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O c Y7�d <br /> APPLICATION FOR INELLIPUMP PERMIT <br /> SAN JOAOUIN COUNTY PUBLIC HEALTH SERVICES <br /> ' ENVIRONMENTAL HEALTH DIVISION <br /> P.O.BOX 986,904 EAST VVESER AVENUE,STOCKTON,CA 9MI-M8 <br /> 12991498-3420 <br /> NON-REFUNDABLE PERMIT EXPIRES I YEAR FROM DATE ISSUED <br /> ' ICNRPMIS M TAFUPSMI <br /> AFRKATION 16{HPE BY MADE TO THE SAN JOAQUIN COUNTY FOR A i4@1R TO CONSTRUCT ANDpN INSTALL THE MM CEWRRM.THUS AMUCATION 16 MADE IN COMMIANCE WNN MN <br /> "A"COUNTY DEYFLOfMfNT TREE,CHAPTER 9-1115.3 AND THE 6FANOAMM OF BAN JOAQUIN COUNTY MIRK HEALTH BERVKE4 fNMNCNMEMAL HEALTH MMpX, <br /> JOB ADDMOMR APNE 18348 E. Frazer(0 6 5-15 0-0 1 ) I," Linden PAMM-SQUAPUF <br /> ' oAwERro NAME Lundblad Trust ADD,MI 0. Box 682,Linden HRUNEA <br /> cow,,,,, R Purviance Drillers, Inc —ADDRESS 64,Linden ml PHONE MDNEUS7=3559 <br /> SUB CONTRACTOR ADDREE6 uc) -�pNOxE <br /> ' TYFE DF UIIFUMP: 13 NEW!NRL ❑FEMAEEMENT WELL ❑MONITONND WELLI ❑OTHERS, <br /> ❑INSTA"T ON [3 MU BYSTNA REPAIR ❑CROSS CO!El Tp1ER]PAM ❑VAIOR F%TRACTION WEIR F <br /> Turb QH..i®pMw. H.P. 75 DEPTH PUMP SET18 fr. Flwr WAT^RL L 1 <br /> RYPEOFRNAPI <br /> D.CUT-0CF ❑MONYSICALN£LLf 13 WILSOWND <br /> ' ❑DfCTRUCT1pN: �{ <br /> IN IN[ iffLmok ...T"I <br /> Q INDURIM4 C3 OPEN BOTTOM MA.OFW LE%CAVATWN TNA.Of CONDUCTOR CAPINO O' <br /> El WMERMNNVATE ❑FUJI'A SNI TYPE OF CAMPMTFMANC dA.Of VhLL CAMNO Oy <br /> ' ❑PU.UJMtHtlICIPAL ❑ONVENOFPTNOfOMUf BELL = ERCIR..N <br /> ❑IWW ❑ 811 <br /> ATIONIAO OTHER Omw SEAL MITI BY OROIRMMNDNAMF FA <br /> ❑MOHROMND DPMT..I-P MTD:❑Y. OH, CONCREIEPEDFETALBYDNLLlk-0l. 0.. 6 <br /> APMON.FROMM LOCKIKO CHIMER BONISIOW WE <br /> PROUOSEDCONSTINCRONMMONO MINDS:MUD MTARY�_AMPMTARY AVMA_ CARIE OTHER <br /> - <br /> I NELY CERTIfYTHAT I NAVE MANED THIS ATMUCATION ARD THAT THE W WILL I CONE Nl AMOMANC,E'AMN SAN JOAQUIN MUM OIRWANLl6,STATE 4WB,AND RUIF6 AN <br /> MODUTIONS OFTNE BAN JOADOM COUNTY.HOME OYMER DR UCSNMD ADEWEI MONATUN CERRRFB THEPoLLOWIND:'I C6ATIM THAT IN 1NE IMORMAIICE OF THE WORM FOO VMMN <br /> THIS KIRMT IB ISSUED,1WALL NOT MPLOYKRWNBPUBJMTTOWO% M'SCONPG6ARONLMCFCf.IFOMOA.'COMMCTOMBNIgXO 0fl NBCOMRACUNO BIfiNATURECFRRi1FS <br /> THE FOLLOYAND: -1 CERTIFY THAT IN THE FERIPoPFAAIJCE.OF THEMARI EOR WIIMH TNIB PDMNT IB IIYED,1 MINL FMROY RIIEN6 6URIEETtO WOIUAIAXI COMFGBIRON"MOP <br /> ' CAU APMIEAM N NDDRB M AWANDE FOR AUL RE01MRO IM6PECTION6 AT TIPS)A6Lf422.COMMETf pVIWINO AT WARR MEA PWVIOFD. <br /> ._S=__.J T,N. Corporate Secretary 0,,, 7/15/97 <br /> ROT MAN 10-1.SUMq F i.. <br /> 1.NAMES OF IMMS OR WAGS NEAPERMry <br /> PT TO OR BOUND NO THE IN . A LOCATION OF MOUSE OMME DISPOSAL ITEM PROM <br /> PRO <br /> NRO <br /> 3.OMUM OP THE F OMM.OIVNM dMfNSIONS MO NORTH 131 E 11CN. EXPANSION OF IMAGE DHIFI ISTM6. <br /> ' 3.OIMENSMNED OMUNES AND LOCATMH OF ALL EXISTING AIA PROPOSED B.IMAM..OFYNW PATHIN IMOIUB OF ONE HNDRED fIFry <br /> TRU"NI INCLUDBIO MM <br /> Ff. <br /> BCOVERED ARMS H M PATIOS,DNEW <br /> VAYS,AND WAIK3, ON STIR PROPERTY OR AOAININO PROPERTY. <br /> 4e I�CW <br /> . . <br /> P;gYMENT <br /> RECEF <br /> YF.O . <br /> F. <br /> ri <br /> .... ..:. BU fp <br /> ICEy <br /> . Yrl om slgN 'i <br /> DEPARTMENT UHF ONEY } <br /> APIJ.11-A..Itl DY_c Dn. -1_Arw Z l <br /> ' I D..N IOIp.e,Ien llY otla PVmP In.Pa<,Inn By T��_0.1.�3�: <br /> iDu„unlun In.slvx:6Y <br /> DPmm <br /> ' Att09N11M0 ONLY: AAP FACe <br /> VE EDORI FEEINFO NJMMNTRMRTED MEc PAP RUDER.SY DATE FRWRIHRIVREMDUUT NUMBER INVOICE <br /> ' D SL' <br /> S QU131\2 <br />