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WP0039382
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039382
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Entry Properties
Last modified
4/29/2019 2:28:22 PM
Creation date
4/26/2019 12:05:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039382
PE
4372
STREET_NUMBER
0
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
MANTECA
Zip
95336-
APN
NEAR 22806017
ENTERED_DATE
3/1/2019 12:00:00 AM
SITE_LOCATION
AUSTIN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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AMeuangkhoth
Tags
EHD - Public
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CPT <br /> + i <br /> WELLIPUMP PERMIT <br /> Se.N JDArmx Covxrr EN1AAONYENTAL HEALTr DEPAATrrNT 1a61 EAST HAZELTON AVT%UE-STDCKTON CA 6520S-(MI 468-]AZO <br /> NON-REFUNDABLE PERMT CALL(209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOe ADDRESS.. .. AL.s*,Rs". Crrv.zip !:-3nL Axl 55331 T <br /> CAoss STREET )id'al iolvC -----__APN NA PAACtL SIZE LAND Use APPLICAnON s p <br /> A <br /> Or.Nt a NAME C}"of kWwca PNOire u <br /> OwrEA AooAEss C.mSTATC;2rp <br /> CONTRACTOR SL c-bu^Cc,*,A"9 pp., 016)3758706 <br /> i <br /> CONTRACTOR ADDRE31 2491 B—t--Avenue Cmvt$TATE.2m'ries:Sauar=r CA 95691 <br /> SVecc« AcToR Mt kse Ear7i Gam Tessrg 1> _ pFrpiE 17`4i633-5025 <br /> StRtcoNTxwcTDa ADOREsy 954 F.Lem-or.5: CIrTrSTAid/jM�{+'arc&,GA.52667 <br /> LtceasE -S7 C-5: D-CS Otter NUrrbEA EvgftArwDATE � <br /> DDwsnc WELL SAMPLmG: General IdaierA,Cdit m 8a-clona(4391) DOromoentoropropane{4392) Arsenic(4393) <br /> WTEIDED Use IY✓—rt P—wo 1mI;;&.Agneuollwal irdJst*d vv w okaa:y momo 79 x Sal 5'.lnpfi'fs,'CniraCter2atlhn <br /> Put4c Vyaxr Systen ..__ <br /> i <br /> TY-Py. VV NeN we9 ReplaremerA'610 Was AitsrtmlgoC,a.al.cn O-w, <br /> Uonaarny We81z i e r.`r,os x SOd Bw.rgi s: •,[. ,I x Gecw-.ir.,:a <br /> Out-ol•Sorrfs Weu U9!-a-Snw,—LYaS Rertrwat C^7ss-Lnn�ea4 n R—aar <br /> Nm P—P P; 4p Repia,*Trtnr PLem Repan RPsg'Aa,1 cavr!G <br /> DrRMg MedA d U-:Rotary Air HG'ar! ALyr Cats&Tod x Prat,P—If <br /> Pmgosad Wall Ort &1 h Fac W ren_;_. _.m a n&te° ow&..cc.-, ; aver Pack,GravV S,tr m awnm r <br /> uor-oxici CaEi*•y -3 r Crnductu Cas-9 Lck-on <br /> Wdl Casan9 gall-_r "ISaw Sr&e, PIa4L[ S�fflnLess Swei C^^er <br /> Grout S*&I Gep[,. c tr& Neal Cemen:r94 d Laq•5.16 gai•wsr+7 San:]Cern*+^: sa+..E mm(7 981 wow <br /> Brrb�nlle(20%zai+csn CM'yr <br /> Groan PlaceNnsnt Method P„M', C r•ee."'all o!rw tromie RW m srt Acc6wuh f tnamel _ <br /> PEQESTAL _ InsgMW By DnW P,jmo Cor+eacror 00- _ <br /> Concrete Pedestal ONnensiom ow-w", R L&`gR+. h Tike in Christy Box Ston&PI <br /> Tu L— OL-., HP I',m n Sc! R Sw�ccir Y.a's'Le.51 Q <br /> I HEREBY CERTIFY THAT I NAVE PREPARED THIS APPLICATION AND THAT THE-WORK WILL BE DONE IN ACCORDANCE VIM SM <br /> JOAQUIN COUNTY ORDINANCES. STATE LAWS,AND RULES AMD REGULATIONS. I ALSO CERTIFY THAT MY REOUIREO Lice"m is <br /> CURRENT ANDA TIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE W rH ALL <br /> WORKERS COMP£ TION LAWS. <br /> MII IMU 10UR A ' ANCE%tl-,!CE REOUIRED FOR 'SPIECT,kON-PLEASE (209)953-7697 <br /> SgIlY Tru Er N {i1 Lis b i <br /> MAR <br /> oul <br /> V1gO,yM COJjN7y <br /> T N Ds-pAt <br /> 4 MCPJT <br /> �QEPsRTMENT UBE MLYQ / (p <br /> Apo-(—A—W-By ^" nnVV``FF�' D`r � m 1 Amery/1 (CA EmplaI—IDs <br /> Gnat I:—pecom By - crate SPECIAL Well Parrnit <br /> P—P I:rpwo-By Qre WAIVER Rocoiwd <br /> Sod BclN vlop v",Bf Qatd �![�d 1 Construttsd Wall DoW R <br /> COMMENTS <br /> PE_ SC Recsned CMr:IaI Amolsnt PerRIIt+ <br /> Cowls Mo _ I RemBhed Oau rviCy wi 0 A"rO s itY�100 <br /> loini <br /> i <br /> rt(#1 mlAiP oEMkT <br />
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