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.I APPLICATION FOR WELLIPUMP PERMIT <br /> SAN JOAUUIN COUNTY PUBLIC HEALTH SERVIvD9 i1 l <br /> ON <br /> P.O.SOX 380,304EEAST WEBER AVENUEENTAL HEALTH 'STOCKT'ON,01300 <br /> (209)4613420 <br /> RON REFUNDABLE PERMIT EXPIRES 1 YEAR FROM BATE ISSUED <br /> IGmPMw In TFIPRetwl <br /> AHMJCNION IB IN.BY MADE TO THE RAN JOAWIN COUNTY FOR A RRMIT TO CONSTRUCT ANOpR INSTALL TNF WORK OEEDDROD.TOR.AAIKATION le MADE IN COMFLANCE MAOI HAD <br /> JOAWIN COUNTY DEVFLOAAENT TRIF.CHAPTER 9-1115.3 ANO THE STANDARDS OF SAN JOAOUIN COUNTY PUBLIC HEALTH SEIWICER.ENN1pNMEMAL HEALTH MR.M., <br /> JoeeoOPEeepe APHF 6649 EMBARCADERO bR/✓E Cm STOCKTON PARCEL SIZE/APNF <br /> -rNE PE6AS US 61ZOUV //4$ AFLP/NE ROAD S/O <br /> oWNER's xNAf Dn(YFur PAWS PREF/De NT A.Don /. u C2 9 HHow. 940-09/0 <br /> P.O. <br /> S / 947/ n ] <br /> CONTRACTORVv- W DRILL/N6, /A/C. AMOVID o V/ ACA uw 7RHow,-a4 2815 <br /> C'ONSUATq NT 13,9 5/SF/F 2 Q G 80S <br /> &NecerRRAeAM LA SNE L FRARyr,6E0L06IS T. ADORFBe /ig KFJ�'•CF/EGA 93306 IJcr da s6 RIIOxE,rjjj2-/9/4 <br /> IYPf OF WFIYRIMP, ❑NMM. ❑PFMCEMEHT Mu. 11]MONDr...Wfll F J NJ�JfLIS ❑OTHER <br /> ❑INSTALLATION 11RbflS <br /> MLL eYEM REPAIR ❑CBCONNECT PAM 2"dNj.HI,❑VALOR EXTRACTION MU F ✓ <br /> ❑Nw0O 11 .ILP. OFPIII NMr eR_R. 30'7b-' MIBTWATERLFVEL 0 <br /> RVPE Of WMPI <br /> ❑OVT-0FBEIIVICE WELL ❑OEOAIYRKN WFLLI ❑ bReORINO <br /> 6a OFSERucirox: A^CORD/NG TO CAW- CAWell Sfane r!/58n// /rn 74-90 Scc�/Dn /9 A-2'2 /Oaee S/) <br /> W LLS WIL D G 0 TED UN 6_cfUR WITH EJN SNT ETURNJ O _ R Lr <br /> INTENDEDWE HFEOFIN. CONSTRUCTION SPECIFICATION& A <br /> ❑mm"IDAL EJ OMNBOSOM No.OF N'ELL EXCAVATION OIA.OF COHOVCIM CA&M O <br /> ❑OODDUFVC VAtE [].RAVEL PACR/eUE TYROFCASINO/RTEFIRVC INA.OR MU-CAM. 0 <br /> 0R1mpnAUMCNAI ❑Dow. OEPIN OF GROUT SEAL SPECIFICATION A <br /> ❑IRmOATpX/AD ❑OTHER GROUT SEAL INSTALLED BY OFOUT BRAND NAME E <br /> 11 moNIown, GROUT RVA MU.DED:❑Y— ❑N. COHCPETEPEDEDUALWORLLEROY. 17N. d <br /> A%nOA.OERH L.M.EMERIES n NUDDIM PRE d <br /> FRONtb COMI R "ONm LUMO MRNOO: MUD ROTARY AIR ORTAW ADDED CABLE OTHER <br /> I HEYAY CERTIFY THAT 1 NAVE PREPARED THIS AwLCAIIOH AND THAT THE MIRK MTL If DONE M ACCORDANCE AND SAN JOAWM COUHR OROMANCER.STATE UWR.AND MILER AND <br /> Mm11ATIONS OF THE RAN JOAWIM COUNTY.HOME oMUn On LICENSED AOENT'B MORAY LOVE WI <br /> CERTIFIES THE FOLLONO:'I CERTIFY MATIN AT THE PERFORMANCE OF TILE WONK FOR HAOC11 <br /> THIS FEDMIT IB ISSUED.I SHALL NOT EMPLOY PERSONS SUBJECT TO WOnIMAN't COMMENDATION LAM Of CALIFORNIA.-CONfRACTO TS HIMM OR SUn20HTMCTmO RpHATURE CERTIFIES <br /> THE FOLLERNIM: -1 COO RY THAT m THE PERFORMANCE OF THE WORK FOR WHICH TMS PERMIT IS MMUb,l SHALL EMPLOY PERRONS SUBJECT TO WORKMAN'&CI MRptANDM UWS OF <br /> CALIfENIVRA {TyR�/F�fL�ICANT MUST CALL]4 WORD IN ADVANCE POR ALL MURATUD INSryCTgMt AT I]DEI SNiA]E.COMRRE DRAINING AT LN Vl ATEA RIMMED. <br /> INR^. x //,u_.INL! �.�7/E/,1,1.UT� R. G. n0. CO&Q, rZAW, GEa[.o6/S 7� D.1. //-.20-17 <br /> T� NOf THE M.lU w ev/.1 Sul._•ro <br /> 1.NAMED OF THE VNDF ' rNEARESTTo OReAN.Hoo.OFPOF[IT'. A. LOCATION OF NouSEeE'NAOEmS106ALWBfEM On RIOIOeb <br /> E.OUTUIRIE OF RMIRVIT NFMUM.A. LOCA OUR.....OF ALL ANDAN PRO1pN FOATION OF SPUD mBPoBALSYSTEMS. <br /> J.mMENtpNEG INCLUDING <br /> AND LOCATION l I ALL EXISTING PATH ANO TOPoSED S.LOCATION FR Of MUD WITHIN no Pn OF ONE H111101RD iOTY R. <br /> SIm1CTURFS.INCLWINO COV[1201IWA&NCH AS PATIOS,ORVfWAYS,AM WNXS, ON THE RgPERfY0A 1DJO11eFp RAPFIRY. <br /> j <br /> MW 7 W <br /> MAPSH j <br /> �� w <br /> J <br /> i� MW-6 <br /> HP-9 <br /> rOua TEEN-MILE CONDUMINIUMS <br /> SLOUGH <br /> HP-3 <br /> L <br /> O ♦iHP-� <br /> MW-5 <br /> BUILDING GATE MW-$ <br /> HP-10 LIMITS OF <br /> EXCAVATIUN <br /> aL nrvTCa (BACKFILLED 5/94) EN <br /> ISL nIND TRANCE F <br /> OFFICE U CUR/LR,�AUCRp '. <br /> \ Qt M W-4• <br /> [RE'IDCNCLS <br /> DOARTMERI UtE ONLY <br /> noere.IwD A.agm er _J OM.�� � A... <br /> G�.M ImP�Dr^erOn. R.rolmr�n.^ey on. <br /> OsbmllRl loo"n.D BY 0.1. <br /> C.— <br /> ACCmm1mO ONlY: ANF 1-1 <br /> RE COOu FER INTO ..I nFRnnED C�]/y.A�OI INCEREO eY DATA PNNOrRERWCE REQUEST NVAMED INVOKE <br />