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IUD ' <br /> INE-LL1!'UMP PERNrl J. <br /> SAN.IoaanuaC,,WyEervtatataA=;U-H5AL74Da=poc"Mrr ler SEQSrH AZEL rNtA-W a--S-r_ ?,CA-IS2115-(209)4SG34M <br /> 1ilOW4RIFUNDAELEP»Ylrr CALL 209 953-7697MRINSPECTIDNS EXPIRES'IYBARFROMDATELSSUED <br /> Crn�Linden 95236 �n <br /> J�ADDRESS 1700 T r�,,,, gra - <br /> CRossSTrcr r E Mi 1 APN USE ADPllCCREN]_- <br /> 04uiizNGt.1F C�r1 GIM S P..209-887-- 708 <br /> r <br /> oc�&�Anor <br /> P.O.`` BOX 7 CEMSrar <br /> CopTriAclu Purviance grillers , IIIc PFJrmr 209— S —3 54 <br /> CarrzACTau AnnREss <br /> P O Box 6�] carnrnsTA�EiztPl'in d en, C A 9 5 2 3 6 <br /> !Su-oCONLtACMR PkiOl.E <br /> I <br /> i5USCONTRA ORAZDRF35, <br /> C[rl7$TA <br /> ILme;s6 t a cst 0 Orn er NUMBER 37 423 t XPEA-GON Dar 7/31/19 <br /> Onne,smairlFt LSamm' =:-1 Genesi&&Px.]rca fmm sacteita(4391)_OrnmMOChloMpMpatle(9392)=Arsenic(4393) <br /> INEnreDtlse OamosrjcRrirde C.!m_cdlkWAgdwftuzal OIndustrial C.WatarQuaLtytfiwtorng 0SolSamprm9fCharadermLan <br /> PuDffcvVnler 5ystesn <br /> Ifd�lfmm4lattr, 7t2ter5�mA2n� ea=Nam erPtwa.NwoCe: <br /> 7vPsOFWowr D NesrWeQ C RepL-c meat Well 121Weff A]hral w lM0&ifc3Uan 7 0lh3 <br /> Maritwino Wets) #aFW415 G Sm78tdng(s} �ar�°"°°S L l>eaetfIItl�l °of '` <br /> G Out-0E-Sen:caWell T•OLI-0`,Sennce Wen Renew! 7 Cross CannecUmt Reoa[r <br /> G New Pump Pica Re tz�r.,ent is Ppmo Re air 7 Rais2VVz11 Cr;sin <br /> Wbr.L C13 WMUCITOW <br /> orilrmg"MLthed 0 Alud Rolary G AirRat2ry :3 AulEr 3 CableTaal 7 Push Paint P- OIIter <br /> Proposed Welt Depth ft Exmvadun in cffWneter -open Botlam C-Gr pmt PzcWGraveF S'02: in d2veler <br /> 9 CanducbrCasing in dmmeler 1 Conductor Casag Depth <br /> WEg Casing Mns'rr_nn TlldmemfGdugeJA.SiMScheu -Steel D FlaslFc O Ste-mlEssSreel :I Olher <br /> QautSeal Dauth ? ]Neat Certutt(3�Jbba_a 70gaJrrate� 3 SendCameat saa marTgal wato <br /> C Berlonile(20%srgds) -D Outer <br /> GroutP}ac==tjJethnd v Pumped D Rea Fall n. Other a Relard3ntJf+az!erdlar((0=M) <br /> PmssraL Inumlted By 0 Dimer 0 Fump EZRMdor n other <br /> D Concrete PedesMI CDfinertslonsWid¢r ft Length ftThic`c in 71 CluistyBax 7 5c,ve PIPe <br /> Puetn jjSubrilernblt?D Turbine O Other Fy Y Pump set R Standing Wale-Leu�.J R <br /> I HERc3YcCE AFY TtjAT 1 HAVE PREPARED THIS APPUCATION AND THAT THE WORK M.L.EE ZONE!N SLCC40MMCE WnH SAN <br /> JOAQUIN COUNTY ORnumwCES,SCAiE LAWS AtM RULES AND REGULATIONS. ] ALSO CERTIFY rHAT MY RMURED LJCEUSP 1S <br /> CURRENT AND ACTIVE WITH TFIE CALIFORNIA CONiR =RS STATE UCRES HOARD AND THAT I AM ]to COrKPIUANCE WTrH ALL <br /> `NODNiZ24% <br /> IY1IRTlE1QU <br /> �NCE NO nGE REQUIRED FOR WSPEanordS-PLEASE CALL(209)953-7647 <br /> stcar� ,Zorporate SecretargA,,� /q ! <br /> II <br /> 111 I it 11 <br /> I II I 1 I <br /> I € i I 1 l 1 1 1 1 I <br /> I1 ! 11 1 ! IJ I l Il <br /> I J I 1 ! ( 1 1 1 ! 1 1 1 1 <br /> ! ! II 1111 ! ! ! 1 1 ! I JJI <br /> J 1 1 f l l I I I I I 1 1 I I I I I 79 <br /> 1I <br /> I1 I <br /> 1 I I I s! I ! I I l l f l l lMu <br /> J l IT AST <br /> ) I I I I I I n( l I I . ! ! RECEIVE, ) <br /> J I I <br /> ! I ( l ( i y hl« <br /> I € ! I € <br /> I / <br /> F ARTMENT US/y OWL [7�n/ Z 6 GO IJ <br /> AppII¢tdnAccepledpY c Dam Zv fol Arna`=/� Emplayzelll Q N COUNTY <br /> Glaculru�eclan Date -0 SPEctALINell Permit MENTAL <br /> ENV€RON <br /> Pump lnspe-an Sy D=z Q A WICI ❑ VVAAfER Received HEALTH N <br /> Sad Bating hLsP�tn By 0, DQE Constm=wdWell Depth ARTMENT <br /> COblIvIBJIS r <br /> C=- <br /> E SC aece vad Ghet b F Mmunt Da[e I PeRtIU ` Iwaice: WeU Its <br /> lnFo.-- —Remitted { Servitr Renvest R I <br /> ! fl-WIA I NPa W onal ! <br /> I 1 I <br /> l <br /> I t , <br /> t <br /> -F.Da a,n5 <br /> Z-d tiL9£L8860Z OUl Slell!.la eoueiAlnd d 6-b:EO 6l 9Z Inf <br />