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v.J <br /> `A APPLICATION FOR LIDUIO W{ PERMIT J <br /> SAN'JOAOUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX SRR,904 EAST WEBER AVENUE,STOCKTON,CA 95201388 <br /> 12091 4552420 <br /> AONREFUNOASLE PERMIT EXPIRES I YEAR FROM OATF ISSUED <br /> RIEMPIEIS IS TFlPllutd <br /> .VRICATION It NYRCY M110[TO THE BMI AAOYN COUNTY FOR A 1.1 1.CON[TPUCT AHdOq SORTALL THE WtlIN OESCNOEO- THIS AR4ICATIOH 1I MADE ISCOMRIANC!W'IEN 8AN <br /> JOAQUIN COUNTY OEVFLOFMENr TRIP.CHAFFER 9-1110.3 1AM 111E RANOMpa OF SAN JOAQUIN COUHFY PUBLIC HEALTH 6EgVICEB,ENNW NMEMAL HEALTH DODOES, <br /> JOB AoogEBBmn AFxIYY) G QA.�.,1�IIJ "Y .\'- f- .J Lor _ <br /> /] I Na <br /> OYMEn's HANE IIL Tf� E) F.ht ^ ADORBe lT L/1,A�LrJ FHON! <br /> MISTRACEM RA•sYf- IVI.b('1'�'<l/R� ADDRESS ��/-I-�L] 1�. e�L1�.0Ajfrn LICE gbXE S� Q <br /> WM caNTw.-rGR AOOq[p <br /> LL'I Nlp/[ <br /> TYPE OF SMVG WOn%: NFWINRAtLArpN❑ RBNNREGannM OpTIRI m <br /> NO 6V TIC 61.1EM PERNIREO If PUBLIC BflYEn IB AVAMam WRMN E.FEET OF lWmGMJ Fq0 TIBITpI I I NOW/M//L• <br /> ,y IE/RFNNII <br /> INSTALLATION WILL SEMI N:YDFNCEp COMYEICIAL❑ OVER❑ <br /> NUMBEROF UMNO UMTE:�I a. MMIER OF PMOY®: <br /> CHARACTER OF BO a TO A MRN Of O HET: C Q MORRIS,pI CNAM . WATER TAW tI[FIN 6Cl <br /> FnVC TAN.IM Tw ❑TYMMNQ CAFACT/ W.COEVAIREpPEI <br /> ntO TGTMENT MNTO DUI TD NE .: WYE WUHOATER glppgFY LN1E <br /> UPT STATION 0 SHI TYPE OF NW,IANOOR SEFAMTOR IENCUOSEO SYSTEM <br /> LGc1ExO uxE A+L No.BLFNOTH OF WISB'�Q //YLT�DUVAME TO NEGRI VVOV Q'I�F01N01iNIN yU/ NpFEgIYIpEE ��• C <br /> RLTEREEO. J 'ARDT LEMIN DEIN_DMPAMf TO NcHavar:VOL FOUNDATION_PItl14MYLWE C <br /> MOUNDED yQ(\WOTN LpOTN O[TI_DISTANCE TO NEAREST:WE11 fOVNOATION PGRIRY IMF 1 <br /> •EvnDE NTE •{y p[RH �Y` [Q! 1� ^� NIMH DISTANCE TO HFARR:11 y�,7 1' <br /> �l �_ ., `_fOUNOAibN_y(�RgFYE(Y EDI[I�J�1•(, <br /> 6WIE ❑Wlp}II-JE—ISMI OEFTH WAYAHCE TO NEAREST:MAID FOUNDATMN WIOITJRV <br /> dBFOI.LL FOMITE ❑MgTN LENGTH MRH_DISTANCE TO NEAREST:IML FOUNDATMN IIpMRrvuSE- <br /> 1 HERSEYCERYIFYT RT I EMVE REFNEG TH19 AWUCATBDN AND THAT THE WdN WILL BE CONE M ACCORDANCE WITH BAN AMQUIN COUNTY ORDINANCES AM STATE SM.AM W11FI <br /> NO REGULATIONS <br /> JOAQUINOF THE SAN JOAQUIN COUNTY,HOME DAMON ORUCEWED AMNT'S SIGNATURE CURTSIES THE FOLLOWING:I CERTIFY THAT IN THE fEMH!ORMANCE OF TwGA R TOA WMCM <br /> THIS MI <br /> MRT 19ISSUED.I YMLL HOT EMPLOY ANY PERSON IN SUCH A MANNER AS TO BECOME SUBJECT TO INOMLMAN'I COMPENSATION LAWS OF CALIFORNIA.' COMMCTOWS MNNG OR <br /> SUE-CGMTRACTIND SIGNATURE CEIRIFRS THE FOLL01MN0:'1 CORIF/THAT IN THE PERFORMANCE OF THE NOIR FOR WMCH THIS FERMI Y ISSUED,I VI DGKOV MMONS SUBJECT TO <br /> WOR{MM•'SCONPEHEATMNIAWIOFCALIFONMA.- THEAPFUEANT MUST CALLNMW INADVAME FMALL REOLMEO INSF[CTON9. CON%m,m EANIHOBLLOW. <br /> j����J /] l qq ^ <br /> 910NE0% /1 YI V 11lL A.%II�.� TRIS:Q I P^). - OATD Z V �l Z <br /> U111 I��,III PLOT IUH W.TO 6CA.1 fiCAm_' <br /> 1. NAMED OF 9TRETS OR ROARS MAREET TO OR BOUNDING THE PROPERTY. E. LOC..OF MVSE SEWIDF deFO1AL SYRFM M AVPoRO <br /> , OUTLIM OF THE TGFURY,..OIMUIBIONS AND MIGHT dYCTMN. [%PAN AN.OF 9[NNOE dROEAt SYSRINS, <br /> ]. DIMENSIONED OUTLINES AM LOCATION OF ALL EXISTING AM PROPOSED STRUCTURES, a.LOCATION OF HELLS DR DEN MOMS Of ONE HUNDRED NIFTY AT.ON <br /> INCLUDING COVERED AREAS BUCII AS PATIOS.MVEWAYE.AND WAIRS, THE AYPYITY OR AYpNNG PROFEIRY. <br /> T a <br /> N <br /> T) <br /> -( (c <br /> y I N-P fyl t vs Utz 117. <br /> pIT <br /> -41 <br /> FOn OOMTMar w[ONLY ''i'>I[JI. ESfbL <br /> APPLICATION ACCEREO BY � , �/V /�•✓L��(`�OAM' <br /> TAHR.PR UR OUGGI....EYDAT! I / NNAL INSPECTMON EY <br /> AOOIl10NAL COMMEME: <br /> Acco. T ...ELY: AIDS Mo <br /> OOE FYINFO I AMOUNT gDDTIEO INRDQF A. I RECEIVEDSY GATE q/FENYT MBMqINVOKE/ <br /> �Z 1( 1 C) 4iy3 _tb To/�/yo n 1059i 03a5a8' <br />