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WELL DESTRUCTION PERMIT <br /> PIRLJCwwTgLSYSTEM O rmAW <br /> S.x Aonpua CouNry Exn.DN'..aT.6 xrALrx Do..NIANT 1hFewrHRAPLYPL-S'aocaTon CA95TB1-1TIh)A64.mn <br /> NON-REMLI KLE PERM—"& LL(LIYSI 9517697 FOR INNPeCTIONN EXPIRES I YEAR FaoM DATE WtlE j <br /> J.AY.W. CSfYmr r M <br /> C.ncs Srelxr AIIV P.MEL SIII�A%R UM Ar.I.Ic.TNINE <br /> D»mu_L.e PIxwY s <br /> owNranmhr_as CrrvIST.TUIn <br /> � Oxrt.Ac-laa�enZ os rxoNc SH�i-��111 r <br /> fANr..ITO[AOY,tl'. Z Y6• CxY,8f,illl. l 'B A <br /> I � ciT wru.DRnuxc 41@14 NDNYYft� ulwATrox DArE <br /> PLYPoMrIM CTWTRAtTTR PNON. <br /> Purounox CoertlucioAAvonr65 CmSTMTJL. <br /> O C-51 WW Ui111K Lk.4c NumM+ P.apiNlim OH. <br /> ❑ IWreu ofAlmMl,Tah.miHgFwmv-Uan of xiYF SsplouYe 5,iun.e Nombv E.piau.Otl. <br /> ❑ CHP ll.n�das Nav�ial T <br /> +.nTpfletion for Fipb.iry 4ccnc M�mbv TS.pt9lim O.le <br /> O $..lp.goio CouorySM1enRCawa FuheivH Appliwli,x�.M Pumil Imnu NumM Eapinrio.(.H <br /> ', O CalifvEi.OaywlovJ S.hry llulN.Bhaer lirenx Numb) Emxuim O.r. <br /> RYA1mIIYrllehrCTron ❑ Dry Raplaamet W.L RC6Ped b 0 N/Wtll 0 lactim ❑ I.Hak <br /> I OReld/&p'Ied WeV W.Iw Cr6lrlrex.) <br /> AKmet p.pHlywimmmnin.Nm(Add.) --- <br /> I IrwY 9vi,/W.vt m.amW.4t u.dj.cet pmlmry <br /> � �--�w.>.c•—.--..fwx Drr.0< �apm Bim ❑ c�r.a r.u� ❑ u.p�.a D aAav����� J <br /> Wi LKmpy ao.mW ❑ Ya )ON. cir wSol O No Ya_h IxINI med—FIm(bo) R.Ie DIrs.JZ_weer e <br /> WAbtlar�C.tlK ❑ Y¢ ❑ Na DePrho(CoAI CftlK Ab DhmMr.I Ce.dum.rCdY Asha <br /> TDRA>IIK01uIrr�ircAo Ts41 D.y> fl Dephr W,A, ft DepMdCWK< ' D6p y: <br /> EWIKM.rrW flan _fibpfm Rbgs HIb MMWY ITDA . frvm�ll(pb fth0 if <br /> W.N etlYYrbeg�>Y sne ettAe falbwfm malieh: fmm 6nyr Roy 1 <br /> O WWII.Ie Nada ofmvewy Rmdla ` <br /> l O Lghtlra O Dwwulmmm O am pKmilmrWry fl O aithau EmisAk 2 <br /> O DtmeoKmnf.m mmlp. O oih atrmlJmFwy ._ft O w tpq IN <br /> O <br /> Ona,,- <br /> 0 <br /> ReO Net Cemml(91/A Mg/Shg.Y wNn) ❑ S.W RvYeI '!wu/iy4 v+ln ❑ B.WNr PArb <br /> I D ❑ MNwistom Sp %whelk % Nm ❑ Spcsm Fik ❑ SPtm Sob i4 <br /> PIM MSIIMrd O ftw W O 1.F.II ❑ (Ilhv <br /> l &dCm,, fM 0 CqN lm n MV.heom Cy Ehy O Cmmkrrm E.iHftS .PW <br /> I RERERY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE W1pRR WELL ME DONE IN ACCORDANCE WITH SAN <br /> JOAOUIN COUNTY ORDINANCES,STATE LAWS,AND RULES AND RECULATIONS 1 ALSO CERTIFY THAT MY SEQUINED LICENSE IS <br /> CURRENT AND ACTIVE INFEW THE CALIFORNIA CON'TkACTORS STATE LICENSE SOARII ANT,THAT 1 AM IN COMPLIANCE WITH ALL <br /> IYOAKEIIS COMPENSATION E%MM <br /> M I UM 2d VANCE NOTICE REQUIRFD FOR INSPECTIONS <br /> i COxTR.CfOESIGN.T1m[ rm. SJA.Y1PlVi50YD. <br /> KI I <br /> 1 <br /> I <br /> PAYMENT <br /> RECEIVED <br /> I � <br /> YE}ARTMENT USE ONLY 11AV 2120075 <br /> wPalm6m Ami BE <br /> Ilssnwiin.I.rEYcdm B. hfr6A,,.-J ON, Empmre <br /> COMM L / <br /> R <br /> I <br /> CM r4 <br /> PE SC Rmtlmd AVM <br /> 1 .W U>r Y Y WbIDY <br /> Nl-LE O V LC'C`r <br /> uloaw.a maann�.nm+ <br />