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S =- <br /> APPLICATION FOR PERMIT z >k <br /> i SAN JOAQUIN LOCAL HEALTH DISTRICT - '�•�'i <br /> i 1801 E. HAZELTON AVE., STOCKTON, CA mow. <br /> TIMphonc (2091 456-8781 <br /> PERMIT EXPIRES 1 YEAR FROM GATE ISSUED <br /> fCete in TripF,cate) <br /> anol <br /> dtlr fort,MrP+^ {.. <br /> H.rlf DMrlc1 Iw.OKn'H foc«nv.rcr ria/«MtM 1n.H, w RgAAblr kh' <br /> 4M�m.h L«� «tJo,1BS71«1A../D«np YW 11:. <br /> tAaM F'.rnpiArrf II San J. I Counly O.snarw.+No �1«fwv+W y„STi°+ <br /> f kt. <br /> L:ee Haefn Dn r - . <br /> r' <br /> �//J V Lot <br /> a(/. CMY. <br /> 1tA ACrFoxe . �y7 <br /> 1I <br /> Wc'l����o�Y_y G7r�1 Adem <br /> n./f Nv^a - PlrlrE <br /> �Y//]0 X0.1'' Addrest�00� VII REPPt CEMENT 0 kMt.lb. U(OESTFtU(:T <br /> Gad K1tr Y/LL U <br /> NEW WELL O CITHNY ,fes <br /> TYPE OF WELL/►U�P N + SYSTEM REPAIR O "« L� <br /> PUMP INSTALLATION O�kSEWER LINES. .- DISPOSAL FLO -- <br /> dsTANCE 10 NEAR. EST:. stomlg <br /> FSEPTICOUNn TANK _ OTHER WrCL_ -- - 1 <br /> FDUIIOATON tI!! TURE WELL ., ' <br /> ,0,� WELL PKmum AREA CONSTRICTION SPECIRCAT101�5 L4,d W.E Gnkq <br /> INTENDED USE Dy,d WW EX o 00" r <br /> ocs <br /> L <br /> C1 1np:1.1/1e ❑OPan bo^°r^ _Cl PIMA TrseY TYW d Caelna---�--'—� 'A amIA <br /> t]I7«1rPK/P+tve. Cya"r. n'Ds DMn d G otn <br /> ("7 Pub1k T Via.Dew I 1 Ealwii S:x1oa B.r krlaEad Suf.Work D«....__------�`""� h <br /> K.,.k YI Derr U TYW d/om0 S.."Ma"'I Ito, <br /> W <br /> W44 paolnrolfon O el Drrour FiMt Mawlr 15.4or 60'1 -�-"- <br /> Dell"�--- -- DESTRUCTON III , ..n' <br /> p'PE n, SEPTIC WO K NFW INSTALLATION I 1 REPAIRIADDITI <br /> CoffKnueW— Dew <br /> Nrusalbn vi ores' Res1dR)oa r <br /> 1' Nunlbltdk.dro«^. -WAw 18HYdNrrt' <br /> IkM --.- <br /> rftw d EMq 10601ll 10 _ ..� <br /> pwonw d 1a b a bpd 7 Nes' goe LL _ -, IW Cor+Y+�s^s'rt <br /> C3 Typo/MIO M�fhnS d fAR*I.e SEP IC TANK <br /> fa.ldltb^ _ Prim. <br /> PKG.TREATMENT PLT.4 WM <br /> ii Oieana b nwI <br /> Tob11MgNlex __ OC1 <br /> i NO.S LonOb d E111._.J=t��- rn' n' M <br /> LEACHING II WaE fee <br /> .^may MTER RESue�:J.� .. <br /> SEEPAGE PITS 1 I DoDM --�Wrl FouMsfren <br /> SUMPS <br /> D4wfn b nolresC y a1Q.Y"�C.A aMi. <br /> v r asPosAI PONDS _n 1No 4645- «''^d m.f er w«k wr M dorr-.score)«►rile s.n JogAn <br /> �,.,un"cl�lob++'W:"i undy'!r`in w Isrla�rK+od�c f N�.. <br /> M. in'uG' era '40o,, <br /> work lo� P«^+1 Y wrrd.I r1,A.mcbr eik <br /> i d'' „pry f ;;'t•. a carUlr.IM1.Ic�Poa/V <br /> V7} ',11on 4w C«nplofa drw.kqr ryn..• <br /> Thr pp:r'�.,nI�M I«!/el�rw�wW krW"bn`' an rwwr <br /> Slp d X --.�-/ FOR GEPARTMENT USE ONLY - <br /> 1-' <br /> "'W bV D1n FYuI IHOocUar by <br /> III or GWA doelt"I by <br /> a <br /> SdOtk'rr ,o•nM1: O Lo& 7617821 f1 Manns. 82171011601 E❑NTurlon A�H.P..0 I«I 7000.Sik.. A fl6201 1 1 <br /> 1 a"r^m r H"a P.rrNl/Sarvkol <br /> 'f v'C I ApprcalH Reston M copies b:Emlra^^r'".. <br /> .' , 4 �wanrr 6EwT*eD KLc6rvEpwLWT VJf <br /> _a•.`Y ..M3 <br /> i C7(� <br /> - <br /> �e <br /> �� 4n <br /> v <br /> w _ I <br /> WL <br /> J', p <br /> .. I ,., k YN P M . YXi�. .: 6•.Yu. J. ">N' 4' dT>e+. m x'4 v Iv lr$ { s. <br /> Y - N !1, Ix 1 1..r w ul.mvC �uR DWd11 <br />