Laserfiche WebLink
APPLICA LION FOR WELLIPUMP PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES• <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P,O. OX 388 304 EAST WEBER AVENUE,STOCKTON,CA 95201588 <br /> (209)4883420 <br /> NON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM BATE ISSUES <br /> ANIMATION IB HERE pY MADE TO THE BAN JOAOUIN COUNTY TOR A I <br /> PEasil— <br /> aMIT TO CONSTRUCTAN TON NO TALL THE Nbgl OEBCNREO.THIS AA'LKAMH IB MADE IN COMAIANCE WRIT BAN <br /> "AMIN COUHfv DEVELOPMENT TALE,CHAPTER p�111 SA AND THE STANDAMB OF BAN JOAOUIN COUNry RISLM HEALTH SERVICES,ENNRpNM <br /> MfAL HEALTH MRSMN. <br /> JOB AOpR(88A]R AMAX YYT /. 9/i.l gy A <br /> CARER'.NAMEH.L /�-x��y� Cm L'YAY14SN.� PARC(LSOf/AINI_���J•Q]y-(� <br /> 8 {� 1 <br /> AORERB_P.Q. �, t� RHONE I{J/FJ7%]-,2;f� <br /> COMMCTORTpo. Rax d36 LOC, wD <br /> ADDRfBB Zly <br /> BUB CONTRACTORAORE . &A ✓/,fT� <br /> �.( SS IICF A1pHf <br /> TYPOf l/RL LyJ HAV WELL ❑NFRACFMfM WELL XMOMT."..WELL A ❑OTHER <br /> ❑dSTAUATION El MU-SYSTEM IIFPAIfl ❑CORSE CORRECT AFFAIR ❑VAPORE%TM"10N WELEI <br /> FOR. <br /> OF <br /> N.F. J <br /> RYP Oi PUMP MITA NMP BA_R, I ARBT WATFfl IFVEL D <br /> ❑OUT-0FBFpWCE WELL ❑OT.THINIAL WELL I ❑ SON.BONNp <br /> B <br /> OFBTRVtipN' <br /> IMTFNOb NE TYPE OF WE ONs"'wRON SPCNMATIONS <br /> ❑INDVBIRIAL ❑RAN BOTTOMAS, A <br /> VIA.OP WELL F%CAVATMN_ JS dA,OF CONCKCTORCABMp <br /> ❑COMERKIRtlVATF MOSAVEL PACxohngj OJy�– ryPOi CARMOBTFFIA YCss�[.`e ➢(J(,AdA.OF HELLCAeINO <br /> ❑ 0 <br /> 11NBIkBIILMOMPA, ❑DOW. D <br /> )FA3 D[PTN Of MVUT BEAT i'F�I BFECEKATKN <br /> IMINATION/Ap ❑OTIIFfl <br /> �MONTONNp <br /> -J DROUT SEAL INBinILFDBY_ &j(((,yti OMVT START NAM <br /> ObT SALMIMPEDAVr U.. <br /> AlFflpx.o(rtx <br /> Ea <br /> cpxcMrE PEMRAL ev pwLLEa:Ovr Ow s <br /> LOCxINO CII[Bl(R b%/STOVE AR <br /> RIObSFp CDMSMUCTgN/dtlWNp MPH00: MVO IM]iAMB <br /> AIfl PoTARv AOFR�CAME <br /> OTHER <br /> I HEYBYCERTIFYtHATIIIAVF <br /> 11 OEM THIS ATFLKATz;ANO THAT THE WdW WILL pFONE dACCONOANCf WIT HM I.ii: ; 11C31 11 1 1: NANCn STATELAWS,ANO RUL E.AND <br /> M..ATIONB OF THE SAN JOA Wd COUNTY. NOME OWNEN pM <br /> fl LIC."",AD( 'S SIGNATURE CITIFIES THE FOLLO T'SIG: I DIMITY THAT IN THE P1POP.MN[E OF THE MAK FOR WHICH <br /> THIS PRMA IB ISNFD,I WALL NOT EMPLOY PERSONS SUBJECT TO WONSMAN'S COMPENSATION LAWS OF CALROFFEA.'CONTRACTOR'0 HIANO OR""OMMCTINO SIGNATURE CET.,u <br /> THE FOLLCARW! 'I CETOV THAT IN THE PMORMANCE pi THE WbAt FOR VHI <br /> MICH TS PMIA IS ISSUED,1 RHALL EMROY MOWN'WT ECT TO WONSMAN'S COMPFNgTON LAWS OF <br /> CALRONIIA.- TOMAM]CANT MUST CAI N NOMS IN ApWNC[1.1 Al SITUATED IN`FrE Too N.AT 1]MI 4.M]L COMPETE OMVORM AT UYNOR AREA RYJVIM6 <br /> SIFrS x + �.� Rn....J1l�F �- <br /> (y-sx <br /> I. RANKS Or STbxSB NEAREST SI ORRnNG THE R.AH M)MSTry.E.OVTLINFOFTHEMONT DIMENSIONS <br /> IMENAMMIT"DIRE <br /> ETS <br /> A. LOCATION OFOVBEB BMSBS <br /> TFMOft Pbbpp <br /> ]. OVTUMB AND <br /> LOCATION.1 ALL <br /> MATINS AMC PROPOSED EXPANSION Of SWAGE1,11roSYSTEMS. <br /> BTRUCTVMS,INCLpIO COVERED AEA8 SUCH ASPAIbB,pNVfWAYeAND WAIkB. B. LO OF LLS WROMHFACS OfONE NVNRO I'll P <br /> .ON THE FRpPry 0fl AOXDVURa MpPETy, <br /> A <br /> 'IOW <br /> '. ivVE+i �I1 <br /> C <br /> 7 <br /> 12 <br /> LL,AJD GM1I <br /> SL YE <br /> FA97- M141YR AVENb& <br /> /{�•o /, O[SARTMENT USE OILI '7 Q <br /> n[Pxrn..ne.rl.M pr— —�" ll y-r- ... <br /> Mr <br /> GIeM hylennn pr D.I. P4q kwraen 0, <br /> p.l. <br /> Drlwlbn I,,.Irnr by <br /> D.1. <br /> D.mmrH: liywll-1+ -For max IL�it.rlkLSZ. InF Zi7 F 1- vt wc -r s4TLAt�td6+�', <br /> 5 evu.t'acc.hr..L'�3 n+ld' 4� 1oU35 eJa?tblA fll'mIf '�- _/ —7' <br /> ACCOUNTING ONIr: ADM PACE <br /> IF COD" In INTO AMOUNT SWITTFD CNfCSIKSRH BECRVEO SY DATE PERMIT/.f Of REQUEST NMgST INVOICE <br /> 1 31) 132 <br />