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WELL/PUMP PERMIT <br />SAN JOAQUIN COUNTY ENVIRONNE N7 AL HEALTH DEPARTMENT 196S EAST HAzf tioNAvLNUE-SToCRioN CA 95205 - 1209) 468.3420 <br />r1dVN-KtI-UNUAt7Lt rt KKjMIJ A.� / L•ALL LUy SO3-lby/ FOR INSPECTIONS EXPIRES 1 YEAR <br />/FROM <br />)DATE ISSUE( <br />JOB ADDRESS n`'r'1�Q I lk t)h Road '1 1 CITY%/zIP �(��1. (1•'(%11 ��'i �(..Q <br />CROSS S7REET A V /e n ck y� 1�\ � �,LAAPPN �Q / (��jb�� ` _ PARCEL SIZE✓ •_TAO USE APPLICATION # <br />OWNER NAME ��/fA/y���L/• � C../J '/!/`F ,gW f R, PHONE <br />PHONE 4 <br />OWNERADDRESS rj6t;� yt/L��� LA CITY/STATE/ZIP �\T <br />CONTRACTOR .�—_1• • i PNONEE 1 1 <br />•�i ---777 <br />CONTRACTOR ADDRESS LLf1 CITVIS7ATEIZr ' _ _'q. <br />SUBCON7RACTOR N10��e//• r,N it ln(\` 1��,�1(%�e (1L1 'l f(l C1Y In PHONE C�SCl) <br />SUBCON7RAC`IIoRADDNEsS-L-`77 rYQ�Y)U fi rl'Q'1 CITYIS,TATTEE0P_[yf5n0% <br />