Laserfiche WebLink
Zi)55 '°N W0)6 : 01 610 til ' 10 IWIl p;AI ;I; <br /> )PIELLIPUPAP PERMIT <br /> SAn lean rslCaUNTY Er+vim:t ivrALN nx Q6 ARTi1 E'TF 7BEs EiLSTHGrATCRAVErlUE-SwCKT°N CA9S205-(209)46&3420 <br /> MOfV-RFFUNDAELEPERMIT CALL 209 9S376'97FOR NSPEC71ONs �XPIRESIYEARFFi057DATEISSUED I� <br /> 1 CL '71P ; nden C�9_52�F <br /> .lou Anon= <br /> Chess SrR—'ter •APN 1_v 1 l/�{ �sc47-L l'sE APVLCG77Cn" <br /> O{uR NA <br /> A n e t c S t a n <br /> QVr1ERADDRE-- 1811 Von Glahn Ave c—'s-mrdL scalon Ca 95820 _ <br /> Purviance grillers , Inc p,,,- 209-887-3554 <br /> Carrrrucroa <br /> Ca.7-'ZQcTRR A.DCR-= <br /> Pp boy 64cr,YlsA�Linden , CA 95236 <br /> Prloa�- <br /> S U13Cnr.TRACTOR <br /> S lIEtC OI'STRRCiL7i2 ADDRESS. GMISTATIDMP <br /> LTcett n C--, Ll CS. D L4 ❑btc:s 1LUAia6i <br /> 3 7!9 2 3 EcPIPATION I7Arc 7�31 <br /> ao*sctllcLSa�?L -GenM-aiGlirE-aifCaGfosm flaCtelia(439t)_pituornochlotaplup2112(9392) Alseruc{4393} <br /> Inrrr_:roZD 11_e O DomesLrlPrivale IaigaLanlA4titadlural G tnd�Ttial G Water Quality Mormumg O Soil Szmp utg/CharadPJira�on <br /> C Fubfin 1Veter Sy3'. mrc� Cryo nates w Ptt-MH¢ntxr <br /> «tffi�eatrwmGY.na at�erSYsi-" <br /> TYPEOFWORK G NCUWeL C ReptacenentWel C WOAIIerADMVar fficafcn 7 Other <br /> G M°nZ°ringWelIN e ofwalLs G Sc;l Hodng(s) *.marinas C Geotechaica5 "°Tr�r�s <br /> JUL-0fSeruj=VL�EII r'-/q UNX-S Dice Well Rene'ra1 ❑CMSlr-Catmec1kw Reuair <br /> G Nevi Pump C Pccno Reptacemenl `az plu11��� R2ise VV211 Ca^,inq <br /> II bV�t CNsrau:Trori <br /> 1�71iing1lzr7eII O Nljd Rotary C PSRMJY D AagpCanleTao{ 7 PKinPaint ❑ Oher <br /> 1Prr�pcs ed Well OLPRr f' FxtauaL+an al Cr=eder =Opcn Boden C Crane]Pack/GraVnJ Sae in d-rarreter <br /> S GCancuclerCaSng tntfameter I CnndLrIDTCasing❑CPFn ,l <br /> Well Caaiag pc2meier_in Tnir3rne41GaugSYASTMSdcea =Sleet =PPa3fit �&ajnlessSIE-j J Daher I <br /> GrautSeat Depth i 7 Neat CemEnt(441b baarn-90 gal vra�r� G Sind Cement saw T�e t� <br /> C Bentanile(20"-zu7cIS) D Ocher <br /> Grout PSamuuntptcthod u Pumped D Flc2Fa1l '3 OUIL"_ RetardantJkrzz?ealar�cmns)._ <br /> P®csTAL Instdtled 6y J onlier 7 Ptanp cmmcLor ❑ MCI- <br /> It Thick in :,ChAsTy8= JSInVeP/pe <br /> Punto r7 SLnmers6le urhil[e D Other 1iP PumP5e1 fl SiandmgMfaterLeu�� ft ' <br /> i },'EREaY CETmFy THAT i IkAVE PREPARED-MS APPLICAMON AND THAT T}4E WORK WtLL BE DONE ltv ACCORDANCE`iPJTrK SAN <br /> .IDAQLON COUNTY ORDINANCES.SCAT.- LAWS, AND RULES AND REGULATIONS_ I ALSO CERTSFY THAT MY REQUIRED LICElS'c IS <br /> CURREPIT AND ACITVE MTrH TI-E CALIFORNIA CCMTRACTORS STATE LICENSE BOARD AND THAT l-wa IN COMPLIANCE WITH ALL <br /> WORHURiS=AFENSATION L�1Ltf$_ <br /> R9 ICO 2 1) ADVANCE NOTICE REQUIRED FOR MPEG 71ONS-PLEASE GALL 1209)9 769" <br /> swr Tr�Drpora e 5e cre�ar�AT=lo �� !� <br /> Ilii ( ( I Ifl i III <br /> I ( 1 <br /> I ! � <br /> II If li ( I i , Ilil I <br /> - 1111 I 11 1 ( <br /> � I ( I I1f I I I ( I III <br /> ( 1 fi ( II II I k ! I � fl il ( 1 11 ( <br /> I I I I I ( I 1 I I I <br /> l kf i II f k <br /> 1 ( ( 111111 til ( <br /> I- <br /> I I 1 II I If ll ! I ( I ( I <br /> I E II I ( I 11 Il III I II <br /> S I l l ( I I• I I I I <br /> I I I 11 III <br /> III I I . <br /> (1 R 150 T [3% �O L Y <br /> AppE,czfbn Aarpled By Asea irA:DS'ze li d — <br /> Date D SPECIAlAvell Permit <br /> GtwllrespecCmn By <br /> Pump tnspE=ti°n By Daae `� O 11ilAIVER Receivod <br /> Sal Baring IrLspa.San Ey <br /> rJale GDttsTrtrue�'JJell❑epth � <br /> COkt1:ENi-a" <br /> PE SC Received MnouTd PermiU Srvoim;r - Well1O# <br /> I_ <br /> info <br /> a.asn ..._ Itted _ Service_Reauest-_ _6' _--- - <br /> 0 <br /> I 1 I <br /> - tYJa^:T e0rre q e� <br /> s. d a0ueinlnd eOb 60 6 b )o <br /> 0 <br />