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' 06-22-2000 02:45PM FROM TO 4671118 P,02
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<br /> 3 �AA....�iSAN 30AC:IYC LOCAL l#T3AIi : BIBFKZ
<br /> USE: , / lbll E. Hazelton Ave,, SCcktor. Calif
<br /> Teleghoze:
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<br /> (205) 466-SISI ,. '•:..
<br /> APPLICATIRN Fait WELL, CONSTRUCTION Olt P UMP ?'ERIix`
<br /> "r� �•'3 � � .. • �'!�:��ros:'•'', , „ter-,�J�- •-..
<br /> THIS 1I.EWHIT WIRES' 1 YVAR FROM DATE'ISSUED
<br /> (Complete Est Triplicate)
<br /> 1 Appllra :,oxa is'- .irde'to the San Joagvit�'?.ocal Health' D1.straet. fora€' 6t 'tet, Gi4 ?�'d L
<br /> dnneifox „nacbllr:the,mark.hereiu..described. : This application.is madcdP]faacra.'
<br /> Coc,y ua .ordinance+'�aa. .Z8b2 as,d'the Rules-and 'Etegulat3oes 'of.'the Son-joaquiu Z:dq�Y
<br /> 1 ! '�i .,•� ,: �.. �: :'�'� .:: � :I � � _ nd-S' 'w ]4 .i 4� \ r {X �1,{y 4,y�'/.�Y'�r Wji,�,
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<br /> 2]E�PEts L RECONDITIONRECONDITIONID[+Y*
<br /> �•..DESTRUC'�ION '� "�� �:,-t..;;n,.
<br /> ' INST`�TICN . PtWREPAIR Fu^Pim .fP'.-REPLACEI IT;' rT.:
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<br /> DISTI�SIw� ,:�NAiEST::- : SEPSEPTIC..TANK U*ir2l LL NES FII• FRIV ',te..
<br /> TiaAG3 DISPOSAL. P ! "::::.;' : ,:.�.k� �.,•i+;;i
<br /> POS FILID 5E1PAGS P '.= 01'888;: � y
<br /> PRIVATE I OMSTIC WE'LL-.� 'pu)1 C•:. � q:.
<br /> y INTENDED:'USE. TYPE OF. WLLI: CANSTRL;,CT,101t,.S?3C1 1CATI�ib"
<br /> Cable Tool Dia. of:Well.,
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<br /> .'Dp¢��cic/Prfveta "Drilled Df.:. of'47e1: '::Ca9iitg 'r G •r " ; ', 'f'
<br /> `- , Dc -aeric/.pilbiic'• Driven Cause Of:Casirig'cf:"
<br /> cibo t:''Sed31''�':`-5: '
<br /> Gravel Pack Dept4l,:of:. *s;� ��'�•�. .'���:
<br /> yq' Ca;L�s�d .',�ro'teat3on Rotary Tgge of• urcut
<br /> Qther Infermation.ti:.
<br /> :•,,5 '.�..- I,C:.,ophy,i91Ca7'� 5ux��cr'8r�a�:T tsl' e3:,•n .._,.';: ,;�;d �t�'�`a,
<br /> 1'iUN4y W" ContlCsctor
<br /> X135 i. . P'i7 ' TALLA
<br /> mock. Done r '^• �" r'S�.-, •i�« p e
<br /> .i'w�F���t:_ - :�"'5tat4R'.work.D0F3E.
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<br /> res rib -Material and PXacsduze' 5 I .hezeby aSree tea comply-with'. 11 lav&.1d:.regulati(me of the, San, ;Oaq,ufnk-10cr,]., t
<br /> .� 1 i�" x d:',the �I a2c.4f..Califaruia, ertrinlag .t4 er regulatins'x€11`,:conitr�let $61 AN! r T
<br /> "a€t cryo lotion:'of::M work:oa a::iiew well .X.will furnJ xh; e•_'Si�zi:. Boa 'oin Laca�
<br /> notify them before puttires',c[xe i eli.
<br /> i,nf:)!7n.•iQW.: is true'to the•beat.o£'•.,,M ic'r�npiledga. arid'b6xief. L WY ,3`..CAL. T+OIt'A:.GROITt>LtiSF�G" 11D '`''
<br /> r !, ..T AN7 11 PxNAi.. I14S_SCTiON.
<br /> -PLOT PLAN ON $lV}RS'E -$107777777
<br /> FOR
<br /> J�Jgr_ T. '' W.f; ,rai' tr.' ;tl'
<br /> a i A iFLIC.+ :7C% ACCEPTED'BY
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<br /> S TX il\Ja Ir,Sr LS4ii Vs'+ M t INSPECTI
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<br /> .17,1$l'-GTIO BY DALE ' IiVSPLc�;:t��I.. 'y AATF
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<br /> 1 ; .E D 1426 &evs3.-.74
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