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APPLICATION F(IR P&RNIT <br /> SAN JQAQUIN COUNTY ?IP:' C HHALT13 SERVICES <br /> J HNVIRONMI'NTA, r,',LTH DIVISION <br /> 1601 E. HAZHLTON t';8. , PL'ONS (209)468-3420 <br /> 1 P O BOX 2009, SINICKTON, CA 95201 <br /> PERMIT F.RP1(j,Q$ 1 in FHOY DATE ISSUffi! <br /> (Ccmplete in TriPliClite) <br /> A"Ilmtlao l+ Ito aby area to 6sn Jasputo Cmmty ror s i.ra:t to can+[rmt "d/.r isstatu the York M»In described. This <br /> applInatles Is tach In toonliarce vita Pan JosRuin County Oral nsnee so. 549 snd IOU W the Rules said Ngulations of Ssn <br /> Jogato Cama Pu011c Reslth senitw. <br /> Jot Adw091, LO J. 1` ^'"+• 'A--Se__,. "' I <br /> �/�[ fir Lot dlw/Ac resge <br /> Owrw'E Hams Add.eu _1�[I,d'�JL Phar <br /> Va.Q�t�x7.6.7_ 3I1Lz26 Plw. Sio <br /> Ctanla(I Maar tt,y_ LrtenN N. <br /> YPE OF WELLIPUMP NEW WELL '1 WELL REPLACEMENT r DESTRUCT" ❑Out Or Nr too W11 <br /> PUMP INSTALLATION ❑ SYSTEM REPAIR 0 OTMER O word. wrim Well Cl <br /> DIST,- .f.E TO NEAREST: SEPTIC TANK Sc.WER LINES DISPOSAL FLD._ MOP. LINE <br /> — KVNDATiON Ar.A"LTURI WELL 01111011 WELL -FITS/SWAPS <br /> INTENOFO USE TYPE OF WELL PROBLEM AREA CONSTRUCTION SPFCIFICATICM <br /> [7 IMuxtAl <br /> c—)0—p"Bogan ❑MaMacs Oaof was E.cons wi Dig.of vital cas" <br /> (I Dtwrxtel Pnyau ❑Gtwat Pact, El TIwy Trpo of Cawq SpwlRCMofm <br /> III P%&k I'1 at" Il Dolls OW!,of Gtowt SM Tape of O gN <br /> I I Nrgncn Am... OWI, I I Ewwn 9w4cs Sod Inatsll+d by <br /> Ragan Ways Co" 0 Too M R,Awo M P _. _ Sow V/"Dwu <br /> NM Daggvwrn n WoS Daw.Nw S0,111FA AYUHdl 1 DAVO �. <br /> Ofed, . TiIW Nowa" d Sop" Q <br /> Y R NFW WATAl1ATIOId t i ►Aaf DD1T pkf 11 eaosa wagon o PA"u w \ i <br /> dtattEfBr*low Igw.J <br /> Nstgdpdkd yI�sgfkf R�.OwIn�Cenrriwtigl_. / <br /> Nun*w of aw,4 wi,to:-/-- N. d Mor <br /> r m S <br /> ChwWw of wN to•Wpen of 0 Iwt: e ��'IR�g+ WMat tabN dWM <br /> SEPTK TANK ❑ TytN/Mlp _ 011 Capably No,Cos rlpwwtwte <br /> PKG. TREATMENT PIT.❑ C7 Vad wd so Datpoom <br /> Distance to nw,wf: Wall FaPiWtbn P apas v Unsf <br /> LEACHING UNINo.A Length of on TqM ItKIIfl wo X <br /> PILTIR SIO n Dktanco Id m,aisa t: was, � itNndstgn��40 ._ PflEow"LM S t <br /> / / <br /> If <br /> SEI ' <br /> PAGE PITS p.� pptn �--_Sw Numw =- <br /> SUMPS /LI Datums to nwwt: Wag 1jhQFwMglwt �Q r hopwry Lim <br /> DISPOSAL PONDS 0 <br /> i MIEOy Cattily Nt 1 he.o WOPatw IM a(MKIIgn and IINI the wwk wA W dote•.acwldwtco wut Soft JOptdn c fflff C+dwwwwasA etala hosts,st10 <br /> roast and fapt4lgno Of tat SM Josown County <br /> Mang www w Ikwtwd span'+sipneton CInd"IN t0ii g. "I CdClAy that in tat padwwancs of the wwk No wetkh Oft pottrif is isaa d,I s1IaA not <br /> an"N"atiy O&W N wch nwnw a+,o wonne Wbwl to workman 1 COntpeneallotl ta.vs Of Cawdlnat."Conn ~s IIOY+f w M►Cwdfa W4 owwwa <br /> pWWM tha fol"":'T"ROY that.n tN pwlo•nwnes of tat that lot which that owmK a Wo s L I of W a WNW pMtl1N PAPP 0 tbknwyg oottlpsl so. <br /> don Ig ya N Cadiwnie." <br /> iNg fNpAranr Y? o,don I clan. CarMws wo ov an wywdF OWN <br /> IL <br /> DIPAIITMRIYT UM OIWV p <br /> Adddxaman Asasowd 1stra.._Y!it_ I+t Dips, l�b^ 1 l Amo <br /> nl w Gnat wifpaswan by _�_.. - Ora PIM wwwdw " 1e T, <br /> AdduwnM Cwnl.wnts. _ <br /> Appaf,%ot - Pot. all copies tot Un Jo".I. County Public 11w10, <br /> services, Ro+irovsnLl Realth f f alt/NnieW <br /> 1601 E. Raaeltow Aw.. P 0 Box 2009. Stockton, CA 95201 <br /> HIO AAIOVNT Mit, AMOVNt AtMIREO CASit AECFNiD gY DATI FERMIT N0. <br /> ;� :INN .,... L`{�o _L1/Jmea -lost `11— <br />