Laserfiche WebLink
SUN cONTRACTOR <br />0 VAPOR EXTRACTION WELL <br />FIRET WATER LEVEL <br />Typf OF WEELJPUNIR El NEW WELL 0 REPLACEMENT WILL 0 MONITORING WELLS 0 OTHER <br /> <br />INSTALLATION 0 WELL SYSTEM REPAIR LI CRONE-CONNECT REPAIR <br />UWE OF MUIR <br /> 1,2 Now Anself H.P. DEPTH PUMP SETZIQT <br />aln.orsERvicE WELL <br /> <br />01 MORITA. AL WElLS 0 SCR SWUNG <br />APPLICATION FOR WELLIPUMP PERMIT <br />SAN JOAOUIN COUNTY PUBLIC HEACTR SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />P.O. BOX 388, 304 EAST WEBER AVENUE STOCKTON, CA 95201-388 <br />(2111) 461 3420 <br />Cvsc%',6 <br />IN CO FIANCE WRII SAN <br />DOISREFUNDABLE PERMIT EXPIRES I TEAR FROM DATE ISSUED <br />(Comptes hi NORMA <br />APFRICAT KIN IS ERRE re MADE TO THE GAN JOAQUIN COUNTY FOR A PERMIT TO CONSTRUCT ANDOR INSTALL THE WON( DESCRISECL TINS APPLICATION IS <br />JOAQUIN Caotny DEVELOPMENT TFTLE, cHARTER Ill 116.3 AND THE STAND e OF J II COUNTY PUBLIC rIII SERVICES. ENVIRONMENTAL HEAL o <br />Ron AOORES.VOK APHE g. .4 .0 6 fr' , .1 pel p z`e.., Lire .40 d ; PARCEL SIZE/ I <br />OWNERS NAME 'V) Ars, 7v es, ......49./7,0‘4 4 , 1‘2, • <br />ccumbacroR_CI AcePortdcte2 /2 ....7-,...,"deucf .37Ws • <br />CONSTRUCTION SPECIFICATIONS <br />F CONDUCTOR CAIN <br />ID DOMESTICIPMVATE ID altAvil. PACK.4112E TYPE OF CASAWIEFEELIMC WA OF WEIL CASING D <br />0 PUKKAMNPICIPAL 0 DRIVEN DEPTH OF aFIOITT SEAL SPECIFICATION 4 <br />ta TRIMIATIONMO 0 OTHER GROUT REAL INSTALLED BY GROUT BRAND NAME E <br />0 IAONITORING GROUT SEAL PUMPED. 0 Y. 114. coteceirre PECIERTAL SY MAR: <br />APPROX. DEPTH LOCKING CHESTER SCHUSTOVE PIPE <br />0 Y. 014. 0 <br />S <br />PROPOsED CONSTRUCLIOINDEPLUND METE1012: WO ROTARY AM ROTARY AUGER CARLE oiNElk <br />I FIENERY CERTIFY THAT I HAvE PREPARED THIS APPLICATION AND THAT THE WORE ma SE DONE IN ACCORDANCE IMO/ IAN JOACIUM COUNTY ortOINANCES. SATE <br />REGULATIONS OF THE RAN JOACHIM COUNT.. NOME OWNER OR LICENSED AGENT'S SIGNATURE CERTIFIER THE FomooRNO: 1 CERTIfy THAT IN THE PSWOMIAISSE <br />THIS PERMIT IN elemo, . *HALL NOT EMPLOY PERRON/I SUSPECT EDMORE/4ANS coMPONEATION LAWS OF CALIFOPNLA.' CoNTRACTOTES WINO OR SUISCONTRACTING <br />THE FOLLOWING. • I CERTIFY THAT IN THE PERFOOMANCE Of THE WOES FOR WHICH TINS PERM, IS IMBUED, I ImALL EMPLOY PERSONS SUSJECT TO WORKMAN <br />CAUFORmA.' THE APR= MIME CALL 24 NOVO IN Mist FOR ALL REOUNIED INSPECTIONS AT ROM 41TOS4231. COMPLETE DRAWING AT TOWER AREA <br />Msned X i ep ev7 Mel_ ,.,...-IRIF :/7 r r•f:7 5 Cm. c_ <br />LAWS. AND Nalll• AND <br />OS THE WOM FOR WHICH <br />SIGNATURE CERTWIES <br />COMPENSA N LAWS OF <br />MOYIDEIS, <br />Plot PLAN Mom s• SANK N.M. <br />I, /MEMO OF STEWITS OR ROADS NEAREST to OR SOUNDING THE PROPERTY. 4, LOCATION OF NOOSE SEWAGE OMPOSAI/thrWEEM <br />E. ONAENSIONEO OUTLINES AND LOCATION Of ALL EXERTING AND PROPOSED S. LOCATION oF WELLS WITHIN MENUS OF <br />2. OUTLINE Of THE PROPERTY. GIVING ONAENSIOMI AND NORTH DIRECTION. EXPANSION OF IIEWAGE DISPOSAL:7i <br />STRUCTLMES, INCLUDING COvETIED AREAS SUCH AS PATIOS. DRIVEWAYS. AND WALES ON THE PROPERTY OR ADJOINENG <br />041 PROPOSED <br />NE ISIWOREO FIFTY Ft . <br />. <br />_ <br />4^- e----C-F- <br />. <br />1.; <br />0 <br />:N. ic•4k <br />.... <br />N <br />t, <br />. <br />• <br />. <br />. .. <br />. <br />• •• <br />. <br />. : <br />- <br />- :L.,..01 <br />. <br />••-ii-(. <br />••4..\ITr'.! <br />gni.. <br />. <br />2 . <br />-,FA..• <br />. <br />i .69i <br />- ...,.-i--. <br />•••.I -:.• iloviEiV• <br />C .. L , <br />DEPARTMENT IMF ONLY <br />ANANNIon Paw/Ned ST bees (I... Z, CP ji -7 1..- "0- i D--- <br />On. Inometion SY Km. InHNNIUn sY I L..19 9*.? 14.44 DON Z./..2."3.-' <br />121.RnmAset I•mnent n B L <br />c......,”..., ,IL, 0 At .- 41, .I•P, .., /._ / <br />.—.8•-.... ...NE.,/, ... <br /> <br />AcCOUNTINCI O NLY: MOP FAC1 <br />PE CODES FEY INFO AMOUNT MATTED .40111 ASH RECEIVED ST DATE PRIMITME/Tviet RECTUM NUMBER INVOICE <br />-L o 0 S 0 S <br /> o.. <br />I A. A.J___ ,i...... <br />72.0 /3/O <br />Pub Health Serv. - EnvIro. 173 (3196) <br />0 DERTEsucTioN, <br />EMPIDIED USE <br />0 <br />ET <br />0 <br />0 <br />.1 <br />PHONE I ADOPFSS TICE <br />TYPE OF W