Laserfiche WebLink
66tiS '°N Wb3I :3 61Z Zl da �r �j15P n�LJy <br /> WELL/PUMP PERMIT <br /> SAN J akauw Courmt EtrvlRauaanM-HEALTH DEMM-MIT less EASTHAzErm h AMUE-STacicrarr CA 93-205-(2M)46&a42D <br /> MON-PEFU aDAB E P03UNIFT CALL 209 453-w 697 FCRINSPECMONS EXPIRES 7 YEAR FROM DATE ISSUED <br /> IJaeADUR—rS2257 Lucile Ave c,,,.,,Stockton 95209 b <br /> �rossSrxgr Don Ave APt t9c4�c� � �AAms�y_-t rLanvuseARatJeano.�� <br /> G'rlx,,,CJastc <br /> Linda Smith Pxor ?09-h1 2-441 n <br /> (Cww-arAcuREss2257 --Lucile Ave CrrvrsYATrzI ual4 CA 95:209 <br /> ICorrr;Lq=fr Pury ance Drillers , ILC 209-887-3554 <br /> Ca'r7i•ACMIt ADDRESS PQ box 64 CMISTATF171P�'-'1ntj en , CA 9523 1 <br /> ISUBMITRAOMR <br /> Sua cmVTRAcmR ADDRESS L7rYlSTATFJZJP <br /> �UcEllsE rt C S7 u C-Sl -D D-M 0 GihEr ,1U 377923 ptaEunam Dar 7/31Y <br /> ;1 <br /> Oo:.r,CWELLSSAUP MMI=Gen ETaIMiner2UC0Gi0>aIRacleda(4391)7-Din[Amnchdorwropane(43g2)=Arsenic{43431 <br /> �liv>$v EDUSE 140UMEMWPdV2je ClrrigaliaLrAgAcullmral C tndu Wuial G WaLr GualityfAcr310 ng O So1l Sonip[ngrCharacleriaCm <br /> i 1lc wn Ce fit 7' <br /> pabxitiWesystcn <br /> maers�tn\arr � vas yr Rnc�n s <br /> i <br /> TYPE 0r WoRK G New Wefi i ReA=zment Wil C C Geotechnical 2 2019 <br /> C Potam'torinBVw(s) #aeereus G Sou Bol(ng(s) Tolr�tags '°rte y <br /> ou�-Of Sena=Well C Out-0`Scv rF Nen R�e:.al D Cra--CrsmecGon Rcitair 8AN OI,I' <br /> G ¢+ Gm <br /> Nevr PunPup Reatacernenl PumP Repair O RviseWeB C'�9_ r•Jq QYIN COUNTY <br /> Wm-L GZ7rlrrn ucnon HEALTH p MENT <br /> 1Dritrmg:vle-.It" O Mud Ratary r Pdr.Rmtary �auger ❑Cab'.eTaal -1 Punt;Point C Othar PA FR? <br /> IPropa.ed Well Deplh ft ExravaGc, M CrMelef C Open so"M C Gravel Pacid gravel Sae in darneter j <br /> D CanducinrCasin9 in tfomeler I Canduenr Casing DEplh 1 <br /> Wed Casing D'2me;e;_in Tnidate-,nGa <br /> lugaFASTM Srb n _SIeeJ C Plastic C Stabit sSteel -2alher !' <br /> Graut Seal Deptha 0 neat cerne,t(s:Jn aagro-ro gaff'�alrr) SEnd Cement sau=bd7 sal•jLtar <br /> C 8enlan3e(717:6 sv5ds) -3 Other <br /> GrnutPlacnmentIdclhad Ci Pumped 0 FreeFaP. D Other :,Remrdatt/arcateratnr(came)__ <br /> PF�TaL Msnt(ed By 0 puller ]Pump Contractor C Other <br /> C Canerett Pedes2l CDimertsiotlrY'lQltr f', LengJl ftThidr in -1 GRriszyBcx 3 Stave Zae <br /> i <br /> Pa up Submem-bILG Turtil[9 D OIDET HP PumpSel It SlanTing Water Level ft <br /> I kcR_`aY CEKrlFY THAT I HAVE PREPPLRED THIS ATDpUCAT,ON AbM TRAT THE WORK VJLLL tE MNS IN ACCORDANCE Vitrrt SAN kl <br /> JOACUIN COUNTY OtRMNANCES,SiAi—c LAWS, AMD RIILFS PND REGULATIONS. l ALSO CES FY THAT MY REQUIRED UCENSE is <br /> CURRENT X40 ACTNE WITH THE CAI3FORNIA CC)gM=RS STATE UCSISE BOARD AND THAT I ACA IIQ COM?UANCE WITH ALL <br /> 'NDR JM14 LAWS- I <br /> i1711![P 24 U UCE AIQTICE REQUIRED FOR mLSPEG77ON5-PLEASE CALF_(299 5Z-7697 <br /> s. _r,Cc)rporate Secretarg,V-/ /9 I <br /> L. <br /> II If ! f I II I ill 1i ' <br /> LI ! i 111 I i i <br /> ! If ! III ! i i <br /> ! II I II it -1 ! I I III i1 <br /> II 1111l11 I II I i II IIIIE ` lllllil <br /> I IlI1 III II ! I I I li 1 ! <br /> ` I 11111 ! 1 1 1 1 1 II illlkll I II <br /> I 1 ! I I I I <br /> l 1 { ! I I I U I I <br /> I- <br /> 1 <br /> , I II 1111 - If I ! Ill E II l II <br /> l i 1 I I 11 I I i I I I I 1 1 <br /> i I i <br /> ! ill I I I! I ! illi <br /> I I I i I I i I I <br /> p4 LTM <br /> EIV7 US DWILY <br /> re_�f//L!! <br /> AppG�]ian Rued By <br /> Gml[cpea'ion By . Date _ SPECIAL WeII Permit <br /> Pump Insperlion 13y <br /> - <br /> QAZII� 0 IALAlveR Received <br /> Sal Haring l��BY I <br /> Dale Canstrualedwell Depth ft <br /> COMMENTS <br /> -PE SC Cedl ir l Permit] I rrva _Well1W <br /> D <br /> h .- - --Rr-trdtled I ServiceRE4uP5t: - - -I-- <br /> I <br /> 1 I 1 I <br /> O-Dacs a-j IDS <br /> 8 d bL9EL8860Z !(� (P L out SJ811!JQ aoue!AJnd 8 X910 66 Z L deS <br />