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APPLICATION FOR WELLIPUMP PERMIT 4N JOAOUBI COUNTY PUBLIC HEALTH SERVIClI� �/ ENVIRONMENTAL HEALTH DIVISION'304 EAST WEBER AVENUE,STOCKTON,CA 955 P"4A64M nWnr MND MW!#Vt1lf 1 eta Mg IAT[ISUR tale*'"A T/AraMW APPMATON M HER ry MADE TO THE OAN JOA"COtWY FOR A VETS"TO COOMMUCT AMOM NATAUL TIE WON!D'SCMW'""A WJeATaM a MADE M CM.APL 1 WITH SW JOAoON CCUMTV 0EVKDPW R TIttL.CHAPT619-111 5.3 AND THE RA DAIOE OF UW JOAOIIM COUNTY KNIM IaKTN EEIINCEE.V oWKWO MTAL HEALTH 01W ON. c' JOA ABDMISWO 1 AMI' %W' B*ST;-k �yc. CMY 'I► ell __-rA1CLL CESAPW?O"L►4•� e1am"MAMe R' k)V% (Ir J#Vq ADDIWDH ►i{E 3. 51'-, I recy ,,,,„I*(2N)69�`EI7�►� COMMAOTOII AdMaE+.1c �•• t`�y1rL+LE+an�al �'Mc mwsool0137 amCOMtIMC.OA *►1 R,I ��!I+y Dry l lth� AEOIEEEgot Q•T.lot z.Avveh IIID►,Q` 716 rHM1�E, %9-rmwvmummm /. O HEwwnt ❑MUILACEAtwf Wal ❑Mommom a Wel I ❑OTMIA ❑DwTALLA"w ❑wet whim Term ❑a eeVOMM ICT M WAM ❑vAroM E%tMACTIOM wet I � O"-O rwv* M.►. very"maw wt---fr. Slat WATO UM e IVY"Or MMI ❑ovrar•AiMYIA:t vTel ❑tHEOMHYMCAI WILL• ❑ AOII Ao1AIw I ,AN,ro IC�11 Tm or WILL TgM M►'v-� r,lttl-a le !1� W II"' STr~t1 A ❑vwjnwAl ❑ore!Aom OHA.Or WILL VWAVATIOM CIA.Or COMMICTOM CANMO e ❑DOAEAIH,•1MAVATI ❑OMAVEL►ACLWn TVre Or CASS"tISPYC VIA.Or wHl CAIMO O ❑"muc M1mmovl ❑ommom am"Or Nlow IMAL WOOS ATM A 0DAAOATIOM1Ae ❑oT"OH MOW IEAL DwTAULD W sHavt wAlo NAtte tor1'la► (.111+ET E ❑Mowmmm Y wow AEAt mompow®w ❑". coMolam rEomAt OY ombim®Y.. ❑M. l AMMDIL tlertll /.D umko O emovE"AOXNTG"pry MaroAw eeMATIMwt10H110HALILte Al"IM MOO MOTAMV AM MOTAMY A N —_OtH 1 W%SV CPMPV T"AT I"AVI MarAEO"M ARKATIOM AND THAt TIE vmW Wa K OM N MWOAAMCe w""*AM JOA01M COMI I OIONACW RATE 11ft AMD IMLO AID IaelAAT101a M TIE AM JOAOIwH O011Mfv.1101AE OWNER OIIUCellel0 ADeR1 eeMtIME OMTWEO 11E rO1LOIHD10t 1 CNItf V iNAf M TM reWpYA10E M f111 YTOIEt►OHI YMACIt TIM rmw w H om.I MAL NOT IMlov RIEMw Vim"TOwNiwwe eouromm 10M LAMeer OmaO m6.amano Poore ISMO opt AUO•COMTRACTMO AaMATME CIWWM TW/OLLOviom 'I com"THAI M THE pmemAII.'1 OF"it WOlet PON VOW"TIM VINE Of 1001M.l MALL IMWW VOW"MIICT TO wO10etA1'A 60WINGA"OM LAWS Or CMJFO.M�I(L'-.TM AwwA T MMT CALL fA Iw1Aa M ADVATI00 NM ALL MMIMIM NM»1wM AT a/M Neil».CMELIT/DMvww AT LOwel AIWA M nWft. wr-+u 7 '�-Gy Ta.lmio. s1.fT 6,0161111 — 11 -1-17 MAT MAR/H,"M So"O.M. .so I.MAMEA eI etMEETE OR MOAN WAWAT TO OR OMRwNe T"e 1'110R111'Y. 4.LOCA109 Or"o1IAe WWAW DISPOSAL AYATTM OR HIo1OAED i.Ot11t"Of"a P"OPU TY.DMAw DMANNO101a AM 000I14 OMECTwM. WNWOM Or WWAAE DISPOSAL WOMMI. a.OOtMHEDIae OWnw"AIO U"TKIN OM ALLMIM Aw MIMOSID 0.LOCATION Or vRLLA 1N"ION MA&W Or OWN"WHIPWO"M ry. ATwlCilllae,NWAR NO COVeEO AN"AOCM M PATI0%OWWWAYE,AND VWUS. ON TIE MgreNY OR ADJ011 m rTbrBRY. ;...d.... . .......e:........'.......p.......j�..............jd...:.....l;........;t.....?.e. .e .#.....d.....;......ii.,...F > #....s......j.....I......e..... .....i.....y.....{...... #..........<...... . ............ .....i...... b ......i......!.. .....;.... .. ....€... €.. ...y........... ......•.... d i E .....:......a.....:. ........... .. .....>......i... ...d.....:......i............;..... ......t. y. ..i ..;...•.....:... ....d.....,......9....;... ! s .!. ... .:.....{... ! .. .. ..j.. .. i . . :.. :....•. ...;.....�.....4.... ........z..... ..H.. s .. .. ..i. E i i •. .e....� ..{.....i....•{.....�....•...... ....F.....`....:j......j..... ....;.. ........,. >.... •...j.. 6...;.....{,.. .....j..... ....{ ..i.....y.....i.....;...: • �' ; .....i i .....i.... ..:.....:.......... ..:.........:.....d.....i.....y..... .....e......�......}.....i.... ....`....i ...4..... ....i...... ....'..... ..e............i......# ...�.. .... ....... i ! ...... i i .. .: . i.. ..........e............ .........l.....�.....j......i ....#......{.... ..a:.':.... l... ';.. .....:... DErAMiITETTE OEE ONLY a 9.0-4-1 F V.I. c.....+. W L t YL 1G`1 1l 5;.. MIT, ADI TAC* 1 T9 DMO AAIOUIt MawtteD ememocAM Deoev»AT DATE roommenR"HEomf mmom NYOM•e o s -arc01132, Pub.HbeMh Serv.•Emko.173(ItOn