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f <br /> APPLICATION FOR WELIJPUMP PERMIT 321 <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DWISION <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 <br /> (209)465-3420 <br /> 1100.11FUNOARLE PERMIT EX E!I TERN FIVIII DATE 13SU90 <br /> tGo"i.E1 Is TP4Qat{I <br /> APPLICATION le IIERE My IIADE TO THE MAN JOAOM COUIITY POR A PEPAMT TO CONITRIICT ANDIOR PHITALL THE WORK bESCIOMED:TIMM APPLICA710H M MAGE RI C*MPLIANCE NRTII SAN <br /> JOApUfI Caumv bfvEl&rwNT inn.CIIAAER 0-1115.3 ANO THE STANDARDS OF MAH POAON"COUMy KIML.IC HEALTH SERVICES.ENWFIMMENTAL HEALTH OM". <br /> JOS ADORLe{NOR AMI. L:J Cm RIlam PARCEL MIEFJAPNf_ �dyyfy/yy�yFyMF�,,, <br /> aWNER'f NAME ADONEFf INON[1.779� <br /> CONTIIINCTo11 ADPIEMI f 9'e1H0NEF� <br /> UMCONTPACfOR AOOIEIf11DNta <br /> TVF1aryeLLPPLTMPI dMWWCLL )XIIPLAUN1ENTWELL IUMOMTORMWELL. ""N't <br /> ❑THirrALLATION IU(YELL SYSTEM IEPANN ❑CM66CONNECT REPAIR (3 vAmn ax'MAcTION WELL f J <br /> 13m-0%.wh H.O. OEFi"PUM► FINeTVVATERLEVET O <br /> f"K aT FUMn �T 13 1GR wm m A _ <br /> 13oVf-0FSERYICE WELL L]aEonlrelCAL YYF7L.. <br /> pLaEfIRtICT10N:�I� r1EI1IFI <br />' N V ,�-I �ON{RIIC 10 i►ECIRL IaN{ A <br /> Q md1ETRIAL UaPINNOTTOM dA.of WELL E%CAVATION DIA,Oi CO"OUCTORCASM O <br /> ❑ooufsTEN'MVATE OoRAm PAcousaE. �Cl2 TVPEOFCAeMONTEELPMfEIL DNA.OF WTLL CASOM I�JN O <br /> ELN <br /> ❑N�PVNSAwmcrAt 0 ow EN DEPTH OF GROUT 51At,� SpEaMATION S1ZP-I � M <br /> 15W1SGAIMMAG ❑OTMER GROUTMEALMfMTALLEDMIY I'dIWI FJT aNauTMRANDNAumrA7rA 641kni+ E <br /> Q UOMOMM GROUT MEAL PUMPED,I1'E��L'r ❑H. CONCRETE P[DEMTAL ev DRILLER:0 vw IRN. J <br /> AMID R.DVT", Har LOCKING CHIMER Soxislaus_ S <br /> nroTnfEDCONeTRXTIONANVLPIOIMETNab: LLRDTIOTANY JUN TMTARv AUGER,_—CAMLE__CTHaR <br /> 1 HTEMV CERTWV THAT I IRAVE PREPARED TRC*APPLICATION AALI THAT THE Wom WILL ME DONE W ACCORDANCA WITH SAN JDAOUIN COUHW ONOMANCES,STATE LAWS,AND AULIO ANO <br /> REOULATIONO OF THE SAH JOADUM COUITIV.ROUE DWNEIL ORLPM#KD AaeNT-1 SIOHATLRO COO IFEf TNM P*LLOYMOs'1 C1UWFr^THAT M THE PERPDIMEWCE OF THE WOW PON WNICN <br /> PISS rumiT H ro"O,I*HALL NOT EIMLOV OERfONS SUMJECTTO WORKNUU S COMPIMAT"LAWS OF CAt"FNUL-CONTRACTOR'*HIWN OR OUS :ONIRACTM MIONATUNE CERTYR* <br /> TNIE PEALOV MMO: 'I CEW IFY MT M TY! RFONAANCIF OF THE WDT1L FOR WMCH THOM KNOUT W NOSHES•I SHALL 110 LOY P4ROD"s/INJECT TO efONIOAAM^s CO"N"Al"I M LAVYM of <br /> CAI,IFaI*I AP AI ATYf7 O •Ne ADVARCS FOR ALL PT[MIIRID d M*'g1l001 N^M`y'l��JN �OEOSETE 4RAYRNa A7 LOWER ANA NROVAED. <br /> I."AIRES OF @TIETTM OR ROAO1 NEAINEST is ON■oumvING THE"wNFMY. {.LOCATION OF MUNI 1EWAOS d1POuu fYit[M ON PROPOSED <br /> 2. <br /> OUTLINE:OF THE INNGPEMY,orim UPARNNONM AND"Offm DM:ECTIaN, EA►AN11ON DP sEWAaE I MPOSAL SY17Eui. <br /> O.DIATERIONIO DUIIINF.1 AND LOCATION OF ALL ERRNINO ARID PROPOIED S.LOCATION OF WELLS*YYTMN IlRMI OF ONE WJNMD FIFTY F7. <br /> STROCTVIRM,Ih CLMNG COVERED AWAS INC"Al FATIO%DWJFWAV%HHD WALLS. am THE PROPERTY on AbJORSOM OPIOPERYF. <br /> n.. <br /> I <br /> '4 <br /> :.. E. ._ . r.. <br />. ... ' . P�*MMT <br /> __. .. <br /> 0.1999 .:.... <br /> :. . . <br /> _ .....SAPF JDAW@u COUNTY <br /> PUBLIC HWALTFi fiEHYIGES' <br /> -, �YIRONMENTAL HEALTH DIYISIph' -, <br /> "MAST 011 ONLY <br /> A.FENRI..A" <br /> a.w M.P..+IIw MT ^OfN PNEIE t__r w of <br /> ACCPUNTING ONLY: A.C. FAcf <br /> h CORES FR IRFa MOUNT MITT CH uH R*MrM SII 111111111. nf"ffovw CE Memel MU11MY1 INVOKE <br /> l la '3 t ze 6j <br /> �(---y, 2W lto <br /> Aub Heath Serv:.Ereviro,173{1197) <br /> S R 60 s 6Z <br />