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APPLICATION FOR WELLIPUMP PERMIT <br /> BAN JOAOIIIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O.BOX 338,304 EAST WEBER AVENUE,STOCKTON,CA 95201333 <br /> 12091 4883420 <br /> RUR REFUNDABLE PERMIT EXPIRES I TEAR FROM DATE ISSUED <br /> 1111.11o.M TIRIRANnI <br /> AMWAT30R IR IIEK eY MADE re 111E RAII JOAOVIN COVM V 100 A MIT"l0 CON ISITI ANDIOD INoJot LIR MbMR DESCOME0.TIES AIRICAl1ON M MADE to tOMR1ANEf.11 RAN <br /> AAOVIH tO11MV DEVELOINENt iRIF,t11AITf0 B 111 R.]ANp lln RIANDAMR Or RAN AAOVM IDAIII Pule.ee IRA/ITO SEIINCFB,fxNMMMMAL MIATI I..", <br /> Joe:...elan AMI '15 E. Grr�IN �li e.rr S/aC �o+-Y Mrl"t."EMrHr <br /> Ie3�C e- - IYS -- <br /> OwuT'eNnat C C.e.RP7L - ADMnfep SlJpEJ[Ilw'l'I CAFL 9511 pnbMR / Y <br /> tDMMC.On S eL r(�'17 (,,,� f)r nc. ADDIXRR�..J�Sw1�wlNN1 IbE512 GO outrol (PS87E2. <br /> She COMME+OX nDDn,.S / <br /> IICI nIOM I <br /> OF WF_r�MP. ❑NIYI WRµ ❑MRAcvATr Y,RIL ❑MDunDmuA MRu• O Mv.A - <br /> ❑Shoa'Urbx AMT,.YRlt.Mrnm ❑rMRa CI."IXrnm ❑vLlpn Ez+MCfaNwTly <br /> O ur O D,nW TA Or'Nnlgr Rb H. Inter VAAtm 1111 O <br /> nvR or Thrum <br /> /� vnonr[nNCRwru ❑DmnnD1AIWnV ❑ bILe.rl 11 <br /> MR.mrc.aN: Del-ivr fm ¢✓�•-r 2 f �'-X2.1-T �' 4a I <br /> E I <br /> IXIiN EO VEE 111E OF wea {PECIFICAluaf. A <br /> ❑RaVMWAL ❑.ASIC..... Me.O1 WFIl IXIAVAl1ON gA.Or CON1111CTOn <br /> ❑MW ❑DMVECAPlrl�nl <br /> 1 MERIICRVAII L IAeo.If rvT f <br /> DfneMDRI[[M <br /> IT <br /> LI MONr mn.OF MW LCnR11M J�- - n <br /> rTShr ENCMAL QDNVIN re"l l Dr That...aUl_ eRCRIEAIaN e <br /> ❑ROROAININIAO ❑011il.0 MrSor MIT aeu AtM0 <br /> ❑ OCYONIR EMM!NAM � <br /> MDMrM LI�PE.IyJ vM <br /> Don... Nrcf <br /> CIS. A <br /> AMNeR.DII[H Three'.[MI[pIM R ouro,O E M1M r <br /> TDTMM D'ou TVC+baMIVNO METHOD; MVO Data' AID MIAT' AWED tAelF O.IIFn <br /> 1M.F'1FM CT.NV 114t IIIA4!MFrAMO.IRR A.[Lr.A.aH AIM'her 1MWIIMR~l M.MM M ACCOMANCf'MI11[AM.bAOVIN COVMV OInI11ANCEE.RIA.E UU'e.AMO nlnFe AM1 <br /> MOUATIMS Or TIM SAN JOAOMD COUNTY.IbMEeW1R0 On MIDIO AO[M'[eMNArVM t[TIIRSLIR rOLLOW1N0:'1CMo,1NAI ea TMfoheobe ANC[OF 'MW SSIOIO4 Eeu <br /> .INAM VFO,I{IIAµNOT[MROY MTA[hNS RVe.REI tO WOeRMAN'[COMMNreryDN1AWA OrrALROrNA.'COMMC1011e1.NEND OnRVe-COMMC+Ob MAHATMAS tEMRRE <br /> 111! OWMIO: CfTRY 111AtMTM.f MMOgA a[ t11E MMA 1Dn fWOCMIT111R MOMrr iA 1RRV[O,Ie1lAlllMROY MneOMe eVRJFCT TO WODIIMAN'{COMRNAAneX 1AWe OP <br /> CA1 A.' 1Nf rLICANIMW <A f.NO IM of 10R ALL MOWIlry1MA'"[")R�I/bf fAI11Rr1 Eff.N[i.[OMRAErIMW.NE MIOWEROMA TIND <br /> L <br /> RO!FIAM IIR.w 1e M.xl MN._ <br /> I.NAMU pr bMF.e O0 MAOR MAM IO On ROIN1ORXi lIM rlMRnrV, A.LOCeIION Or IbVSE SfWAOF DIRMUI SYMIM Dr.naMSM <br /> },OInIRR OI rlM.+aR11TV,AMNO DMTI.bNe ANp NOTII TMEIaN, fRPAHMDM OF RFMIAM gSMeµeVR114a <br /> e,D1M[NRbMO OVrIMEN AMI IOCAtbN Oi ALL F%IRfRXI ArM nbM{!E [,LOCAIbN Or WEIL[WW 11M MDN[OF OM TIIIIIMD r 1,M. <br /> a.nucrvMe,MNCLVIX1q wv[ASD nrcne[Iron ne rniroe,DnvEwnve,nuD wnlRe. Dx nM r..OMRiI'Dn AD.ronnxD MbMnrv. <br /> web. +o bt <br /> �7 Dor�ada <br /> � Tajo Bili <br /> IIICVJI.If uchm <br /> rdLV�jy <br /> errAArM[xr.1 ONLY <br /> nlmPrxFm A--hA eY.-J / E rFll..E•' G <br /> dM A.nrc.Nn er Onn <br /> '—u—IT <br /> Dw,r:n.Mn A.nY.II.M el DN._ <br /> t^��•�.5.1 2f FOn rvtl7- 'L q =B3 LSSU¢ FTI- Q�j7la5LL�Q c(d11yJ1zITwT -1�✓Fwa nn <br /> Go <br /> AcceVll xD ANL: AEM I UCI <br /> rF EDDY lermmO µ...IARANMT e"ICMMCAM. I nECVVEO eY DATE r9WrnTNc[etOVrt <br /> ENVAeOI nrvOICE <br /> o aaog .y DIILI6 <br /> Pub.Health Se:v, Envlb.173(31515) --. _— -- ---_--- <br />