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SRN-30-1996 14:38 M ENVIRONMENTAL AUDIT, INC TC3755123212094683433 P.C2 <br /> E?tVGtONTdFA[7AL H-SALTH DIVISION <br /> P 0 ROX 188. 44 >L SARI JOACOIN ST, STOCX7D IL C:. SS 7.388 <br /> 17091 4M=G <br /> aOR.R�LROLRCI PtRWT E[PIRSS 1 YEAR FROM DATE ISSUED <br /> ragYu 4 Trip0mal <br /> Appifatim is here by eade to the San Jeawih Carty :or a permit tc ctrtsiruct and/or install the: wort ec=r.ibed. This ewlio:ien is <br /> cape in c Lianoe with San JO*Win Co ty Deva'. I 'ft Titt^, crtapter 5-1115: ars the Standards of San Joegjin t. n. hsaic Reath <br /> Services, Emrirormen:ai Health Division_ - <br /> Jab Adores/Or APN: 5400 Pacific Avenue EityStockton Parcel Sitn/Ap%O 2 <br /> O.,s RmoeMont Ward & Co. . Inc. ~wires: 1 331 S H^rYnr Rl vrl_ T'h111erton. Gn pho J7j4-773-6227 <br /> Contrastm. Environmental Audit, Inc.Adaass 1000 k, Ortega Way,Pla is 50x'198 Phone t 714-632-8521 <br /> its Omcr:ror N7 R• W Tlri 11 i nq Addresslzt(lY ;l pi� LTi afa r t7k Liet 658786 Phan 9 916-631-7165 <br /> TTP£, OF VELL/PUw . 'a' REV :E[L ❑ 2EP'-ACD4EH7 L'E'1 It MJKITDRIRG WELL A ❑ DIM � <br /> ❑ DES:RU=llm ❑ =-OF-SE'ti YICI NEL 0 GEOPWSICAL WELL ii '❑ SOIL BORING <br /> yi IHSTALLATICN 0 -" vmrlF'( RE➢aia 0 ROSS-=XEG REPAIR ❑ VAPCR EXTRACTION w-' -' <br /> ❑ NSM 0 Repair H.P. DEPTH KW SEY FT. FIRST I KR LLVEL <br /> {TYPE OF PUMP) <br /> OFTDED DoE TTPE DF Y l coitr IIOTIOR SPEC'F=T16M5 <br /> ❑ DIA. DE C=Clrm ras2HG N/A <br /> Il2OUSTR2 AL ElLPiN =T-,CN 011k. OF LELt c^ACAYATi 1 <br /> 1 " <br /> ❑ DCMEST:CmIVATE GRAVEL PA=JSI'1.L_,_ TrVE OF C.1SIVG/SrzEL P Sch 40 DIA. OF VEL' CASING 4' _ <br /> ❑ PUSLIC/MIJMICIPAL ❑ DRIVU OE.aTR OF GRClJT SEAL ADprox 48' SP!=F1CATiCN <br /> ❑ IRRIGATION/AG ❑ OTHER Clan SEAL IRSTALE:) ST-T AC W�GRCTT 8RAN0 NAME�nr1'l RTIf? Tcrr�c TI <br /> 8 MONI7CAINL G-Ctli SEAL PIMPED: QC Tes 0 No =D;tfc,E PEDESTAL BY DRILLER: ❑ Tel ❑ No <br /> �PgD�DAH 70' LECTIN❑ CHESTER 1tox1=4 PIPE <br /> PROPOSED CJRSTINCTIOYIORILIIRe VETHCD: Kr ROTIZ— AIR ROTARY— A2.'C-sRx UtDLE_ OTRE+1__ <br /> I hareDy certify that 2 have prtparvO this aci.:oW <br /> t:m ars that :ne work vitt x Genn in >a�proance inth San Joain Cxn:y CrZirurta. <br /> Stste Laws, and Rules =4 Aew� atiorm of the San :oawin Cutty. Have o r or licernr_ 29ant's sighorArt certifies the fellowirs: <br /> certify that in the periortartc Of the wort for iniC. this ;mmit is issues, I shaLL rat emaloy persons SLDjoet:te'1T,1RCAAW'I CCC—ASATICM ' <br /> Lova o1 California.- Cmtrac:or's hiring or c:--cmLrac:irG signature cercifits the fallowing, • I enrtify that in the Perfors^<e C <br /> of the sort for which this Permit is isaVad, 1 hath eamley pnrscrts S1L1ieCt to =RRXK,%W'S CMPENSA7I0a Caws e! California.- THE APP <br /> LIC:XT' -- <br /> MUTT CALi 24 w IN ADVADCE PoRECPONS AT 12971 ab8-2113. Ca+pin:n 2raw:rR ac lover arta previdad. I <br /> S19hcC X Brent Mecham retie Senior Pmie -( jl_rT,i Dact _Q_96 <br /> E iflill ! II 111 1 iI I I r <br /> i II 11 li 1111 111 If 111111 B <br /> ii I ! I ! III Illi ! III { { i ' <br /> hili 11 111 ILII 11 4111111 ' <br /> DIPART111817 USE ONLY <br /> Appliatim ACCtpted By <br /> OaLe I 3� Area <br /> Graut Impmtim dry Date PLm 1,154=c�tJim BY Date <br /> Gest -im Impect:m Sy Date Ccsoenu: • "' <br /> 73 A=U)ITIRE SHLT: AIDO I FKs <br /> K CODES FFE H6O ALDUUT 25UTTED i CHEC+1%CSSH XtrET1rED SY DA7E I P®mmSSRVICE REDDEST XUMNER i IRyDICF <br /> n'oA 8 I I/ Z3z 1i309b ' S.Poo <br /> I I i <br /> I I I I I I <br /> I <br /> i <br />