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r P 0 BOX 389,445 N.SAN JOAOIllN ST.,STOCKTON,CA 95200798 s (209)4893420 F VO1LAIFUNDAW PEAMIT IXPIAFS I PIAN F_R_OY DATE ISSUED x �-� -- (Gepktr M Tliplkrtd —-- A1PT.ICATK]N IE TARE AY MME TO Tllf SAN s,;AOLIIN C^1,141Y IORA F4!WIIII)EUNVI-M CI ANL'OR INST AIL INf WGA!1HSCRIA1D FTIIE A(YSK:AT-ON IS MVH IN COMINIAHCI WITH VAN _ JOA!LJIN CDt MTV 1XVILOPMIM TIT If,C4A f B-1115.3 ANO II%FT A"�Arrn Or FAN JOAMrfN COVNIV IUPI Ir IIIALTH Of RVA.16,V%AWNMI'JAL Hr A1T 1f'HVIMON. .! 1 'fes �(.�C^�� `,!�)'2f,.-II I".l)Ar'NI _ .I, Joe AaorlFRrrvR AR//��.-+[^ Y:C/(.'f-{✓-/`�ti. .�,�% rlrr..f�l.�...-f' .LG - / ,. . OWN[n•R NAM '/: J. ! �AOfMf rA/r(.t,r V."', .'t ' COHTRACTOR �� ADOF0 Oil I.ICI In NINE 4 RUB CONTf1ACTOR� AODRI BS LICF PHONE A Qfp,W WELL W of RACE MfM 4NI l ❑MOMTO'bH/l LN1L! ❑OTM[IL r8a r �'�:.'•': G wat'ALLATKIN ❑WELI AYSTLM NPAIR ®CINIBACONNFCT 11E1'A.A ❑VAFORIXTRACIIONWILL I J { - �3 ry ❑Nw LJ RAT.I- - H.P. UfvrH IVLIP sIT�^fT. f[neT wAfEn LI-.TL 4 (rVW OF PUMP[ r ❑OUT-0F.U[RVIC[WILL 0 OEOr'NYAICAI,YdU/ © IDTL 1-OIRNo s 1 nth firr' ❑o[ATfa1CTK7N: ry! ,'I�_II U•�Eo 1 rIE of WE" - co"TAM f10N tOfC'-'ICANoftb w MDUSTAIAL 0OPEN BOTTOM LAA.OF WILL EXCAVATION DIA OFCOHOUCTORCAIPHO - O • ` '� TYPE Of CA61N116T[[L/WC 61AOF WELL CANINO. 1Lry T1OMESTICNMVATF ❑OMYEL PALKAYLE _ D �fi• .1.y1'1 _ y IMeUC1MUMCO'AL ❑DAIVEN 4(PTH OF GROUT iIA4_ SMECtFICATIUN ❑DROI ATIOWAG GROUT WAL INGTALL10BBY OROVT ARANO NAMES❑OTHER I' ' GW)Lrr SEAL PJIAKD:ON. 11 Ne CONCAETE P[OCPIABV DRILfFt:❑Yr❑MDttORep F CIN. is 555 Arna4 � LOCAINO CHESTER FIGNMOVE hPL 'T •`h'.}"6} z'''•'a RROFOSTD eakBTpUCTIOIINLLILLRO METHOD:MLA ROTARY ANI AOTAAY� AUGER CABLE OTHER :r I IIfIIEIr';11Y HAT 1 IEA PAf4b 1 WS AERJCATION ANO THAT THE WOHL NILL BE DONE M ACCOADANCE WIN BAN JOAOWN COUHTY ORD-RANGES,ST AT LAWS,AND IRAES ANO SEDULA THE SAN N COUNTY,IIOMF oNMER OR LICLNK0 AGENT'S SIONATUAF CEIITIFHS TNF FOLLOWING:'1 CERTIFY THAT IN THE PERFORMANCE OF THE WOfK MR WINCH TNI1 PEltlf,'SH L NOT EM P[ASDNS SUBJECT TO WOREAMFJf'S COMF41MTgN LAWS OF C1LIFOgAA,•CONTRACTLMY 7 EISNO OR SUB'CPNTRACTMA BgNAT1111E CERTIFIER 1 T'HE pTNAf PERP=A11C[DF TIIE WORK FOR NMICN SHOE HRMIT IS IS6YEb,I MALL EAA"U:Y fEI1BONe M!n![CT TO WWIMMAN'S COMPARATOR tArr7 OF CALDO /YET SS ND M ADVANCE FOR ALL RECASMD IFMSPECTIDNB AT(.Vrl AY.}Af}.CONIP ETF DRA1rNIr0 AT LOMA MFA PROVIDED. - � 1 } 5..� a Y M' S !� r i ,. .,•i ..�I !WT PEAR Ia.H Ir■.r.I/..L. •I. tai ry TAS' NAMFf OF STREETS OR DADS NEATEST TO OR SpLINpNa THE PROPERTY. F.IOI:ATIOfI OF IIONRE B(WAOE dW'DeAL SYSTEM OIL PROMIED n� OUTLVK 01'TNF FNOPEXTY.OMq.tNMFNSIONR AHO NOrfTN DNECTK)N. EXPANSIOK OF SEWAGE MOROSAL SYSTEMS. OOACNSIDP"OUTLINER ANO LMATKON OF ALL EXIBTIAD A'A PROFOIKD ■.LOCATION OF WALLS WtT111N RAOR71 0/ONE N4NOR11 FAR1T K., t _ ;i•rl� I J J s wrmxTi1AEB,OICLUOINO COVEIIED AREAS I:UCH AS PAt 011.DRIVEWAYP.AND WAIJ(S. ON THE PROPAFRY OR AWOYANO 1IMPERTY. Y yL r y ,LA T aZ♦ vL.? 3C3��I L t�-._ �i�' .. _ � t,^r `�•';. l � L rjZ t� a IZ y ra �S xe s�T,,r'� ' L ;/►'�/`,,:r?�p�'q" { J v� •'' •'`�` {s �F 4 r P/1 i IYl E Iii 1 REC�tYED HO �s 4 .SAN,JOAQUIN CC?UNTY " :T.PU80-HEALTW'SERMES ^r ENVIRONNIENTALHEALTHOIVI�I(7N 7 U9 ti DEPARTMDIT USE ONLY s 'A/p11xIIPn Amrr1// ^t. r1F .AOrwA r,.rAellan er n.s, PW.,r I•rr.cllor.br—.� / O.I. LhH-ullrn-P.OP.Hr-- !°y Ali- A7 r /�/D it _f�O.. r .J �.yYlis f r��CSS•Q 1 <-'r' } li 1,1E h rFCOOLIN'IIRO o11LY: `�' - AIDE INFO. AMOUNT W HEC AAH AECDVED BY DATE PAMTlsor ECR Waat{T NOWM INVOICE kM Y ��T'R`[ !1i r {' .�° � p1-•'('yh'f,' A �r ak - ' � i��h N.Yf"F n� �StY!'rta�r,6"�„-�'Gv�ti,• -�7 yr s. - 'a , '!^i. N.•.'nl:rr`-;Ml"�4„iFk�'.f'r •. ° xrn rr E: r.