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Z6/23/2006 10:32 2094683433 EHD PAGE 02
<br /> San Joaquin County -- SIVE
<br /> Environmental Health Department M{rIGATION
<br /> w. 304 Fast Webar Avenue,3"11 TIO", Stockton,CA 95202 UNIT IV
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<br /> - 468.303 Web:Www.ean Jouquln.ca.us/ehd _.
<br /> "i• (205)4683A49 Fax:(209) os
<br /> �� NON REPUNDAAt.6 PERMIT EXPIRE9I YEAR FROM PA715 S9VED
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<br /> W.�.,p O.Z Grwt'J]0.0TAFLY DEPTH OF GROUT SEAr,_ ,rPEMIE TYPE TO EE USES GAUGERS 0 HOSE
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<br /> ODNOVC76R CASING PROP09EC ��-(�--�_
<br /> c,MMENTS:
<br /> Y NOTE: OFFSITE E )RINGS REQUIRE ACCESSAGREEMENT OR ENCROER_i I�ENR"PEi�Pu1
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<br /> 4S IFlORKING HOURS NOTSCE R>c4UIRE0 FDR1HSpECTItlNS,
<br /> I Hcreby certify t -1 a prepared this application anC thatthe Work will be done in aocpf dnmce with San Joaquin
<br /> Runty e s epulaHons,and all applicable California Stat6e La
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<br /> DEPARTMENT USE ONLY
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<br /> INOFtR PLAN DATMO:
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<br /> '?CODES FEE INFO
<br /> AMOUNT REMITTED CNECRa REC'DPY DAYS PERMIT 79fiRt7CB P',E4U89Td INVO(Ci
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<br /> ,57_ WCT VJ.aIvgRC-57 Letter of Autkoriaction to SIDI perinit�_..,"encron::hnsen•t 5ock,,.
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