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APPLICATION FOR WELLIPUMP PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES - <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P 0 BOX 340, 446 N.SAN JOAQUIN ST,STOCKTON,CA 96201388 <br /> 1209)4603420 <br /> NONREFUNDABLE PERDUE EXPIRES I YEAR FROM DATE ISSUED <br /> IdYPley le TEjEobl <br /> AERICATION IB MER OF MAb TO THE SPIN MAEOI I COUNTY FOR A{FRAN TO CONSTYKTµpUR INVALL THE IODISE DESCRIED.THIS NR1CATION Ie RAIDS M COYg1NCE NTEH 6M! <br /> JOAWIN COVNl1.OEYFIOPIVENE T/ . 11B 11 ANO T)I�JANDAMB OF BAN AAOUIN COUNryN NFµTH EENYFE1,dVYpNMFMKEFALTN CM010N. <br /> J0 <br /> 6 ADCIIEM,Ofl Mw CT' �J ,�/''��`'//YT �J� PAKK 6RFJARI) <br /> OWIId'6 NAME NORESS /'797L. ! /'(/4m 99?4 PND)EP <br /> COFRDAC}Ofl ADORES. LlCi lllK]/ �RIOFaI � <br /> W CONTW R AOORBS lDI "RomS <br /> TVR OF wE'vweN+: ❑Fan VAT, ❑ wwm,,wEu ❑ ❑ <br /> r,/MQWIORxa wEu! oTNm <br /> ❑INSTAWTYJN ❑ LLTTTEN REPMR IY CROSSCONNECT IEPAEI ❑VAIOII EYTMCT]N N9L• J <br /> ❑Nr.❑RI)ex H1. DEPTH MMP SEt Fl. FIRSTWATEA LEVEL O <br /> E OFNM% <br /> ❑ UTdF-.E1NCl N41L ❑OF,ET9i��M��'y61CAL Nl/11®) 13 <br /> �}!�0&TINT/NO <br /> ❑CE6TIRICTNIN' FMA {'ALJ�,A/YM Af/S�/l.i �J <br /> W <br /> INTdD®USE TYRb F1E CONfTRVCTbN iPFCWCATON6 .E rf <br /> ❑INDUSTRIAL ❑OISN BOTTOM RA OF MU EXCAVATION OfA.OF CONDUCTOR C.VMp 0 <br /> ❑WMESTICMYVATE ❑G.'pAQ'l6DE_ T OF C.WGhTR. 0'OF WEII CA&HO D <br /> 0PlIl1CR.1UNICIP,LL ❑DPoVd Cf1EN OF OMVT RRL 9P OMATRIN a n <br /> ❑IRROAT.. ❑OTHER filOUf SEAL MRAI,EO SY OPoUT BR4111 NAPE E <br /> ❑MORDORNO GIb11T 6EK MMPFD:❑Y- ❑He 8 (yE <br /> APNIOX.D[ITN WCXMG CHESTER IOXMOVE PBE 8 ! <br /> MG .CGNETIIGCT OQ#StAa1G METHOD:MV ROTARY AIR MTMY AWEA__CANE OTHER <br /> 1 HERESY CERTIFY MAT I NAVE RFEPARED THIS MRk.'ATN1N AND THAT THE MISS W lE CORE M ACCOFIO C FAM GRIN I AGUW COUNTv ORRNNICEG.STATE TAWS,ANO FOUS M'D <br /> REGINATMIN6 OF ME BAN DAWIN COUNTY.ROSS O RORL WWO AOEM'B.b R[CESTRWY <br /> S THE FOUGAT:4 CERTIFY THAT M PMANC <br /> THE RROE OF THE MW MR WSHKA <br /> T MISRPAfiTIS HIMED,I SNYL WTEMRLY RR60E0 SUBJECTTOWOdMrEN'S OONRIRAMIN TAWSOFCHI &'COMMCTU R's WWNG di6ueLOHIRALTMYi 616NATIM£CEIRHIE6 <br /> TR FO...: -I CEISNY MAT IN THE AMCE OF TR NdR[MI%...THIS PERMIT R ISS.,I MNL IYROY FEOONS..ET TO W RDaAY'.COMIdeATO.LAW6 OF <br /> CNIFORNII' T PIICAMT YIbTC FHO (M IIOVIWCEFA JILL RBWIfD IXIIi AT IRp1E�M88.COMRCTF RI8WIN6 AY'OVhRMEA TD/KI`EO.�T� y/�( <br /> NPC Y Tele _/ _ • <br /> T --IS S ."ISS <br /> NJ,MEB 6TPF1T6USfOAOBNFARBT TO Ofl IOUN MPPOFERTY. A, IOCATNW OF HOUOE EEWAOE RSPOSK SYSTEM OR IItlMEEO <br /> OURINF OF TME T49RRrv,..G RMENSNNII AND FORTH RRECT O.. EXPDIBpN OF IMAGE 016PoSN SYSTEMS. <br /> 3. ....FE.CIT Rfl.LOCATION OF ALL EYJ.HG ANO ROHO 6. IOCATION OF..NRMN MONS OF ONE N VNd1EU FIFTY FT. <br /> .TSUCTVRB,INCLVRNG C.I.MSPS F..AS PATIOS,RSVIWAV.,ARE WAIK6. OM TME NO TERT RAP 1...FHOF4T <br /> _ <br /> D.FT,IEHT S E.N11 <br /> pp Ju�IM OY_ <br /> Graz lrna:lon By_ DYe Perp lrvpxUan ly ,Del. <br /> pnrrwrlm I.ePeaUen BY DeIA ' <br /> MO ONLT. AOI "(' y <br /> FF C'OOG FH WF AMORIT NBMTATS P.VJITIFR 6 REOIIF9T N-- 1--E <br /> L SO — � — O <br /> � C-7 <br />