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<br /> PERMIT NO. - 7o
<br /> :_Y_EAR cF`v DATE 15SUED���1�
<br /> _i.;'E ISSUED Tf
<br /> r"i trict for a Cernit to construct and/or install the work herein `
<br /> F
<br /> ,toaou,n County Ordinance Na. 549 for sewage 6r No. 1862 for wellfpimtp ;
<br /> !0 S g r'� E W. .. ...R' '°yr R,tdlvisior Ndek
<br /> id-" Phone '4
<br /> -77,1 ..-'C'vkrILf - rc a tin. aZ3 Phone jg;-U:-6 19 r' ;
<br /> '-'.LL PEPLACEMEXT L OESTAULTION U
<br /> ; D ;NC1 LLwTION ;v,TEM REPAIR FYI OTHER IJ 1►� y�,. .
<br /> i
<br /> dEa LItiES DISPOSAL fLD. PROP, LINE ;
<br /> ALq!,OLTURE WELL OTHER WELL PITS/SUMPS
<br /> T`'"r or '.fEi.E. '_�'IiLEi? r,P.EA_ CONSTRUCTION SPECIFICATIONS `
<br /> S
<br /> 1-I GPnn potto^ _;sl.,nteca Dia, of Well Excavation
<br /> r 1 •ravel race Tracy Dia, of Well Casing
<br /> L_..:lCI to t.
<br /> Type of Casing
<br /> Depth% Eastern SDeeifications
<br /> Depth of Grout Seal i
<br /> Type of Grout
<br /> Surface Seal installed by
<br /> of Pu •;' ._W...__-_._.... " + _. State Work Done
<br /> ,?,1 Diameter ----_- ',rtiirq Material (top 50')
<br /> - i.`•'pth ?'ller Material !Below 50') �.
<br /> �,)f (Ni septic tank or seepage pit permitted if public sever is CA
<br /> available within 200 feet,) 61
<br /> —T! -'eryf!f residence Col--tial Oth-r OQ
<br /> +,v,n7 units: Nu-tor of hedron^s Lot site
<br /> ^! inrl to a dPoth of J fest: Water table depth
<br /> Typel4fq ..- - _-- -- - Capacity ----- No. Compartments T
<br /> Capacity Method of Disposal
<br /> )'%Lando to nrar t io, Foundation Property Line
<br /> I . k vin .A L^.,-gth p" l �' _ Total length/sire
<br /> L jt;tance to nn,rrs. ;rI -� roundation Prot'erty Line (�
<br /> Number. - --- C
<br /> ftctonrr to rCnnrlat ion y--T Property Line
<br /> .•••• i .u+��rrr.mr....���i�innmirnn.�rriw•ri.�rr `
<br /> •' t�•at i hour pre;'=arnd tna It •: anA that the work Witt ",, done in accordance with San Joaquin county '
<br /> res. a.ld cul-, f,td rnn,,l.,, ,. .,,,. San 3oavu+n lotai Health District.
<br /> n•, �r:r' �r,i ,;,^ nwinv certify that in the, performance of the work for which this
<br /> I + r.el n^,nrr as rt '.,tcn-e subject to wnrhman!compensation laws Of California
<br /> "I cwrt,./ that in the Performance O- the (work for which
<br /> .u,-'1, .r.+•1 r-J/1. .. r:`dr'S r•r-n•_:n Sat tfln ldwr'. of falifprn'a,"
<br /> 1 f✓r, !4�(/J- j{f(F �Jw�[_�.. .-_.,_ ...-_.._._,-.._. Date:
<br /> ... '._,•,. -. - -- Y YaetPCa N71-TSDA
<br /> [: iJ- // L91$3
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