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=.Ts <br /> SM JOAQUIN COUNTY PUBLIC I EALTH SERvICE <br /> EkAVIROW"TAL 11RA.LTH llIv1SION s <br /> 4U N SAN JOAQUIN, <br /> PHONE (209)468-3420 <br /> � <br /> P d hOX 2005 <br /> STOC$'TON r CA 9520 <br /> PI; IT E%PIRE9 1 YEAR FR QATE ISSUED JJ-RN 'j <br /> r=>< {Complete In Triplicate <br /> "iPPlicitlon !e hereby e+ede to 6nn 1 Ntjal" � <br /> 1ppllceiloo !e made in c oequin County fat n permtt to construct and/�t inntnll thr oath here u <br /> Jolluln Count dance vlth Ben Joequln County Ordlnenr.e Na. 51r9 and 11362 end + <br /> Y Public Health 8ervicee. the ilulen and flegvinttonn o�Sn,iF <br /> .lobAddre,; �5qg Embarcadero Drive <br /> city SLOCleLoll hot stze/Acrenge N/A <br /> Owner'1 hfirne Pegasus Group 1148 n1piTTe Road --_-- ------- <br /> Address W? .n_ut_Creelf CR 94596 ( 5!0 ) 930 081 0 <br /> MiLcheli Drilling & !' . O . Box 27.3.1. -- - --- ---.----- — r11nna <br /> COnIraC101zlyiron. Corgi Address Rancho Cordova CA957�11- <br /> 1YPE OF WELL/PUMP: license Mo.672617 916 ) <br /> NEW WELL Phonea5-2L---9­1j-1)-B_ <br /> � wELt. REF'LACEnIFNr (I --.---_-_w.�- <br /> PUMP INSTALLATION C7 DE51nUCTro rL:1 mt or Scrvtce Nell I.1 <br /> blSTANCE TO Nf ARE$T: SEPTIC TANk SYSTEM nl pain C7 Of}IEn 0 tlonttoring Well <br /> -�� <br /> bAf101,! SEWER LINES �_��-_ DISPOSAL FLO. plloP. { 2 ) <br /> tOUfJAGhICULTUnE WELL LINE <br /> INTENDED USE typt Ok WELL r_nontm AnFA OTHER WELL PITS/BLIMPS <br /> .11-1 ndushiet --_- CONSfnUCTION SPECIFICATIONS <br /> O Open Bottom ❑ fvlanteca bin, of Wall Excavation tt—_ - <br /> f I bomesllclPrfvate C1 Gravel pack Dia. of Well Casin _ 21r <br /> L7 Tracy Eyre of CaSin <br /> I f ifluae 7X1 Diller Monis toryV4)elra p_.SC__�l-��Q PV� Specifiratlons- Oyr+S10tS r h11c <br /> 1 I t+rtUatlon bepth vl Grnul Sea! 7�1�r <br /> _ Approve. beptl, I I Eastern -- Type of GrourPr <br /> Otlarid <br /> "Mrilr Walk bone U TYPi of pump Surface Said Installed by._ -"�- <br /> q k <br /> Wal! beslruclbn I] 1�rell blameler yam- Bee11nK ltnterli.l t Depth �]etlltoArf e+a <br /> Oepth �-de lnCtll; yLrouC- <br /> IYPE OF SEPTIC WOAI(: NEW INSTALLATION 1 I nEPA__7_in O1ller TIONrI 1l bESTnLucT Monter <br /> oe r�Y sand 10`35 t t <br /> Initagation will cervi: hefldenr n systan, penniited if p,rhlic suwnr is <br /> Commercial available within lou tenl.l <br /> Numbir of Iivin Unit}: other <br /> � f+lurnber of bedroom! <br /> _ __f hirlcidr o1 1011101 ddptlr at I feel: <br /> TIC tANk tj typo/mfd ----Water table doprh <br /> Pka. TOATI th,f l l#.DI Capacity. No. Compartments _ -- <br /> bislance to neafesl: Welt Method of Disposal <br /> _ roundalion � property Una -- <br /> LEACNIlim LINE L1 No. A 6119111 of llney <br /> klliEfT ht:b I7 bistanei to ne6resl: � TOWIengll,/51re ��-�--- 'u'4�`-"•"` <br /> WOII kvundaTion Property Line <br /> SEEPAGE PITS I I bepih y - <br /> SUMhSbisl <br /> 11 aNumber <br /> nce to nearest: Well �•- �--- _ <br /> blsposAl hONoS [] Foundation Proparty Line <br /> f hdrrtby c/Ally chit I hiv8 b or"thfi eppllcitlon ind Ihal tl+e worts will be done in accordance wilt, San Joarmin county ordinances, Slat" laws and <br /> rblii ind riaulitlonll 01 II,a! Sin Joiquln county <br /> llama owner or ficinlrid ioent'i Ilionelure certifral the following: "I chrllly !},et In tl+e <br /> employ my porion g ouch minndr i3 to becomi Ikubfect 10 worT,rnin't compensarfon laws of CelRornra." Contractor's hirli,g or suh-cantractin <br /> perlorrnence of the work for which this pannit is issuod. 1511"11 nor <br /> Ilartllles thi following: l cirtffy tl,it In illi performinci of the work for which this permit is!sued, f shell C to <br /> Ilan flava of Ceflfornli." � Q siQnaNur <br /> employ parsonit subject to workrnAws carrq,nnRa <br /> Thi ipolleinl u t c5fl for iH requl id Inrps lon1. Complete drewino on reverse Ilde, 11.W, Irwin , 1 tic . <br /> $I�ni # tltla: Senior Geologist <br /> --.. Jule 14 , 1995 <br /> Data: <br /> bEPAnTM�Nr USE DNir `~�---�---~ <br /> Applicillon Accepted b / <br /> Y <br />' frit or Clout Inlpiellan by bare Aran--- - <br /> Addltlonll COmmanti: hnal Inspection by <br /> :�ataflcnnt - neturn fill copfrs to: <br /> . San Jonquln Cnuutf hubllc liaaitlr Ser,+icrn ��� � -�^_.. <br /> Eeviroumentnl tiro}tit permit./services r' <br /> 145 <br /> it San Jongrrin, P IInn 2non, Stkn, CA 951olFEE <br /> INFO AMOUNT Ot1E AMOUNT ntmiTTED / <br /> CASH nECEIVEp BY BATE <br /> lH 11 74 IaEv,,i rr sr r'E miIT No. <br /> iN Ii M <br />