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-WELL I PUMP PERMIT I <br /> JDA E WEWRAVL V FL.Sr,,kTUX CA 9S7S2-(25E)IW&34 k <br /> CALL <br /> SAN IOAW{H CAOTrY ENVIROr1MLNTAL HEALTH ppT <br /> NON-REPUNDABLE PERMIT CALL(2091 9S3-71597 FOR INSPLIC'rlOns EXPIRES I YEAR FROM DATE tssUEo <br /> rm2R Kcwe'EC� 85336 <br /> JOR ADMTAa I c <br /> SIOD S C� �- <br /> t�l�pAelry. APN ,�PARCLLBVa�r-^^^UeewmacnnonN Ars <br /> CPUCS ME" PWy Ehra� Y.Yt.�.-6445 <br /> VGA <br /> ONNER VAMC ... ... _ ` Lk - 6A <br /> cITWB*ATvuT . <br /> OwNEa AppaTAE PleOtr.M..M'-GG Zt�gf, <br /> cover,, CTOR tit Cr1YBkA2LfLr <br /> 1(, <br /> %Ala+.��' <br /> 'QrDRAC'fOHApOnr.a S PRDNE <br /> i <br /> BDREDNTPACT011 . .-. <br /> COVBTATUZIr j <br /> SUK'ONMACTORADDRP88 - -k t •• -_ NUMIER $(12756 E%IIMIpM WTE DI,D� <br /> LIQ ❑C-5T ❑C61 DPW .u. To..Mp__ RWw _ S-d <br /> v G <br /> GFARMmtL IMPOPIrATWH: CsOMoLM X OSoii Sr�m1On. <br /> INI'EHIrf9 U U¢ 0Nbl a SyTmn� <br /> irJPrisve 'PtkdAV�Wv CI IodIWdd O WataWeEtY McW""'In6 CJ <br /> 7vre OF Waeos �NCw WWI CI R.pi WcEmnt Well ❑Wdl Ala OIWJMadifimu oCI TM Mksep Huk ❑Oiha sdberings - N <br /> ❑CrMshani__ <br /> -M of welk OSoila ir4(s) <br /> C3 Moni:drin5 Well(s)__ N O ow-OFServicc WdI Rrnml <br /> pont-0r-se,,i�weR <br /> ❑WtllDstmction it ❑craw-Conneeliao R <br /> O it <br /> ' Mew O R � - <br /> We.•IpfaTRtILTWI a 11 ❑Cebie Tod �Pudl Pant ❑Other <br /> Air Rawy 0 A ,, n dhlMRr <br /> DdIRK Mdhad O Mud Rolwy in diameter ❑Open�1Om ❑ s'd Pack I(inwl Sitt___i j <br /> Props* Well Dep]h ft b:nTok[m R - <br /> OCwMuctaCawRl iodioerter / COMrmmr CesinBDRIH <br /> I. ThkkRreaIGR:RdASTM Schur C3111.1 ❑Plnstic ❑Stdnlrss Sled ❑Otha .. <br /> Wdl GSInR DionvJa p SRq CloCaocat sack m."/TPI wkRr <br /> l Coma mlb bwIJ-109-7 ware+l <br /> Gram Sad Deem R %solids._.% Tt°1"e ❑Specs on Fik ❑Specs SabmitmL <br /> ❑eenwnim(2076 aoAds) ❑ManvficSpa ❑Rewrdaml Amelmtw(omw) <br /> Grow Pbeelrat Me1RRd O Pumpd O Free Fdl O D OWa <br /> IaaRRed By D Dnikr ❑Pump Contactor Oiha <br /> PFAIC6TAL Width ft LenBrH_--R Thick rn 13 Cho." ❑Stow Pipe <br /> ❑Cancrek Pa4aN DIIReReiaK el.: HP�L 'Pump�.S-�1-rt SwodinS Wwm lrni R <br /> Pulm? ubn:asibk )(Tubi. T]OdN <br /> ❑Open eotmm ❑CdeW Pack OUlrawd �o- ❑other <br /> W[u.Da1ROLTNm Tmal Depth R DepM w Wm+ ft ❑CeMgm be Perfoated fmn__R w__R <br /> WDu:neter__in ❑SarW Cemem cockade/7 Rd n IW O BmwnAe Peaks° <br /> SUUK Mok6a1 ❑Neat Cemrn]r9l/b bas/3-lOgal rrmer/ ❑Syrsron File ❑Specs Submitted <br /> `� p awnarBe I20°/s solids) O Muufsctuler Spx%sdids__% Nwrc — <br /> p TTee FAR 13 Olha r! <br /> PIreRNRt Meth 13P P <br /> R bebw Sam O Complae m Esbtln Smkce ad <br /> D Complao wiN Muskraom Cap <br /> JOAQUIN COUNTY ORDINANCE&STATE LAWS.AND RULES AND REGULATION& 1 ALSO CERTIFY THAT MY REQUIRED LICENSE IS <br /> I HERESY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THAT 77IE WORK CERTIF DONE IN ACCORDANCE WITH SAN <br /> TO <br /> STATE LICENSE BOARD AND THAT 1 AM IN COMPLIANCE WITH ALL <br /> CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRAC <br /> WORKERS COMPENSAITOM LAWS. <br /> �-� MINI M24HOU ADVANCENOTICER QUI OF INSPECTIONS <br /> TITLE <br /> SIGNED/r <br /> i <br /> QcW <br /> MFARTMEM USE�v—LY/ �+y IOl�1]J <br /> In,.°aoB =1— y <br /> hR <br /> pc., 13SIF[ciAL WeH Perdt <br /> WAIVER Received <br /> Pump inspecdai By oak 13- CybW'g%id WA Dsp* B <br /> Dte1NC4aA IRrP6tim P Ode <br /> COMMENTS <br /> ------------ <br /> )tieeYl RIi IBp <br /> PE '6C RerdsN Dedo _ 9ereRe l IwWo/ <br /> Codes Inky B <br /> QJ <br /> I <br /> ewiI4�K1YR�4LIRARy <br /> END t)<3-0as <br /> :]ItYtp1] <br />