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AMICATION FOR-%jL jpUMP PERMIT <br /> SAA[ JOAQUIN CIIBNTY'PUBLiC HEALTH SERVICES � <br /> 11LE <br /> ENVIRONMENTAL HEALTH 011 JS10N COPY <br /> sot EAST WEBER AV6Ni1E smcr oK CA <br /> (20s) 'W&Um 3rd �Ficor <br /> NDWREFi1NDABCE PERU <br /> APRJCATroN 18 HERE&Y MADE TO THE SAN JOAOUIN COUNTY PDR A i6 <br /> .10AOUIN COUNTY OEVEL.OPTA@/T PEiD4R TO CONSTRUCT ANppq p,1T�THE WOW OESCTOSED.TIRS <br /> TITLE =NAPTFA 8-11 i 6.3 <br /> AND THE <br /> g1•,WOARpg of BAN <br /> JO APR/CATIpN IS?IApE IN COMPLIANCE WrTN IIA <br /> JOB ADORF88Oq APN/ �U�Ny� woUI COUNTY PUs1IC MEALTH 68"CEB•�"RDi ENTAL HEALTH Df VISION. <br /> -76'-/-7 �c; �C ETv <br /> O , ^ CITY C t c 1 U�IJ PARCEL SMVAPN. <br /> awNER-a NAJAE-- J rl✓1 I l/A 1 Sy <br /> [ <br /> wNrn,ucTono C��V/'h �r, �t;l✓� / , � PHONE: <br /> Z iSC2)i 2/-1l <br /> ADDRESS -36 S <br /> SUB CONTRACTOR - ADOREss !;,Fp Lrc f lbw.- y S LV <br /> Llcs PHONE t <br /> '•'/PEL.L,'P1J <br /> E OF WMP NEW WELL Q �p REDLACEWmT WELL � ,.,J U <br /> ❑ UTION r`w-I L <br /> -WrALQ OTHE11 <br /> Q wFu srsTta.nEPAI11 ❑ CROtstoHNECT REi•.1R <br /> D Nww D <br /> P...wH.P. VAPOR WELL) <br /> 1-11-E OF PULFPI DEPTH PUMP SET FT_ � FIRST WATER <br /> D OUT-OFWELL C3o[oFNY>acAX WELL J C <br /> ❑DESTFEJC'f1DPY ❑ 300.sORINO <br /> B <br /> INTUMED LOSE OF wEL <br /> CONtTRVCTION 6PL�IFICAT1ONt <br /> *amu G OPEN noT-roP.l / <br /> /Y"4 A)Tc rc.7 OU.OF WELL EXCAVATION �O A <br /> G L10ldESTICIPWVATE �ORAVEL PA,C,7XJs� . .# n� oXA.OF d7EplK:OR 681110 �? �� <br /> ❑ PUSL1C11.tt711K'JP TYPE OF CA8lNOMTEM p,r T-V L j Ype 4n 0 <br /> AL ❑O"VEM DEPT71 OF GPbtTT � C11Ar OF W�GiNNO r//J <br /> ..J OOROATION/AO ❑OTIIE71 WIQV2FAL ✓P"f2i•r., ,.J�O! $�. G.-.I <br /> fTC'.ATIOH ^' �� <br /> wowropm, r HEAL IN6TALLFD er j�?- T/J w..X D.�1 GROUT eRANONAAfE e...�111.v %Q R <br /> p � G�Ea/•t c <br /> 7,S-,;< oROXrT SEAL R/MPEn $Y6. ❑ CONCRETE PEDESTAL By omum❑ <br /> A1FltIO X.DEST/IYr �1y6 <br /> AXOPOsm CON4T1RICTTDN/Els LOG?IO CPEYTDt SOX/ETUVE PIP/E� <br /> ll)NO MlTHOD: 4tUO ROTARY AM ROTARY AUOE3X--1G�CAWU S <br /> O'TTIEIt <br /> I HEgEdY Cf7RIFY <br /> OF THAT i HAVE PPEPATED <br /> THE -)as AiY(ICATK)!1 A/JD THAT THE WOR7X Wql 6F DONE IH ACCO ----_ <br /> REOLMTIONB BALL NOT E#APLOY- NOME OWNER OR UCENSED AJTEJJT•s WOMM"NfN,,T,,, JOEY COVNTY OFf1, 1: b• 1 1 I c lAwa. <br /> '}Qs PERM77 it 17sUED,1 TUJIE CEI IF¢C TILE FO THAT W THE ANO RLR.EB AMC <br /> THE FOLLOWIMO: 1 COMPY THAT M THE PEJl OPWA^P�gtj�T}LEOwo COMTM*VTIOJI LAWS OF CALIPONWI`' COJJTLS,.,CT�O��RNq HE�RMANCE OF THE WORK FOR WHIC1- <br /> =AL1F0 AP—ft T MU�QALLt HOiJ�i M ADVANCE FOR ALL MAMCM THIt FER►fr13ItRJED.1>IHALL ERAPIAY PEl1eDNi NDJECT TO'MORIONAOR �N^C C MGIONAT ONLAWSOF,�)/ J��'�! � m 09�7 a AT X20N/aRa-Z422 CTO U ETE DMwM/0 AT LowM AJEA P7'IOVXOm. <br /> lT16. (5r -a (u r S <br /> NAAulE8 OF STREETS OR ROADS PLOT F'XJLN 0,—t6 66.w <br /> NEARM'TO OR DOUNOIW TIM PRI <br /> ocrnimE OF THE PRXSPEISR'.OWING ONA&MONS AND NORTH OIREMON. A. LOCATION OF HOUse AEINAm DMPOSAL SYSTEM OR N10POSEU <br /> .,. <br /> 00017sPONED OUTLIHF8 AND IOCATION OF AL1 MZ"V40 ANO P110POSED EXJ*—OFYEW_—K W-I BYSTE7A8. <br /> fTRUCTTIRES,1111C CovERED AREAS SUCH As PATM.OWIEWAM AM WA=L 0. LOCATION OF WELLS WTTyN RADIUS OP ONE HUNOREO 1:1 1. <br /> ON THE WUP9CTY OR AD_,,VMM PlgP'ERTY. <br /> MAP ON ACK I <br /> . ......... ....... <br /> ...................... <br /> __.......... ....?................ .. <br /> DEPAIT77I Lne ONLT <br /> 0616 J 7 <br /> i.eaR kwoeetf...qyj:: - <br /> 17+.6 Pt,ns �. <br /> O..eitrrsn trrP6oNer.Sv OM6 <br /> Tdnwn6rrc Z <br /> vc <br /> ACCOUIMWO ONLY: AIDS i <br /> FACS <br /> PE CODES FEE VI AMOUwr I�YSTTM <br /> 35' I �- CIIlCKJlCASF1 PXECEIVEp IIT GATE (( <br /> ^ � I F'@wfiA6lVICi RFAc/N.�mT mama 1.11.f I HCl,' I / � I O ✓ <br />