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j APPLICATION FOR PERMIT <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. HAZEi_T ON AVE., STOCKTON, CA <br /> Telephone (209) 466-6781 <br /> PERMIT EXPIRES 1 YEAR FROM DATE ISSUED <br /> (Complete in Triplicate) <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct and/or install the work herein described. This application is <br /> made in compliance with San Joaquin County Ordinance No. 549 for sewage or No. 1862 for well/pump and the Rules and Regulations of the San Joaquin <br /> Local Health District. <br /> Zea,," <br /> Job Address b City._ eLot Size Q Gs PM <br /> J r <br /> Owner's Name FL') Ck __.-r_ Address `� q <br /> Phone <br /> Contractor_tw 6 AddressC License Nof?qhone�� <br /> TYPE OF WELL/PUMP: NEW WELL WELL REPLACEMENT; <br />