Laserfiche WebLink
APPLICATION FOR WELLIPUMP PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES61 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 3388,504 EAST WEBER AVENUE,STOCKTON,CA 95201388 <br /> 11091 4603420 <br /> NON-REFUNDABLE PERMIT F%PIPES 1 YEAR FROM DATE ISSUED <br /> ICBEI Ieu In TIIYDnMI <br /> APPLICATION IS INN eY MADE TO 111E eM"AWN COUNTY FON A RNAII 10 CONSTAU TA MR INStA THE WONT DEWWO.THIS APPLICATION IS MME IN COMMAN Wllll BAN <br /> "AWN WVMYDfVEWMW THU.CHAPTER 91115.8 AND INE STMDAMB OF BMNAOVIN COUNTY MOM IMALIH SfONCEB,ENNM)HMENT0.1NA1i11 p BION, <br /> JOB ADON..R APNS CIT, Stockton PARCEL NEMAMF�/097- <br /> SE'1/TL&NC R�Y CLEAN7dN� DEFfD�NTS TSD DP * Tpp�� 1900 Powell St., 12th Floor 41-29 <br /> DWNENB NAME; o na T, 9gra s aw, v INS r c - econ AppfE„ ._, e _ RIOHF E51n-652-4500 <br /> COMMCHAT ApplfeB RICE NWM0 <br /> 11350 MonPark-Place <br /> NUB coNT11MTOR AJMJMBe Ranch CnrdOG.,CA 95742 ME706568 MENm,916-853-BO10 <br /> "M.Ffflt. Mn 13 ONA LL E7 AN LACEMENT wfu ❑...O.AI I. 0 onxN <br /> ❑INNTAUTION ❑WELL On SIEM I1FPMfl ❑CM..L....,HEPAR 0 VAPoN f%1MC1MA"Mut J <br /> ❑H.n 11 RqW II.P. UEPI II MALI 111_IF. FIRST WATFN UI_ O <br /> (I OF PLAIN :1 <br /> ❑OVI'OF NIIVME Wtlt ❑VEUM1Y61Lw1 WLII I____ LY MOIL NOMNO VAPOR E <br /> ❑OIBIWM... <br /> INIINOID UB! Y O tACTIEN!SPECIFICATIONS A <br /> ❑WWStWAL ❑OPEN BOTTOM OIA.OFWCLLEACAVATION 1-inch OIA.OFCONWCEONCANHO N/A D <br /> 11 DOMEBIMN1YVAll 0...1 PACN/ME TYPE OP CASINO/lutturve NIA DIA,OF WEIR CASINO N/A A <br /> ❑MemeFVMMIPA ❑OWVEN COOPER OPOUI.1. N/A N4CNMATION cement-bentonite N <br /> ❑IWYOAiroNIAO ❑GMM DAOVTBLAIINNTAIIEDNBY N/A OPOM BMMI NAME N/A E <br /> ❑M.NEMN. O Mun SEAL M.Ple ZH Yn QN. rC.ATf MW,A_eYONMrR:OYn [].N/A S <br /> AmION.ONTO,multiple borings 5-45 ft bgs IMAN.D1IIIIFIRIN/BIOVEPOP s <br /> MOM.W CONOMMMON/ WNO MFINOO:MW MIAMI AIR RICTANI AMEN CANE OTHERMVdr,8111iPush <br /> I HIMI CERTIFY THAT I HAW MPAUD THIS M ATMN AM THAT TOM DUNS SIU BE DONE M ACCORDANCE MEN BM MAWN COVMY ONMNANCEN.STATE LAWS.ANO MOM ANO <br /> KOUTATIONB OF TRI(BAN MACHINE COUN .HOME OWIIEN OR LICENSED AGENT'.SIGNAL ON CIRTNIES THE FOLLO l'I IDENTIFY THAT M THE FIWORMANC(Of T11E WOW.FOO MOCK <br /> 1N.MMMT IS ISSUED,1 INIAL MOT EMPLOY FERSOHS WSJECT 10 WONNMAN'B COMPENSATION LAM OF CALIFORNIA.'CONIMCION'B MASON OR Na CONTRACTING a ATNH!CIMNIES <br /> 111EFOMON'W0: '1 CIRIIFY THAT NTIRE WW MAME OF 1M"All FORPONICH 11110 PERMIT 111NMD.I NINE EMPLOY PERSONS WSJECT 10 WORKMAN'S COMPENSATION UWB OF <br /> CALIFORNIA.' 1MNAMDCMIMMTCALL24NNWINMVANCEFONALLREp INBPNTDNGAATIM14Mi13..C�OMNEIEgN AT LOMA AWA IAJVTMD. <br /> SAFIA 1�[,9- \Mar _� Till. S1 \/O\ YNI �'C.f\C✓L� OX. <br /> NOI MN 0—1.S.NJ MY. •N� <br /> 1.OML OFBTOM ORMMS MANOR SDIMITOONe A11f NORTH Till COMING". <br /> MING". A.LOCATION OF HOUSE Bf\VMED SYSTEMS.NYD[M OR AN19EF0 <br /> E,OVTUNEOFTINMg AN DAMNS WNBAMMAIND FROMIG. EAPMNOH 1 Mile <br /> SOTIM.. e..1ON. <br /> B.OW FIRMS, ONUMS AN.DITEM AM OF All FA PATI MONg1VNFO N.LA SHEDNOP ,C ADMO MM VN OF ONF IIVNOMOfiTY N. <br /> BEAM FIRMS,IHCLMIM COVfPEO AP(AS$MIT A.PATIOS,ONVAYAn,AND WAIIt S. ON TIN 1AOPFNIY Ofl MMININO RD Wn1V. <br /> GETTYSBURG PMC <br /> ASB <br /> IS <br /> TO <br /> B BE <br /> SO <br /> 30POMPONS"stit� <br /> C [•: 9mEny ANCNIION:::•:•[ TO <br /> E0 PEACHN III 1-hune" <br /> Is MB; �3 p <br /> P NAI ME h.1 72 . <br /> : IM SII Iy.IIf e <br /> DFIMIMFHI Ni N.. <br /> �] �j--ll—" <br /> AryMNkn A..Md. Dei. W'�T'L / Ar <br /> a.A G.Pe.BF oma F—P WPNN.O BI DMe <br /> IM.u,nan <br /> I.0-e, DM <br /> L..n�NN.: QEE��S 1'Wrtux,lh �81T IC4.$aUL6LSrIS� 4.U�e55r <br /> A.COUNIINO.Mu: Am 1All <br /> BE CODES 1111M. M10VN1 A.,,,. GHlCRFFANI MCMVFD NY DATE If1N1111NDINLF REOUFEF HUMNNI INVOIC! <br /> D L2197 012913 <br /> *SDCDs Defined in the First Final Consent Decree Order, Judgement and Reference to <br /> Pub.HeeM SeW. EnvINT.173(3/88) Special Master filed with the Court on January 18, 1996{ SectlonIV, Paragraph G. <br />