Laserfiche WebLink
HOS 'ON Md : - 6l0 <br /> ' l�lEL!_,rPtJ�tllP PERlUIIT <br /> Sari lonaulNCau:urrERwiorMErrr:.LHE9L1HDEPAMMEWT 1868EAsrHnmmNAvEwEj-SmcrcmvCAISMS 2MI <br /> -REFUNDABLE P-197 CALL 69 953-7697 FORINSPECTrONS EXPIRES i YEAR FROt7 DATE ISSUED N <br /> Comstock Rd cn,rmkinden <br /> JCMAOURES'a <br /> Duncan Rd APN - �� P,u:ms� `� U_APeIjm-nnu; <br /> CROSS <br /> N <br /> OrurEa n7A,lE Jim B ogg i arc) <br /> PHONE J�nra--1-�S�r— <br /> OWNER Ano REss 15219 E Eight Mile Rd rarrYrsrarFlzlP L i n d c�n r A q 2 <br /> CawnzAc= Purviance Drillers , Inc PHa!rE 2n9-897-35-54 <br /> CO:S1TtACTOK ADDRESS PO Box 64 11111STA,.,,� n <br /> Liden , CA 95236 <br /> PHat� <br /> SUBCONiF2AC10R <br /> tSURCON7RAC OR AUDRESS <br /> :NsE cs; D C_61 -j D-T ❑oj,er NumeER 37.7923 ExpmAmoN DATE 7/31/19 <br /> Dam_-%Tit t ELLSAatPLrs=r;General UkerzUCordorm flacleria(4391) Dibromachloropioparle(4392)_Arsenic(4393) <br /> SnrtaaoEaUsE ❑DomeslirlFrivale Irrigation/Agriarftaral G IndustOM C WhLrQualtiyMoniftwbg ScilSzmprirrarClratade+izalion <br /> PublicWeter Syslem <br /> UdW stmtlion Or=r. 1=11systhn n� Costlai I�rr.-ar PR®�N v�Ce <br /> TYPEOFWORK a New Well CfteplaaemenlWe:l a Wd!Alter orIfVodrfi=tion 7 CIw <br /> n Monitorv)VW!I1{s) :a`%!jEB C Soil Bodrtg(s) .altroMls I- <br /> E. <br /> ❑Out-Of-Service Well r Out-OGSesvice I,Vd9 Reneval 0 Cross-Crwrecilon Reparr <br /> D New Pumo &�Iump Re t..elt C Pump Repair O Ralsewen Casio <br /> V`/�L COlL;7AUC7lON � <br /> DiWiingffiethod O Nlud Rolwyy C Air Rotary C Auger O Cable Tool 1 Push Point 7 Outer <br /> Proposed Wcll Depth ft r-_Lgllon in diameler _Open Bottom G Gravel PaddGravel Sae in diameter <br /> 6 Cbnductnr Casing in diameter 1 Condu 1nr Casutg D ub St <br /> well Ca;ing D"amrler_in Tnslale_4/GaagPJAS?A Sched -Sled ❑Pladi c D sizium Sled 7 Olher <br /> Craut Seal Depth $ D Neat Cement(94 rb b3ar-10 gal wah-.4 ❑Sand gal rrdl <br /> Benlunile(20'S Solids) 7 Other <br /> GrOut Placeruant Me1had C Paanpad D Free Fefi 7 Other C RetirdanttA=elemter(rerne)_ <br /> PEn-- installed By 0 Driller 7 F=p,Conlradcr ❑ Other <br /> P Cancrem Pedestal Len Ih n Trvck in l Christy Eos 0 So"FIPe <br /> Ptrrty D Submeniiblex Turbine a Olher HP Plmtp sw-a ft Siarldng Waler l.Hv>d fl <br /> 1 HEREBY CERTIFY THAT 1 E PREPARED-MS APPLICA-nON AND THAT THE WORK W1LL BE DONE W ACCORDANCE WITH Stew <br /> JOAQUIN COUNTY ORDINANCES, STAT--LAMS. AND RULES ANO REGULATIONS_ I ALSO CERTIFY THAT MY REQUIRED LICENSE IS <br /> CURP.HUT AND ACTIVE V07H THE CALWORNrA COYiRACTORS STA7E LICENSE HOARD AND THAT 1 AM 1N COMPLIANCE WITH ALL <br /> VJD P�SAnAttiS _ <br /> YII ANC&NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)553-7697 <br /> Sir [� „corporate Secretary,, <br /> 111 ! II I f I <br /> I I I <br /> # I I i [ I <br /> ! II I I ! <br /> 1 <br /> 1 <br /> l ) I I ! #tit r l I I �,qy , ..,. <br /> k I jellI I IjtiN <br /> IIIII ! 3 C . <br /> I I I I I ry UEPHk ry�r'v r <br /> i I ! II <br /> I D_E ARTMENia <br /> NLY <br /> Appl'ioaCdn Acmpted By Oete t�`"L Fmpinveert <br /> Grout Inspection By 'lDate SPI=_c1AL Weft Permit <br /> PumpInspeclionBy V*, _' 'A .12 WAPAR Received <br /> Son Bnrin9 IrtsperlioA By Dare Caost u[tad well Depth it <br /> COMIAENT5 <br /> PE SC Received Cheew Amount Dace Perm, UPsty (nuoite: .Jell <br /> re Req <br /> Codes--- IntoUsh._ fitted <br /> _ _ -- <br /> 1 <br /> rxr,Pr>--:;iIrr <br /> �<3� zOana <br /> Z d VZ9U9960Z out SJaIII.IQ aoueiA.lnd db0 00 66 �0 unf <br />