Laserfiche WebLink
"� BCE #14573 <br /> WELLIPUMP PERMIT <br /> SAN Joan=COurwr EmImowEeTAL HwILTH OUT 1888 East Hazehon Avenue-STOCKTON CA 08208-6232-(209)4883420 <br /> NON-REFUNDABLE PERMIT CALL 208 862-7667 FOR INSPECTIONS EXPIRES I YEAR FROM DATE ISSUED <br /> Joe ADDRESS 2680 REYNOLDS RANCH PARKWAY CTjZp LODI, CA 95240 <br /> CROSSSTREET RIGMAY 99 a E. MRRNHY Le. APN 0586014 PARCELSRE__LMD USE APPLTCATmN# 3312-0982 <br /> OWNER NAME COSTCO WHOLESALE PROM 425-313-8100 <br /> OwMe ADOaEss P.O. BOX 35005 cfrdsrATFMP SEATTLE, WA 98124-3405 <br /> N <br /> DDNTRaDTOR <br /> JONES COVEY GROUP, INC. pHow 909-972-7581 m <br /> O <br /> CONTRacioa AOOREae 9595 LUCAS RANCH ROAD #100 CRWSrATFJLP RANCHO CUCMTONGA, CA 91730 <br /> Sueconirtaoroa LEAK DETECTION TECHNOLOGIES LLC pHoM 520-207-4878 <br /> SuecourR.LcroR ADDxase 1400 EAST PASEO PAVON CmWSTATEwTUCSON, AZ 85718 00 <br /> UDENBE IIC37 11 C-61 I10-00 IOmer NVET9ER 804431 EHPIRATIONDATE 8/31/2013 !n <br /> GE0010PTECALINF11RRATION: C001dinat99X Y TownahlP_ RanOe_ SactbH_ <br /> INTENDED Use ]DamastlrJPdvele O hNafionlAgdoftral x-ldustdol ]Water Quality Monhodnp ]So83artpMyCharedarimtlon <br /> ]Pubk Water System <br /> HertaraMawn Amer. WRIWEre.N. or <br /> TYPEOF WORN 3 NeI O Replacearmtwe9 c Well AlteratloMAodiecatbn 210m,. ELD MONITORING <br /> 9arMnm <br /> j Monitoring Wag(a) #ahvega O Sob Bor4g(e) tolealps C Ge0letlhlke <br /> ]Out-%SaMea Wag c Out-Ol-Service WeURanawal O CmsE Connecfi Repair <br /> ]New Pump ]Pump Re tacamenl O Pump Repar O Rmse Wed Cast <br /> no t. <br /> Ddilinp Method ]M PlrRotary c Auger U Cable Tod O Push Polnt ] Other OU <br /> Proposetl Well Depm ft In diameter DOpen Bo vel PawGmvel Size in diameter to <br /> I Conductor Cing_in dlarrI ft <br /> as <br /> Well Casing Diameter_m Thirkneas/Gauge/A Plastic U Steld"sSleel D Other " <br /> GmutSeai Depth al Cement(94/b bag/6-TOpa/wated USan sackmW7 gal water <br /> m <br /> 0%eogds) ]Otiter N <br /> Cement Method u Pumped UFred Fag UOther JRetardant/Accelerator(MI <br /> 0 <br /> p er <br /> enp <br /> u ft <br /> 1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN - <br /> JOAQUIN COUNTY ORDINANCES,STATE LAWS,AND RULES AND REGULATIONS. 1 ALSO CERTIFY THAT MY REQUIRED 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 /> MINIMUM 24 HOUR ADVANCE NOTICE UIRED FO INSPEC770NS _ <br /> $WREp J LE DATE 12/14/2012 <br /> EIVE® <br /> ---------- - - - -- <br /> 17 2012 <br /> NTAL HEALTH <br /> SERVICES <br /> 111 1 1"FAI][H nEPARTW TT <br /> O ,b MENT US/E, O/N,LY �//�p�yp�/ <br /> Application Amptad By Date�Ji Pres Employee IDS" <br /> .2I <br /> lmaPeclbn By Data SPECIAL Wel I Permit <br /> Pump inspeclon By Date WAIVER Received <br /> Sol Boring Inspection BY Dale Constructed Well Depth ft <br /> COMMENTS <br /> PE Sc Received Amount Date Permw Involee# Well D# <br /> Codes Info Cash Remelted SI Rog oast# <br /> !A 7 <br /> NELLAUNF PF.RMR <br /> E1U0aM <br /> eausa <br />