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WELL/PUMP PERMIT <br /> SAN JOAQUIN COUNTY ENvIMONMENTAI.HEALTH DEPARTMENT 3"9 WEBER AVE 3""FL,STOCKTON CA 95202 (209)46g,u20 <br /> NON-REFUNDABLE PERMIT CALL(209)9$3-7697 FOR INsPEc-rio%',5 EXPIRES I YEAR FROM DATE[SSUED <br /> JOB AuviRF&- 33700 5. K05TER RD. L01 <br /> Cn-yrnp TRACY 95304 A <br /> CROSS STREET JJNY 132 - ). <br /> —APN -OZ <br /> 255-j_fi07 PARCELS14'! AND USE APPLACATION if 3 <br /> inn <br /> OWNER NAMr ED THOWNG & SONS <br /> Pmorq, 835-2792 <br /> OWNER ADIDRE9.;33500 S. K 0 S T F R RD. CITvIS-rATEIZ10 TRACY, CA 95304 <br /> CONTRACTOR HENNINGS BROS. DRILLING CO. , INC. PHONE 545-1185 <br /> CONTRACTOR ADDRESS 3525 PELANDALE AVE. <br /> 7 rt"rVOSTArrizir MODESTO, CA 95356 <br /> 6 <br /> SUBCONTRACTOR <br /> PlIONE <br /> SuBcONTRAcrORAUDIUESS CITV/.WAw,PLar <br /> LICENSE b C-57 13 C-6! 173 D-09 1❑3 Other NirMRFD 241101 S EXPIRA'r]ONDAT'. r-�4 <br /> CEGGRAPHICALINPGRMATFON: Coordinate, X YTownship <br /> Range SetttoR <br /> l[NTEsDF.DUSE -'�-W.iclp.tc 0 rrri9AtlDn1A0C11ItUraI 11 Industrial 13 WaterQuality Monitoring 0 S-0i I S—ampling/CharlacEcilm <br /> ion <br /> 0 Public Water 5 <br /> lfdiffmni 11— rho..N. Wr— <br /> TYPE OF WORM 11 New Well C RepI&1;emcnl Well E3 Well Altcratioa/MDdifica6on 0 Test Hole EI Giber <br /> 0 Monitoring Wel[(S)_#of wells [3 Soil Et..g(s) 46flidrinp — <br /> El . <br /> Geouschnical <br /> ti <br /> 0 Well Destruction 13 Out-Of-service Well 13 Out-Of-Smicl Well lleot:wal. <br /> 0 New PUMP 0 Pum o Replacement 13 Pum 2 Repair <br /> WFL1.00N%TRUCrlO,N . 13 CYOSS-CtinnOction R pair <br /> Drilling Method IN Mud Rotary 1:1 Air Rotary 0 Auger 0 Cable Tool 0 Push POilLt 13Other <br /> Proposed Well Depth 230 It Excavation 1 211 in diarneter E3Open Bottom <br /> ;n di,,— M Gravel Pack I Gravel Size_in diameter U <br /> it l7 Cnndtrctor Casing o'cler I Conduct.,Casing Depth fl <br /> Well Casing Diameter 6 in ThtCkness/GaUgc/ASTM Sched-1L-QC-L— 0 Sfccl EX Plastic 13 stainless Steel L 00ther <br /> Grout Sea] <br /> Depth TO% ti 0 Neat Cement(94 1b bag 15-log"I n 1r) 0 Sand Cement avak mix 17 sal water W- <br /> 00 Bentonite(20%solids) 0 Manutbicturer Spec%solids_% Name— 13 Specs on File C3 Specs Submitted <br /> GrOtIl PhItement Method IX Pumped OFree pal[ 0 Other 0 Retardant I Accelerator(name) <br /> PEDEsrAL lost �Y �G Driller , CXNmp COntril=T 13 Other <br /> PUMP L1 Concrete Pedestal Dimensions! Width_ 't Lengthfl <br /> r Thick in 11 Christy Boa ❑stove Pt <br /> 1:3 Submersible C3 Turbine 0 Other ump I :" <br /> R <br /> Standing Water Level I <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AN THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br /> . 6, <br /> JOAQUIN COUNTY ORDINANCVS, STATE LAWS, AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE I <br /> ' S <br /> W <br /> CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT 9 AM IN COMPLIANCE WITH <br /> WORKERS COMPENSATION LAWS. WITH ALL <br /> MINIMUM 24 HOUR ADVANC N TICE REQUIRED FOR INSPECTIONS <br /> SUPERVISOR DATE 3-16-0 <br /> 6�1 f <br /> ——— ————————--- <br /> Z <br /> ri <br /> -A <br /> —————————————————--- <br /> -————————————- <br /> —————————— - ——————! <br /> T\ <br /> L I I <br /> -——————--- <br /> ILI G' <br /> T%,571 <br /> PARTMENr 0, E )PfNLI, <br /> Application Accepted By Date <br /> A­ <br /> A Area *yee'ID&/;&'24 <br /> EMpj <br /> Grout It y <br /> istivaion B Date 0 SPECIALW <br /> Pump Insticcliun By i�4�0 11 PernAt <br /> Ocstruction]nsiamijon uy Date 13 WAIVER Received <br /> Dole Constructed Well Depth <br /> COMMENT'S <br /> Ve' /2 <br /> PE —�&C Received <br /> ec AMD <br /> Date Permit! <br /> /*f By -IL Remitted""1— ServiceR ON I nVelce of well IDN <br /> Y;W <br /> 'LS-33 <br /> aTs' i'—&d <br /> WELL FLWF PERMIT <br />