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APPLICATION FOR IYELLIPUMP PERMIT <br /> _ SAN JOAOUIN COUNTY PUBLIC HEALTH SER—ES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PA,BOX 388,304 EAST VVEBER AVENUE,STOCKTON,CA 9mi'; S <br /> 120914683420 <br /> PON REFUNDABLE PERMIT EMPIRES I YEAR FROM DATE ISSUED <br /> ICOmpYb IS TEIdmYI 11'! <br /> AWYCATIOX SHIPS BY MADETO THE SAM MRWIN COUNTY MR A FIRMIITTO CONFATF CT AWAHRROT LL THEIROW OEBCAYO.THIS AHMEAMN M MADE W WMNMICEWRx BAN <br /> AAWIXCWHIV gYSLOagITIRF,CIgRfll& <br /> 11 .3. SITAHO/A➢SOFSAN.pA COUMMIICNGLM CES.E MNMEMRLNEA WWON. <br /> ]OBAmReRORAAN, c,ec c/f,.,�,/�p e3a„� p PAARRRq�jeaE,wFIF� <br /> owMwB xME OT,pL Pg1.OT/ AODRM,, FACNS/JF.�RR�CW'T"I� O/�[S 1CLS <br /> CONTRACTOR HR4. RAEcrxG ^,W/ANATGI'YDL Ir.6��6rfgmM19iET�z <br /> - q�q la.B u3� P�c�eCa ��p��Wgwf7 MIRREF9sSY <br /> I.F WEL/BY P: ❑14VIwLLL o R6UBEME1rt IF,E,E ❑MOHTOMIM ❑OTNq <br /> ❑gRF.T.N ❑WELL BreRM RPAm ❑CMBBCUwMTIFPNA ❑YmONE%fMCTmN WELL. <br /> ❑Nr,❑R.O F.P. Df➢fN PYM..ET_R. FRSTWATEREEM U <br /> Or EBFMAAP, <br /> y /�❑DIrtOF. EWELL ❑nb NWELL. ❑ bMINI <br /> _=N �ieXfas�U.Mo.n'�✓� M!✓-� � Ll�yt c z F�6 OT' C/RS.fwL <br /> RCAMx <br /> ❑IWUmML ❑...TMM gA.OF VALE%CAVAImN gI.FC..HC.I. O <br /> ❑WNEmCRryVATE ❑GRAVEL PAC%MDE OFCAIM(RMW C AOFHWEAONO O <br /> ❑RIBU.m.RAI DER. pgTX DF..DT.. ARACIFICATON A <br /> ❑SRW T MRD ❑.. mrtATIFOEV OMST SMASHB1m NAME E <br /> ❑MOMTOXM .. M..:❑Y. ❑N, COMMTERSEBT sw OREEm❑V. ❑x, S <br /> A.R. bclXmcllEeTP bileTONERrt S <br /> ARMed CROMMASTIONNRWMOMETO.:MDDRE'R AMMTMV AOSSO cAmu OTNEA <br /> I HERBY CERTIFY THAT I NAVE REPARSO MR RTg1CATW AS.TMT THE WOM'MLL HE DOME R ACCORDANCE w .VN MAgm COUNTY E..STATE I...MSEB AM <br /> YEAWHA OF ME BAN bAGM COUNTY.HOME OWNER OR UCgEW AGENT A SIGNATURE CERTIFIES THE MLLOWM4:'1 FIRRITNnT ISTHE RMOaAMCE OF WE NOMPoR MR,H <br /> WHO MOST M DIVIDED,I SHALL MT EMROY RARING Bb.ECTM WOMARMI9 COMMISAMN UWq OF CANMRSA'COMRACMHES HARD OR WBCOHT AE TRO PoHATME CESTME. <br /> WSFEDO— :�IC xnT relent Au aRov Rnbxabucr TD wgmRA11'a cDAl uws of <br /> C.WFOMA:M IS IN SNAWANCE fd1ALL 1160 ISNI OM14R[dR`MM AT IDWETIARA Rb <br /> M:xJ% CNL SRR®TIx� AgT(ef"� //e�� <br /> mANMm'1.BUI,I BFw�'m //,/��e4W Om <br /> 1.NAAEB OF ,OMNOPEOETOONS ANM IOORTIEPERMS. A.IOC/,TRIH OF MYK 4WAOE gFOe.LL eYRFMOR RpMRp <br /> ].OUTIMEOF WE MOUTURRTY,OMMOION or ALL AND NORM PROPOSE gPAMRN OF BEWAOEgWBN M1ISH <br /> ].gMEMM]XEOOVTRANO AMLRED AHEAD <br /> MCH AS SA . 00nMxOFWFIISWTwq MMUEOFONEXVHMEO FIFT'Ff. <br /> mMCTVRe,NCLYgm[OVSIEO RWhS bCMMPATNI B,D.S.ORYFVIAYe,AMO WN%O, n TIE gbRmYOq RppIHI1m FRORRTY. <br /> `1 J <br /> \ V <br /> p,,,H.1RM Y.e GNEY <br /> AARM„N.A-- <br /> .,—N.P.St A, D.m J' FunFl:y..a.:,Br <br /> D.xwAnImmm q 0.m <br /> DmmmR.m:CIdT;OIF.5Mx;UM4yh 3stl& &,kj T1- .0 <br /> RCOOtl, SHEIRM --TIF— CNAHEAR BM ..Y DALENMNPRRI <br /> 3 2 a o YINLT •Z RmRTI.O DE—To <br />