|
4/
<br /> APPLICATION FOR PERMIT
<br /> SAN JOAQUIN LOCAL HEALTH DISTRICT
<br /> 1-PI E. HAIELTON AVE., STOrKTON, CA
<br /> Telephone 12091 466 6781
<br /> PEom,r -XPIRES 1 YEAR FROM DATE ISSUED
<br /> (Complete in Trlplirute)
<br /> ,. 1...xw.•,.r e. . .. ,.,.�Il,DQ'Icl for a rmrmd In'."."",Cf amen,mama the ,nnk hnam this,r,trM Tgla
<br /> . ,•"''^"'•••.'• .. r.. .•J.. 1ur xwapx m No IWi7 n well p,,.P"'
<br /> avor Son n
<br /> J �j /' re Russ and R l.1'..vqf n,a San Joahum
<br /> •nas 1: - !j� , •_�' = k I';1 _ City l.aL Lots y -
<br /> �t_f�, PM
<br /> Address �'�J_ �._L-���L_ rl r�r'L'C'_F_'nA',x4F4. _j3r,�e—;i_
<br /> — ra (•�.; C'i_ _ _ .: ... r�_C-- J-i= -a�_�.;e1S LcemY Noalci P"" ,-''nC•
<br /> '�F WELL
<br /> 'PUMP fa.V•tFu v WELL REPLACEMENT LI DESTRUCT'UN f 1
<br /> PU1m IVtiitl Lt:�,pJx SYSTEM REPAIR L1 OTIIER L7
<br /> VCE TO NEAREST. 5(PT!,: IANK J' , SFWER LINES ...— _ DISPOSAL FLD.&LLssC_ PROP LINE Uc— ' }'
<br /> F(s11NPATJGN AGRICULTURE WELL
<br /> - - - _ _ _. JTN_EP WELL_ PIT$_/$U_M__P$I1C1('
<br /> "CNDfD¢:i vPF (IF WILL PNON:FM AgEA CONSTRUCTI6 I SPECIFICA"I ONS
<br /> ..nh0' }' Ill,nn I'xt.m M1 same, Um of Well EacavalbR �- Do.Of WON Call 7].�—_ �!
<br /> ,'
<br /> neurtJPrlvafe (.IAVOI r'ary I .,v ivw ur Costing �a 1Sy► Spec am
<br /> he r gnu" now Depfh Id I...url SealT
<br /> 1
<br /> MI n/E/,Orpol ,� fn✓ _..
<br /> "nit AVlnn• Oq.n. Fasrmeal n ,7SurlatY SIns:dbIfFI
<br /> d pJLr_y ( r
<br /> Work Dnro I TYM rI Pmrits �.. _. HP. =Stab We^DpM •I— _ _
<br /> •rmumn Wrx Do—'ri, Sealing Material Imp 511'1
<br /> —_ DfP•' _ _ Filler Malarial foolow 50.1
<br /> 4 SIP/10 WORK Nf is ''1 AT`i1N RI(•AIR,AOpITION I MSTRUCTION 1 I Mo bpfc sYsle,Winton,it pnpY[aaRM,la
<br /> ---_ ---_
<br /> assailable n+llxn 7O7foot l (�f
<br /> .iatam wA serve. gvsvlrnr•a Cnmmr..ial OrMr
<br /> for a•bong un." rA,•a,•-...1 n.•oms
<br /> W soil In•d•Prh nl 1 r..,., - _ Warm table depth, _
<br /> TANK Is1m M19u _ Capacity._ _. - Nn. CornFernnrrrb
<br /> TREATMENT PLT.I - M.Ihoil of
<br /> Ded.m.is rn nna"! Wee ._-- FNinstation - P,gm(ry Liam
<br /> '•WG LINE I ! No A 1 rngm nl t-.. 7rNM 4n0th/arra
<br /> r AFD ! Dnr.nn..u.ora...... W.JI Foun,Mtmn ._. .__._ hOpoo v Lha
<br /> I-A PITS Il.gnh Spn NuT M
<br /> ..._I s D.a.....•s h,naris WWI Fdudalmn Pmpwty Lina
<br /> .AL PONDS I
<br /> -_ rand,that I I,aw pV j,sf,.d rhe..emhenr „nM in,fns vrNk.,It lm dune.�e.exrdr:en with San Jnanlum emmry ddhFarreY;shat lawn, anire•a,blams of In.,"n,.",vyon i nt,81 tb.,no ITUnct
<br /> .caner ot Fceesed ag.nl s snp,auxw rnn.hn roe mm,wr,q "I earpry that m IhY(mdormanca of the,,twat Im which(Kia permit n rlairad,1 Mall nnf
<br /> r env pMfon in•.h•r,annm as is,tm,'omn asst w•r r I workman',eomgmfelmn htwt M CalddM"Conwww's hang or wh eonnaetng YRnaNrt
<br /> ,M loanvvng:"I ci•.dv that.n if n Mons- r ,.1 rm,work 1ni ivhrch nn Imtm,f.1 rssuod.1 shad erupt.'Manna whpcf In workman-a cumpan"
<br /> —,of Cah!".A"
<br /> ..g hunt must Call Inn ap.mJuxn.l rnyun:hnns Co•nl a drawhy OR rYVMfa std+
<br /> n i
<br /> rr/ .. L..� �� '1-v ♦ Trtb:
<br /> FO7E► ONLY
<br /> ...m AttAAM In,
<br /> -. _ Data_ Am
<br /> -In
<br /> 1r,apYermn his r - .' t!.: Parn� t(" •final Inapaetmn bNScarl�((eZI
<br /> _%Stet Lrnh M)Y01 Mae•eca 827.7104 (A TfaCY 8115,110116
<br /> IaaNrn.,I nw.in Lnveonn,.nlo H.aph P,nm,USarvieas 1601 E. Hafahan Ara.,P.O. Soo 7009,Stiff..CA 65701 ��1�•(�\�
<br /> Mn,NI nix AY Yr n(V.R[o CA4q _afC[Ntp ar MT[ FERMI Also l\�
<br /> U :73
<br />
|