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APPLICATION FOR PERMIT <br /> SAN JOAOUIN LOCAL HEALTH DISTRICT <br /> ISDI E. SIAM-TON AVE_, STOCKTON, CA <br /> Tsk*honn (2091 486-MI <br /> P_ERMIT EXPIRES 7 YEAR FROM DATE ISMD _ <br /> IComok" in TfIrIko e9 <br /> .x1 ApM<ahon a hpr.bF ' @dP to&*SM Jaepan LOCO fftien OMM:tm •oe+'vx M egr'alrm[t mdtb�Mtei flM vvadt lw.h deecrC.A-Ttla aptlEfaAals i <br /> 1'senh[aetnctwvth Sen Jpsgvm County MRfMnq Nb S+La fa�s•"epe a No 1862 fa•wsit PtP/p efw vM RUM aca <br /> t RW"item of Ilha&w,FpeWfr, <br /> Jon AdGn,ew 30 553' 5 CRY' <br /> O.w*Nrn+e <br /> OF Wil.A KI1 j�� p• <br /> NPE _ 9MP <br /> _WECtt►UMP- .NEW_ WELL WELL AEPLACEMEMf Z: DESTRUCTION . <br /> PUMP INSTAII�TloN 0 SYSTEM PWANQ . OTHP rT <br /> 067"'CE TO NEAREST: S%"AC TANK _w. .•,,,__ SEWER LINES _ <br /> DISPOSAL FLD.•.,—_ PROP. L f <br /> i_ FOUNCu1TiDN_,,�,__AWKVLTURE WELL _ OTHER WELL__ _PfSt SUMPB _ <br /> JNTENCED USE TYPE OF WELL MMUMAREA CONSTRUCTBON SP'EdFlCATIpN$ <br /> u hrdNR+M i Op.n 9ottom :?MenweeOft <br /> Q <br /> atMn_._ ._,. Dim.al Wa4 Caa otasNk/ivlwM c:Gnlv.l Pack I T+a FY Tvw of Ce"_-Da e1 WeR E.cev_ _ —' SOecif cwtnn► "`•• <br /> 1 PUblk �:. oth.r r. . , <br /> ,Mr�aedon ONu ! Depnh <br /> zor_G"M s" _...:..— vw d Grout <br /> _ <br /> _ Avp,*.. Ooplh--.,. CommI Sit""Sf.a W T ,•l <br /> Reyr w..w Ome ryps a Pump —� I P <br /> wasDaas.e m 1] Wee Ow wta _' I', r — Sues Wore Doles— J <br /> TYPE OF SEPTIC WORK NEW INSTALLATION 7 REPfiM.7s TRU'CTIDN tNo MYpNI <br /> ,.,r Millen PM-:!rd/P,bfe seww a <br /> _ Iw.lali n ww ws..s P+HIOIr aMfa=0 Fam.I <br /> Rssee.K. CdafMrW <br /> Numb.,y:,...p onrta. _ L Nunb..W :.; . r , _�. . •. '- ` _�. <br /> Ln <br /> ClMrxw a.cw p•Aptn a]lw'7: _„.__-! /�- �� <br /> SED`([ TANK — wr►� uw depth <br /> TtpsrLA/0 <br /> NcGTREA ,._. CIEMear _. Aa. Compwrm'-M t <br /> . I'M{N7 PLT.[) � /7)+] <br /> t Dow"N�� WMS,••t�11 I JdT LMhbd o1 anpnau <br /> f iry T' s° .uan n"tnr Line <br /> LEACFRMG`tMIF �.No.4 towth of E�Lls _1,,,�. •'�„ .�.T�_.� TAM Wygy4tawa_ -••--_ <br /> F0.TE11 REO ❑ oAmn'Fe ft n. AW7 WWI !_ . Forv,Attibn _ Prgsrry Line <br /> SEEPAGE PTS D Dapo _ Pr U <br /> DISPOSAL PONDS <br /> I ti^ilf camty=W 1 neve pragMA Vla epplcan,..n oral rm dw ma4'ASE he AMM A.atipAence w:M Son J <br /> nllra and r.0ulenbna d IM SM Joaawn t tical flnettn 6ivKl. °DO"n ondrane.e. waft bw.. and <br /> Noor owns a Fesnssd epealYs wpv7nn tyPofi.a Ihs lbh�wa,Q..'1 orally that in'J"iaeonfpeawrlaaomGaneMsarMrystiociteCamraIcwrur•tswo daPma•. sq l OWP.nos+ suet'mr m b.cmap o b woftf , MtMy rot <br /> , <br /> a wQconrecfMq aO.Mfuw t <br /> .t�!w.or�. ry�� tM peAamence of 7N vwk ra+Aica+tivw PrmM n,erred.1.M.nalor Ps�.e.rs a.aleet b.,vA.rfr+Y wnq.ty. <br /> V <br /> Tfr elebfcent n.Ot yt fn r mf6 lnslMed.nw cm mawrte 4riw4rip en%.vr w rd.. <br /> _ Vrt ✓�+ <br /> SKfniOX _� _�� - Tom.. _+�ia�l•—_......:— Dfty _yiC�.i�c:� <br /> , 1 <br /> POR DEIARTMENT Ufd OMLY ""•"' - � _��wL7 <br /> Aep'4stfon 4cuwred;ry -- DM <br /> Pt'i Or" t'`eOser.on br -. —.— pay PFnM Ictus:tro„ov � '�G.. . DwPL.s , <br /> Ad6bnrAi Carnrne: <br /> : Sa a0687at "I laA 3f►712I O Manors Q}7I04 LI TOLY E964C� __--.-.— <br /> Anottem Rehm as co0ae m: ErMfplawaal NSLV%Ffam; ?Ssrvlcsa 1Ep'I E NawRp+Ave.. P.O, Mt=00:Sth- CA MRI <br /> 1 1 <br /> OUE AMKNMf 14tII14nw RECENEO SY - _fMTE :191111 w W. _ <br /> -�awiFiL.en.r 1�. �t ... t (f \' 1� •r ,��Ej/L ��.r� <br /> • 1 <br />