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s <br /> j APP4I114ktION ECR P%RMtT <br /> CAN JOAQUIN LOCAL 14§A1,TN DISTRICT RE,18010t h�1RMON AV%. STOCKTON, CArK <br /> Tol""ft 11"1 <br /> I JUI } b rnw; <br /> f emp 10111 0""101 ENVIROM, rit.ALTH <br /> �R S 1 �Ill Ml#11R jw Lao Mom Oltfrfll fair a wMu it amiuef Nwiff Mff W ft"Wit h�Ri ee Nen!0 <br /> Wei f 8670l�tlip. !n diam in bometice NDS"IN wow&*0,lilt lar ttrarlptNW ens the Rule end Raowstlenl of ape Wn soagtdn <br /> tett Address �_��1414 Si-porsdet_breefi - - — aw fe�eTle}___^_r Lo s>:e 290x cgs PM <br /> owners.Nemo Wickland ProMEties Address 1765 Ch4jere�;e !fly _ phom 916) 921-11 C 0 <br /> Sacramento. M 95815 <br /> Cenkacta lb.ate �AM Address 3242 Ftl, ► CA UrAmt No 401530 poem {916}652-4640 <br /> TYPE OF WELLIPUMP NEW W9LI, WELL REPLACEMENT 0 DESTRUCTION 0 <br /> PUMP INSTALLATION 0 SYSTEM REPAIR O OTHER Q <br /> Ota AbIC%TO NEAREST SEPTIC TANK WA SEMMI LINES -50' t., OISPOSAL PLO..U&._PROP LINE <br /> FWNDATION 10' AORICULTURE WELL „OTHER WELL--W,PITSISWMPS —WA <br /> INTENDED USE TYPE OF WELL. PROBLEM AREA -COtMAUCTION SPECIFMAYIONS ' - <br /> M InduwW M;Z i a Ops,+Salta. L7 Manteca tm at Wee Jlx=watlon " e Ola of Were" " <br /> 0 DOM"tle) _ 11 eq"Pack E3 Trach Type of CeabqW gpKiin"110ne 5% Bmbmdte <br /> In Pubro r7 atltst N Owls Depth of Grout Seel 25,...„,..,, type of Groote oftw6 <br /> 1 t kf wbn W A"Mw I I F.eatnn Swfeeo 5*0 MCWNed by MMWM 99AMUMM - -- <br /> RePek Wort Delle E3 1"ypa of PUMP 14 P &fele Werk Done_ <br /> Weil D"truc*Ml a WON Diem" See"Meww it"fwl � <br /> Depth Met Mi"atsl iselp*5W1 � <br /> TYRE OF SEPTIC WORK NEW INSTALLATION I I REPAIRIADOOTION l I OESTRUCTION M IND saptie eyarem par"Afad 8 puW demur Is r• <br /> evehble wttrtirt 20D foot) <br /> W fhetsratloe*4 w" Raeiderwo— Conny►eirf— Other x <br /> Nurmbsr of"Meths Numbs of bodroorft <br /> Chwacto of OR to a dept+of 3 feet-,-- - - - - -Wner table depth <br /> SEP=TANK t 0 TypatlMfo Cepecay No co npwanem <br /> PK0 TREATMENT PLt El IMathod of 040eld _ <br /> r Dlsterwo to P"rm WIN FourrdGfwn IhopMtw LWO <br /> Oft Lt No 6 Lw4fth of lin" Tefal lergthlehi 1 <br /> FILTER BED 0 vwsr4ft to rtoateet WIN Fourrdatah Ptopeny two <br /> SEEPA09 PITS I I Depth Siso- - -- -- Number <br /> SUMPS Li DOW"M meMMet We0- Foundation Property Lim s �� <br /> DISPOSAL PONDS a � r' <br /> I twedlr FertKy that I here prepetW"oppArstlan and lftet 04 Wok will be dohs in eccom%r.e with San 3opgWn County ordrorbees mato teal and <br /> ruled snd reOuhtlona of the Sart.losgwh Lece1 p4akh Dewier <br /> Noma ow W a ipartaed#Dern a Mlpltstwe eptlllls thb folw&hg 7 eartlfy that N Nle ptrlow6rw'M of the work la wNch this perms b betted,f dwlf mot <br /> empkw arty pvreort Irl much manner as to bat dwa subject to workmen I eompeftatkm laws of comwrle' Contractees hk t;at subcwtncNtq Ow%swre <br /> rerotfw the folvN "i oertllr"in"into pariahtrrree el the work fw wMdt Nees perrrtlt bT ivartod,1 sf+ar smpby pa►vorts sublrct ea wark++wn a can+partra <br /> +tan Ina of Gerfernfe'1 A <br /> The ap~ fat ift"utlera Complete drawly%oh> rse side <br /> g Ilse-4r.! Title .!y-� 04" <br /> 1I FOR DEPAWMENT USfi ONLY p, <br /> AppNeetion Aeaptod by -r„ ,.� Dare 7iT Mm <br /> Pit er GrvA leripeetlen M Date—FirTet ftTspectloh by Date <br /> WitkW of CdrrMMM <br /> _J Stk 4064I78t E3 Lad 309.9021 0 Men" 822-7104 0 Tracy 8768341 <br /> Aapkant Metum di eopla to EnvNomm Wl ks*M Psrn4,dSwvlcas 10012.liaxshon Ave,P O 8m 2009,Stk CA 85201 <br /> O AiACICINT DUE A1,f"T REMITTED (�5M REeEWEp ry DATE ptm r no <br /> 11 Frw <br /> u to <br />