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Arr11CATION FOR W£LMMP PERMIT <br /> F JOAQUIN COUNTY PUPLIG HEALTH SERVICES <br /> ENVIRONMENTAL ON <br /> P.O. B X38, 904 EAST V&-BER AVENUE,sTOCKTONP f �G <br /> CRA 95201.49a <br /> (209) 48t-3420 <br /> ON RETUNPAIll Prim RAR 1 R R <br /> M ATION A HERE BY MADE TO THE SAN AOAOVI COUNTY FOR A P[NMR TO CONRTUCT ANDR)R MSTALL THE WOW OEtCREMED.TMt ARLECATDHI m MAOL M CC% AMC[WITH SAN <br /> AApyn:COUNTY DM1041EHT AM 115.3� 111 E.9 ANO1THC•R�ANDA/Dt OF SAN AAryyIN COLRETT FV W HEALTH SERvIUS,EN'vMNIALWAL HEALTH OTVIDION. <br /> Ae ADDFIEaon APHI 21D'}f ( /El. ��� b •F��us� RARCEE .l Z3 <br /> em <br /> wn+[R't NAME <br /> cONrRLrrOR`J�// � - w S r LFCJ n.oN[JSID•3S 1.890p <br /> L os uci <br /> tut cok-PACTOR ADORw SCSI.482390 RHoHEJ2 .I S•l.l.l� <br /> tYFT V WRiPJMF• ❑ NEW wELL ❑ .ACEMEHT WELL ❑ WO OMNG MEL/ ❑OTHER <br /> ❑ PISTALLAMN ❑ S FTEM REFMR ❑cRosaco"cr H<PANL ❑ VAPOR EZTRACTOH WELL F y <br /> ❑Nw❑PN.H Hl. DEPTH PUMF W[ FT. RAST WATER lME p <br /> RTES OF Klin ❑ [ECCET /p 4f-DERVIC[WE3E ❑ OEOA(YSCAL WILL q SOK.601.4 �_/E-� • <br /> ❑DE DTIUCT*W <br /> !✓1♦HOm IA[ <br /> Ytt OF W i N TR M RWATIONS <br /> ❑NOUETDAL ❑ORN DOTTOM 04,OE wETL CRCAVATOH 1 zH dA OF COHWCTOR CASINO_ IV,aa p <br /> ❑ ocwEanc wavAT[ Q OMKL HAG DQ[ TYRE Or cAUNOIDr[tL(nID P I Q DIA or VIM CASNq ALfi p <br /> ❑ Fv%jcn •INKSAL ❑DFSKH OMM OF GROUT DEAL 2S WfCSICATON J <br /> ❑ PINGATOHIAG ❑OTHCR OROVT SEAL RlAAILED ST' r•IIP/ GROUT LEWD NAM[ E <br /> ❑mow ft a r1. OFOVT DEAL P M 0 OY. ON. CONCRE 1 PEDESTAL LYDNLLER:Ely. ❑NR J <br /> APFILTE. DVTN 25 B LO-=WA)CHERDI SO;ISiOK RIR[ O`jA J <br /> Fq PCS CONETRLCTO N.71N11)NO METIIDD: MUD�`OTMW MR ROTARY AVOEN CAM <br /> i <br /> I�Y CEMWf THAT I HAVE PREPAREO THIS APPLXATgH ANO THAT THE wCW WRL BE DONE M ACCORDANCE WITH SW AAO'JM COUNTY ORDINANCES,RATE LAWS.AND RULE[AND <br /> REOtMTp Ht OF THE SW UOAOVIN COVHTY. Now OV.'N[n OR<K ENSEO AOENTTI SONATyRE URivEt THE FOLLOY/►a:T CERTW THAT N LIR PCMOFwANC[OF THE N9RK FOR WMCH <br /> Trot PCRLIR H ISSUED.I SHALL HOT EMPLOY RRSOH�DVSJECT TO WORIAAMF'I COMPOISAMN LAWS OF CAVFORMA' CONTM OR'!HROHa OR q!S{OHTRaCTINp N►JtR?O W01IS?lAM'S COMPSHAMN UAYD M <br /> .ONATyRE CRIy3 <br /> MFJLt <br /> THE ROLLO` UNG: •I CERTEY THAT W TH[ RMAtNCE Of THE WOfW MR WFNCH THIS PEaAR N NRUEC,r SHALL EAEFLOY PERSONS <br /> EAUFO • T DAHT MUS, /2S HOW b ADVAHC[pGII ALL RtG�WV "A xV 1 do pDRA�AT wvq,AMA�.►►[ D.I. 9 �. S <br /> J <br /> PLOT RAH P.M S.NI DENS •. <br /> f. NAMES Of STREETS OR ROADS NEM'EST TO CR DFA THE PRORRTY. a, LOCATON OF NOVDE*EWA*[DfpOSAL LY$TTM OR RIOMC O <br /> E. OVTUHE OF THE PTOPERIY,GIVU4 DWENSK)N[ NORTH CNMCTON. EZFWSION OF DtW'AOE DISPOSAL SYSTEMS. <br /> 1. :WENHOHEO OVTLWt AND LOCATION OF ALL G[vnn AND pROFOSTO P. LOCATION OF WELLS WTrHIN RADR[D OF OHE NV o FIFTY R. <br /> i'RvcTVR<S.LFCLUDlHO CMARED AREAL OUCH A4 PATIOS,DRvEWAYE,AHD WAUCS. ON THE RRDPERTY OR AD""NO FROpEFLTY. <br /> .. .r.. <br /> ._ .......o. ..:...... .. :.. <br /> O <br /> w < <br /> .;.. ..,.. .........T......:... .... --------......L <br /> ... ..... ..: ^ <br /> .._.... �. .....E._......b...«.�....%.__ ... • •- e....:. «...... e l <br /> i.... ..... ..... : <br /> volt- OBA cxr USE ONLY 4 �//T 7 <br /> YIA.:In A^IPE LI OwD ! '/� / / NFA o / <br /> O,.0 b,F~�By e.. OPw L.r.rn ti IRwD <br /> Acc TFNO any, MDS 0— '✓` <br /> PAGI <br /> R mou FEE rHno ANwUNT RL lbj GH UXAUH by DA" r.► xm"CE RtOUEAT N{ smpl aevelea <br /> 2 'd IC :01 96/ 10/20 Woad <br />