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06-16-1995 10:12AM FROM• <br /> TO �^ <br /> • 151 <br /> APPLICATION FOR VVELUPUMP'PERRIIT 47L3 J,�'J C <br /> j SAX JDABUIN COUNTY PUBLIC HEALTH SERvi: <br /> WHEALTH -tet <br /> Divislog us <br /> P B SOX 38B,446 N.SAN JOAO N STSTUCRTON,CA 962013y JUN 2 <br /> RES)4IE.3g20 1995 <br /> N9NRFFDNIw81E PFAYIT FYy+• 'h0Y W=EU -NVIRp <br /> Awifeati I Is here byi Lade to the sen Ir+Mbp r Tt¢Soal �N,,MENITJ 'r�. 77TT'� <br /> Natls in aaaplien[e Nith Son Josqufn"cagy Oevel my fora graft to P trust WWOF fratalt Ma Work desar thee. Thi Ilpp`��e'i�NvteA�ITi <br /> swfcaE, k`MiromMu�t�Neel[h BivfaipL °P"an[ iitte, gepeer 9-1115.3 NW she Rtagerda of sen <br /> Job ArAlres I/or APNe tJ c3S So� Cc ,({,--Si y.� aw�•fn ca.e,ty pubtte Yeafth <br /> city 'S>`aL,�foc1 <br /> OWMr•e Mae iL`� E �pareel Sian/Apw <br /> i Addrwx S SsDu <br /> ]q Ceneraeeer rl-l�/�^ '1/ Phe ztl9 94 Z-1S01 <br /> C� 7t S } � <br /> Address utOfNL 1„ n � 0� <br /> w CcneraLjeot._ imh��^ St 5 PwaaM u Ls Z4 2( CSn " 6 <br /> phew A �/S �- ,c/06(, <br /> TYPE D PUW' 6 VIEW WELL q REPLACEMENT WELL , <br /> l� DESfRUcricmq MONITORING WErLL q OTHER <br /> O OUT•Op•SERYIW WELt q GEOPHYSICAL WELL M <br /> 13 INSTALLATim Lott BARING. e2L <br /> Q TELL SYSTEM REPAIR tl CROSS•CUYNECT'REPAIR <br /> TYPE aF ) fl x"' (IoPpair M.P. Il VAPOR EXTRACTION WELL <br /> REP7H PtNp SET Ft, FIRST WTER LEVEL_ <br /> MO <br /> IkL SBNSTPUCTp1Y tpfCWCt71 xY/ .n �// <br /> I q INd6YRIIIMt U OPEN BOTTOM DIA, Of WELL EWAVATIOY tD —� -�' ��C "/(1 <br /> fl DWiC6TIv/vRlYATE d gtAMIL PACk/SF DAA. OF O[NWICTOR ftslhy <br /> g TYPE OF r,ASINa/STEEL/PVC DIA. Of WELL GSiYG �� <br /> q PINLID/MbulalpAL tl ARIYEM TYPTN of <br /> q IRR16AT1 /AU tl OTHER S 9EAl SPECIFICATION <br /> *NWIIpp GIMT SEAL INSTALLED BY GROUT-BOARD MA�_--� <br /> PFWX T0RINO . <br /> r I WAIT SEAL PiWPEO, a Yeo 1] Ma CRETE PEDESTAL NY DRI T <br /> APPNO)L D 2•S'+-P2 r hq� [ax DRILLER, q TCP b Ne <br /> �TIW J— LOCXiNG CHESTER SOY/STOVE PIPE <br /> �-- <br /> PAOPOSEO COII.TOO <br /> aTIDYfOp(L <br /> IBM <br /> a NETNDB; IRp AOTARY--AIR RDTAAY <br /> ---AUGERS GRLE•_OTNSR,,,.L <br /> i !'here [Ty toes I h'AVa PrePered this aAvliutim Ona the[ the Nark WI l( Ee dorp{n 4ccordwce N to /sen <br /> stale Law, arH Wlao aM:ReNWlatiaYt e!LWa gen JPrNlin CP W Ord 11RnCAS <br /> cerci/y tMt in the pMonmrce of the.ak for Mlcba thl s tY• Nap ower or lieatvrap epenN.sipmture eertiff" the fa(loai <br /> peraiL ie ieswdr 1 shell roe ey.l%pereaNl aWbiee[to rq' +1 <br /> Saws of Cat fornfa,n raltriata!'•R girip or sub-omtrmttnq sfpytara etlKifi ea the }dlfoWi <br /> 01 the Work far Wtich this permit !e fsaW, t shall nyt • f certify [holt�fnx.the Wf r,,,l <br /> NUEi CALL p0UR8 6YAYDE EDE ALL EBNE®1ESPFartANE1 T GBN 4BE.SggS ect to fuDRpyN+e Sl meppBArfox sew or caLlFemf..e <br /> TNIAPPLICANt <br /> ' CYp It7 ae lover Wee proviaed, <br /> S1yxe Y ` 4h_ _ <br /> Title'�cfiGo�RiA� S� Det. <br /> I PLOT PLAN (Draw to Suss) gaair + tP `� U <br /> 1. Novae e� e[ree[e ai rued. nearest to Pr uoaditp the PraPerry. <br /> J. DNtline+of the W'epertY. 0 V AM alRarmielm end Nareh dlreP tion. L. LPcatfm at haws aaaMse diN."t eVagm W <br /> J. DiemnetWNd outltMs end lxaefm of e1I esieeitp end prrp0ted pr""ed eepenefm of aewae dtepesat &yet®, <br /> strut s, ImiWdinp covered Orap lush as pastae, drfveWays, 5• Lbr llom of wllo Wfthin rmius of 150 f, m <br /> and tmARa• the property or ed7Pfnf.w PrawrtY. <br /> I, <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I� +� DH'ANTNFNT ESE ONLY / <br /> Appl icetlm MCCep[od 4CN+„P(F� fs <br /> Or Out ImpkdtiWIN <br /> Desthctim�'-wectfonlyPump lmpePtim SY Dater <br /> Data CPaevnts: <br /> :ACCOYNTINU.OALY: i AIUA FAC# <br /> PR CUBES FEE we INDUNT RgYTTIN GRECRFIUSH REcam RY DATE pEYIBT <br /> REQUEST NINE IODIDE <br /> d X83 l� z6 4' <br /> TOTAL P.02 <br />