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APPLICATION FOR PERMIT <br /> SAN JOADUIN LOCAL HEALTH DISTRICT <br /> 1901 E. HAZELTON AVE., STOCKTON, CA <br /> Tolflllm" I2001 40644 <br /> _/♦FANNY EXP"M 1 VIAA AIOM OATS 198M <br /> 1CompNee kt TftplkaEfl <br /> Aoolkmd <br /> atro"to hereby meds to the San Joaquin LoHamm Ostrlet!a•prrnit tan <br /> o comuloct d/a Yrataf de work Mrot+r dMcrMd d tM Son JaagaktMM <br /> node i,compawnce with San Joaquin County Ordnmoa No 6M for me go or No. ism for ws1/pum and the Rasa and�+ <br /> Lod Health OM+rCt. S TT(� !` �( <br /> .lob Addrae wag .JT's �" RAJ -— ► Let>3Y. '` Pm <br /> Owrw s Hary Q_Aa*QAkJC S _ Aee►.es ��+� `u -5 MA a Phew 65 <br /> Contractor est Licalw m.37AMY zoom <br /> TY OF WELL/frl1MM: NEW WELL 13 WMITUkAxAmm 0 DESTRUCT1a1 L3 <br /> PUMP INSTALLATION to SYSTEM REPAIR O O'Tfm O <br /> DISTANCE TO NEAREST: SEPTIC TANK _-- SEWER LINES DISPOSAL FLO. PROP.LI M r <br /> FOUNDATION _ —AOR16CULTURE WELL OTHER WELL Ni><I>Kl s <br /> INTE'IDEO USE TYPE OF WEIJ PROQLEMAREA CONSTRUCTION SPEC11F9CATIONS �~ <br /> Manteca L�*m.of~Exavdllon_ iib.ON WM Cooft <br /> M OMnMHeAPrr+r�kai -1 G,-wol Pam Tracy Type of CaeMp..----.- E9Dcok+dom <br /> Q Public 7 01.-v 0e11e Depth d Gant Swan - _ Typo of Groat <br /> lirgttien _._APp'ox. �etar, - EastwnS„rtece Sad krtafad by Q <br /> Repair Work Dore C Type of Pump M.P._t Sbb Werk Dea � <br /> WallDewwabn O .NM Olanealr r s••Mw MatwW bop 601 y� <br /> �pjOdf _ Fie.MMNW Iflalow 601 <br /> TVPf Oi WORK: NEW INSTALLATION C REPAIR/ADDITION DESTRUCTION (Nilly af! �) <br /> ve: M we fww►la <br /> MMafapen will serRaeldence_ Corecrnercel Other_ war <br /> 1111M 60 d owing unMe:-- Nunnbw of bedroom_ <br /> C?www Of sof to a depth of S feet:__ VA"bMe depth- <br /> SEPTIC TANK O Type/Mfo _ Capedty _ No.Cwrrpartwerm _ <br /> PKt3.TREATMENT RT.O Method of OYpeed <br /> Dbunes to newom Was Foundolbn Pmpwty Lie <br /> LEACINMO LM O Na S Lw plh of ime Tod bngWdm . <br /> FILTfit 9w O DIwnce to rNwmaF Well_ Foundation PNOwty lire <br /> SWAIM PIT'S O Depth 11ea— fttat+bar <br /> SUMPS O Olelence to neumt WO Foundation P10001 Line <br /> Od wo"t PONDS Q <br /> 1 ha eby owft OW 1 have pupated deb a of selmn and dust the wok wde bo done in accado a*wNh San Joaquin county etch m ea, stab bwe.and <br /> ndas and replAmmm of fie ft"Joe"I n LOW I/adf►pdalet. <br /> Ham erwew w Immad agent's dpru*"eertMMe Ile liofcwdnp: '9 earWv that N the perforvrenae of thr work far vwhieh this pamdt b beamed.1 Shelf not <br /> wnpfay any parse"b eueR rrnatrrar r to bsaene aubret to w-wUrnews comperraatlary laws d California-Carmsewra lrknf or mb'convmd^0 signs VAe <br /> oertMea the fapcwktp '?owt1N tier at tM pMfdnwnoe d tie woAt for eneniel+this panNt kat Ynrad.1 ehaf annplotr persona cubical b workman's oonnpw+a► <br /> Ilan b M of Cdferrtfa." <br /> The a 1pl an r r w'Jsied Irnepaetlere Corvettes drswiq an reverse lids. <br /> .d TMs: <br /> %--3 -9— I Date, (C.-Z�� <br /> FOR DEPARTMENT UN ONLY I <br /> APfiwdm AaaaMed by —�.. Dab (' A. <br /> PM or tirmrt MepeeMaw by <br /> Data _ FbW bepecdon by <br /> f Jr <br /> Addlllertd Cawcrerrlw <br /> O pill 48&M O Lad 7i•M O amuses p? MG O TNKV 41MMa <br /> Applits" Rettig"et ogim b: bw*w nwnW Meeh Per019smA ae"M F. leaecfbn Ave.,P.O.Ow 20M W.CA MM � <br /> :t <br /> AAMIX <br /> MNY pAT1 PAt0JIR Op ITD IT'MO. <br /> rM �� <br /> _ tis.,y�{►i/4..,yg.h. �. I�Ct - 7.. 'R'�f�� . :t .'S? :�f` .� <br />