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fflu 1` SAN JOAQUIN COMITY PUBLIC HEALTH SIMVI('FZ
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<br /> 1 1 � ' f J{5 � y , 445 N BAN JOACIUIN, 'PHONE (209)464-3420 i
<br /> 1 � ,I�i�t(�ap-A'14', p 0 HU8 2009, STOC[TON, CA 95201 sli
<br /> � RRRMIT TSSFlR6S 1 YIiAR I+IigSY DATdi ISSUED 11"F,'� �'�,rv�r ilQmpietr in Triplicate)
<br /> i ApPllaaslwi to h,rety aula,to San Joaquin county for a permit to cane4n+g4 nliuv Imi u11 the , k herein Aeec:lhed. WIG
<br /> epD1Lo44la0 1a ze" in MIXIIJL - kith ala JmquJm County OMlnenca Jfa. 504 .IIA IaQ mA the Rules Lad Re@u"U41111 of San ' •-
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<br /> iYPI OF WELLIFUMP: WWWELL " WELL REPLA:CEMENY DESTRUCTION Lj 9,LL of art ra Woll
<br /> POMP INSTALG7 r SYSTEM REP ❑ OE�FIEA 6 I/wLtartrt5 Willt]
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<br /> FOUNDATION 3d AWiCULTURE VALL LL OTHER WELL-. PITSJSUMPS 16�j
<br /> INTLNOID�9E TYPE Of WILL PROBLEM AREA CO(#STHUCIION SPECIFICATIONS
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<br /> TYPE OF SEPTIC WORK: NEW INSTAL L.ATIOW I I REPAIRMOa1TION I I DESTRUCTION I I IND WVIK+IyLIM p6jolWdd it PI16k Id"f is i-
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<br /> SEPTIC TANK TJ TW*IF 1q OrPecliY r{p.Ormpvhnfrdp
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<br /> DISPOSAL PONDS ❑
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<br /> Env ilo0ean[al llaaltb Pallet/E1143eoa
<br /> 416 R Lan Jaigllln, P 0 nae 3000, Stkr, CA 09201
<br /> FEE AMWNF ntlt AIAWNr F[x+irTq ru /J ISINIP By 0 FE 11E61YJT RO. _
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