCJ �, 2–� IC I ASN <br /> 04A WoseJar 0r Dale Fid 1M1aatmOn� ! tt � <br /> O"Wucdm wave an M Dar <br /> COMAIMUM J CDe - <br /> ACCOUNTWO ONLY: AM# FAC$ <br /> PC CODES PEs teJFo AJWUNT pAurr p CNWKWCJJN RECOMED BY DATE PMUtfrMWrlCE MMSST NU*BER RNOtc <br /> C) LI s <br /> 0 '� <br />