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TION
<br /> YGU
<br /> SAN JOAQUIN i3OUNTY PUBLIC HEMAT '+EIZVICE-;
<br /> 111,MMI DIVISION
<br /> .1,15 N :)Alli:)AlliJOAQUIN, (.2014)468-3420 d gs^^_
<br /> (j :5()X 2f)09, STOCKTON, CA r-)5201
<br /> PERMIT. FXR1 Rr:L-! YLV__FIZVK QATI:
<br /> Aypiic.,.-an po hereby im"t to Sam c,,Ty s Irmtt
<br /> wc..-p jjctcrlbe3. This
<br /> a ppAlra-son is mde in carspinirict t'n liar. or,= '-:b2 and the 6nd ReKulst'one or San
<br /> Joaquin Coiulty Public_ Xeil,17,1) UelrvlceF:
<br /> Job Add,e-1
<br /> dA,
<br /> Conn
<br /> TYPE Of WELLIPUMP NE"I.,Wft.L WELL A(PLA(EPA'NT,><— DESTRUCTION !.7 Out of Service Well C1
<br /> 14onL1.11116 Well [I
<br /> 9Y'jTFkl FIEPAIH L', OTHER
<br /> PUMP INS TALLA�(l
<br /> r
<br /> DISTANCE TO NEAREST: SEPTC TANK SE"El" LINES DISPOSAL FLO PROP Ll�E
<br /> OT-iEA WrLL PITS/SUMPS
<br /> FOUNDATION AGPICULT�jPE
<br /> L
<br /> TYPE Or WELL PROBLEM ADF.A -ONSTRU17TION SPtCIFICATIONS
<br /> INTENDED USE ---------
<br /> D,& rif Welt Cot
<br /> U,a n1 w6f,E.Cm. I w�
<br /> L*LCra�ei Park T,acv I Vve of f:s"nQ Spec,6zatons
<br /> P,,tdc 17.0 1 hor r" Delta Depth of Seat -Zj�Y9 rvpe ol Grout
<br /> in
<br /> I"iu4lkw —7jCe ApS.01. C aptli, ! I E1112101- S1.1441re Seal Ir'btfil.d Ov
<br /> Repair Work Done 01 Type of Pump H P State Woik Done N
<br /> Wall Destruction 0 Well D'a"wie, Scaling Ise testa! 4 Depth
<br /> -"pth
<br /> Depth
<br /> sle i P41m1I;&d 4 p,,blc WW*1 41
<br /> .NEW JNSTAI.LATTON 1 1 REPAMIAUDITION i RLS, lIU(m1;"-Yf4 ll"O.IlAo '
<br /> TYPE OF SEPTIC WORK a.a able t"thm A2W 16,61.
<br /> ln.IAJ)jt;on will serve: Regidgince Commei,CW Other
<br /> Number Of Ihnng units: Numlber of b&J,oarht
<br /> �Charatof of dog to a depth of 3 lleer: Water table depth
<br /> SEPTIC TANK 0 Typal Mfg Capglic,ty_ -go.
<br /> PKG.TREATMENT PLT.0 Method of Disposal
<br /> R
<br /> 041ance to nearest: Foulrj&,,On_ - Pioperly Line
<br /> N
<br /> LEACHING LINE L) No.&Length of lines 7wa-=angthftnze—-----
<br /> FILTER BED ri Distance to nm,sias;: Well Foundation Prorwrly Line
<br /> lium
<br /> E PITS
<br /> SEEPAGE
<br /> SUMPS L.1 Distance to Await: Well Founoai.on
<br /> Property Line
<br /> DISPOSAL PONDS q awl
<br /> �n accorcla�ce—irt San Joaquin county Dirdnanc0s.21stO laws.an
<br /> I hp4tyy g;:orjjfV that I Itsve PrI11511'ed this aPPICSIi0n 10-d Tnal the-011,w10:re done
<br /> rules and regulations of she S"Joaquin CmmLy . ' u
<br /> Horne owner or licensed agent's wonatuto C*ri,144 the tofio,g�"I Ce r1try:�,aj in the per#
<br /> ofmance of the wor�for wt)�Vt this Permill as Ias ad It no
<br /> y any porgoh in such manner as to become sr,b act Ij wor!�art's compensation lava of Cal.forn-a."Conlraciorr's hinny of Sul>contracting signature
<br /> employ 11 employ P6fPA3n&sUbJ00 to V*0Fkrnan'%componslik-
<br /> Certifies She following:"I corlity 1hatim the performance of the wok for�ylisch this pmrhil.3s isituad,I I"
<br /> tion taw!of California."
<br /> The APOiennil nAst can Joe all required ingPoctione CLm01`5t8 cIlswln an reverts!106
<br /> Sig X-�tl wifa
<br /> I— FOR 11111T1111T III DILI
<br /> Date
<br /> L Area Q
<br /> RR Application Accepted by
<br /> Dal#
<br /> Date F,nm;lr,gpecqjcn L
<br /> Pit<G,-)Inspection by
<br /> AddirtidnAl C,rnimnis: \ "A76-
<br /> ApplECAnt i,
<br /> kturn all cviicq to: San toaqutn County P,.hltc It—Ith --i—,
<br /> bn�j tr.��tat ii,xi,n re—It/Se,
<br /> 445 N u-A -10-0111.. 1 CI nu,i 20(11.. Itk.,. CA '52111
<br /> K
<br /> I� OATIE PEI MIT AMOUNT V N T 1114 E —I
<br /> �FEE AMOUN DUE As'gi 1
<br /> NFG
<br /> SM 177a tv tj-7C) ;:,3 0
<br />
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