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APPLICATION FOR WELLIPUMP PERMIT v ' <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH 5F-RVICES <br /> ENVIRONMENTAL HEALTH DWIS14WN Q @ 10- <br /> 304 <br /> a304 EAST WEBER AVENUE,STOCKTON,CA 95202 003 <br /> (209)4693420 <br /> NOW-REFDDDAILE EJMT E7111RE2 1 YEAR FROM DATE ISSUED <br /> r..0"6"4 TT1,Rnh1 <br /> APPLICATION S IRR SY MADE TO THE SAN JOAO W COUNTY"A N IVAFT TO CONSTRUCT AMMON INSTALL THF V IORL DEOCIMIM.THIS APPLICATIONS MADE N T.OMPUAIICE WTHI SAM <br /> JOAOUN COUNTY LWVRAPMOTT TRLE.CHAPTEM•-1115.3 AND THE STANDARDS OF SAN JOAOUIN COUNTY PISUC HEALTH SNPIICES,EMMIONLBIIAL HI MTH 0,NSION, <br /> JOS AOINESSDR AM' 7600 WINDMILL COVE ROAD CITY STOCKTON, CA 95206 PARC,.,,APH. <br /> pW,IFR,,,A,,RE WI1`IDMILL COVE MARINA A 8 _SAME FNONS, 647..0807 <br /> COMPACTOR NOACK W/020011 ApDRp 4500 E. FREMONT STUC,504513 F.How, 948-8817 <br /> "CONt11ACiOR ADORSS Stockton, CA 95215uc, PHONE <br /> TYPE oP wg�IwP, ❑HEW wfu ❑FEPT.ACEMENT w■LL ❑MOHtOF&M WELL S ❑OTWA <br /> SUBMERSIBLE ❑NOTALLATO-IN ❑WELL SYSTEM MBAM ❑CROwCOw*CT WAIN ❑VAPOR WIRACTDN WMf J <br /> ❑N.,r Is Mei H.P. I DEPTH PMA►MT4 O T- RRST WATER LEVEL 16' 0 <br /> Re 0`11 e"V i s t i n g pump ❑Our-m-w w e WELL ❑GEOPHYSICAL WELL P ❑ son.aol■ND a <br /> ❑DES71UCT0 N: <br /> INIE!M VIA T"I OF <br /> DNATRUC IMM=WXA?lokt A <br /> Ep37/PvLISTSAL 1-1A_OPEN SOT-TOM INOF%w 1 EII CAVAT ION OR DIA OF CONDUCTCASINO p <br /> 9XDOLESTIC,F"VATE ❑GRAVEL FACR/SRF Ty"OF CASNOATFTL O OF WRL CASINO <br /> __ O <br /> ❑P-MasuWWAL ❑OSVEEI DEPTH OF ONOUT SFA _ ■PFCIFICATWH , <br /> ❑MMIOATIOLNAO ❑OTMM GROUT SEAL NSTAUED BY OR101R MIND MAUI! F <br /> ❑MDNRoSNO OROUT SEA PIMPED-❑Y- [IN. COMCRTE PEDESTAL■Y OFELLrFt Ely- ❑N. s <br /> APMOL— I--CHESTER 1—MOVE FIR S <br /> PROPOSE!CINWTNUCMNFNRURC METHOD,MLA IOTMY__AM NOTARY AUOEM_ CARE OTFNM <br /> 1 HEMM CERTIFY THAT I HAVE PR►ARO THIS-rUCATION AND THAT THE WORK 1YRL.IN DONE N ACCOIOAW_E WTI SAN JOAOISI COUNTY OIDIUNCES.SFATT LAWS.AND IMRES AND <br /> ROULATIONS OF THE SAN JOA Ilk COUWrY,HOME OYMM OR LICCUIDW AGUNY-S SIONATURF CERTIFIES THE AM&AANG:'1 CERTIFY THAT IN THE PERpEYANCE Of THE WOW FOR WHICH <br /> TIM PEUSIIf S INSURED.1 SHALL ROT OAPLOY POISONS SUSJECT TO WGISSM.VPS COMPBISAT101'1 LAWS OF C/11FOPSA'CONTRACTOR'S HIRING OR SUAII-CONTRACTNO SIUNATUR CERT MES <br /> TE FOLLOWNS: 1 CERTIFY THAT N TR!FEROF'AIAIICE OF TNf W —OCH THS P[PPAR S IIWKWD.1 SHALL EMPLOY"IVONS*UGAC`T TO WOPWA IR'S COAM■MAYp LAWS Or <br /> CALRONIIA.' TIRE AF"IICART M�STyCA N NOI.EM N ADVANCS PGE1 ALL I !ILMRED IN"W"OIM AT(Wj"ASSJ.r11.COMPETE DMWSO AT LOVVM ARA PIbVIDMO <br /> MIFW R ,? L� RKIAT,,, RETAIL SA.'LES DO. 6/1/99 <br /> PLOT PLAN V.—N Sexy M.i I. <br /> T.NAMES DF STREETS OR ROADS RAREST TO OR SOLAIDIFD TIRE"WPVMY. A.LOCATION OF Hl1UM SEWAGE DMIPOSM SYSTEM on PROMSED <br /> r.OMUPO OF TH R PROPERTY.TIMM tVkOPAWOHS AHO NORTH INFECTION. O(PAISIDII OF INEWAOE INMOSAL SYSTEMS <br /> .3 J <NMNEO <br /> . DROOtrrUM S AND LOCATION OF ALL EMHT■10 AND PF MO l LDCATDN OF YRFUA WITHIN RADIUS OF ONND <br /> E HUNDRED FIFTY FT. <br /> STTUCTUMv.NCLVONO COVOEO Ale"9UL71 AS PATIOS,pMWAn.AND WALAS. ON THE PROFETTTY OR ADJOOSLG FFOMM". <br /> E • <br /> .... i...... :. i ...:. . <br /> .. .. .......... <br /> , <br /> A o <br /> ENO <br /> w <br /> . . . 1419 . <br /> ..... <br /> $SVA H GUIN ax1 <br /> �• NYY <br /> sETavlcEs <br /> I <br /> ENVIRON •MAL HEALTH LAVISION <br /> IL /000�. <br /> .. ..._..._. .._..............,....n_........ ..... <br /> rAwLY <br /> AFF■.wlPw A.MNA Yg� ),,— �/\ <br /> c..n..Iwr <br /> AC COv.TwG ONL r: HIDA FAC/ <br /> F <br /> OOP FTE HNG AA«OUNT 11CLSTtM C"acKJRASH RECTSV■O ST DATE FSELIITMEroct REOUFIT NIAMOR NVOICE <br /> Pub Health So".-ErMMo.173(1197) <br />