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AFFUCA1I0M FOR WaUPUMP PERMIT <br /> SAA JOAOUTA WURTY PURLIG HEALTH SERVIC:S -- <br /> SiVIROHMpITAL HEALTH QIYISIOK i <br /> P 4 UX 321. 446 II.SAM JOA4UIX ST STQGXruK cA 96MI.U; <br /> TOtt sEFUROIaIE Pfl1111T FXPIREY t rFAa Rpt DA—iSSUE4 <br /> It+wkaa:TrskYosl i <br /> ACID"caticn is here by sada ca the San;auxin County far a pop it to conevruet and/or inacatt the wort described. Thfa smLicacion Is <br /> ride fn c®tianca with San Joaquin Canty 0aveiapmmc ride, Glaocar 4-1115..3 and the Standards of San J <br /> Services, Fskvaruvental ifsatth Oivis'ioems 1 os9uin Gatany h=tta Hootth <br /> Job Address/or APR& =42406 A10.0ell <br /> A4Q <br /> ��JJ �f �!J Ter<ek Sfz*/APat <br /> ouvr•1 xawe �i (/O <br /> 1 Y��c13GT. Q�t/7� mane / <br /> caneractar ser-16 N .4dJ 10,001 WOK41. ,tea„;1 75' A%// L Fat <br /> SW contractor CtJ `� _ 6—s? t/J$ <br /> � .^ Address R"- o / L.fJ�'{�atG Llai��i/`eS' Pinetle ! g! _ ' ?� J <br /> Type OF PtAeP- (3 HI:H WLL Q RuL4cg)NmT uEu Q MONITORING'JELL 0 OTHER <br /> Q OESTRUCTIOR q 0U7-0E-4EAVIcX LELL Q .EOpilysi AL vaL l ,� SOIL BORING 1 <br /> Q INSTALLATION, Q '.ELL STsrEM REPAIR p ==-amm= REPAIR M VAPOR C(TUCTOY HELL Y 9 <br /> q Mer q.'Royer s_F. <br /> (ITP$ OM TMP) '30TH PUW SET_FT. FIRST WTER LEVEL <br /> - <br /> III7ENOEl19se - ae ma OXITAUCTIOIF;ate CATIVRs <br /> • INDUSTRIAL Q OPEN 30TTCN 01A. OF DELL 0=VATIOII GIA. OF COMDUCIOR CASING' _ _} <br /> Q OCMSTIC/PRIVATE Q GRAVEL PA=j3t=_ IM OF CASINGlSTEEL/PVC OfA. OP HELL CASING } <br /> Q P%muciMummPAL Q ORIvex DEPTH OF Gmout Sa_AL SPECtFIG1TIOM '# <br /> Q IAA!WIf ON/AG 13 OTNE3 caalT SEAL [NSTALLm IT GROUT aaA,o MAN" <br /> MGM[Tax iNG ^ M=1 SEAL pumm- a res Q so COKIM NEDESTAL RY GRILLER: Q Tet Q 314 <br /> APPROX.3eM *ex' L=IRG CRESTER 3fm/STOVE PIPE <br /> PROPOSED WNSTIM11 10RIORILl1N0 1111171102: mn ROTARY_AIR WTARY_AUGER_CARLE_OTHER__ <br /> I hereny certify that i naw prepared .ins application ane Nee Chs warn watt be dorm in mwrasnee with San JdaWin County Ordatwmat, k <br /> State Law, and Autes and lequlaeicre at ase San Joaquin CatncY. Ma*arrr or Licensed a91nt's signanum cartiffes the faltering: et f1r <br /> aartify that in the perfarmetkC*of the+art for which this Permit is isswd. I shall not eaotay ptrsa m aldiacm to woltly M'S mmpegsATIOR <br /> Laws of Cakifornis.e Contractar's hiring or use-contrmatinq sigmaa•e certifies the fottowin9: e I comity chse in the perforasnc* <br /> of the out for which Geis pemit is izzima, I thall asplay persons maimt cc U01110"'S CLMPENSATI01 Laws of California.* THFAPPUCUIT <br /> MUST'CALL Zt HOURS iR ADYAI=FORASL WTIONmp <br /> R AT 011 �'.• Catece drawing ae Lamer area provides!. <br /> Signed x TE[ke E7'F',"Qh... ._,._, Gate <br /> �1r3f9� <br /> PIAT PLAN (Ota* to Scale) Bute * co _ <br /> 1. Names of streets or rands nearest es x haunting the haul* <br /> property. <. Location at sow*" disposal. *"ca• ar <br /> 2. Outline of the preasrTy, giving aiseskions and Rarth direction. Proposed eaprsian of 30.09*d1600"1 SY159ee015. <br /> S. Oimensiened a ctir0a and taraeian at ell exiseing end proposed 5. LacaeiRn of wails within radius of 150 ft_ an <br /> structure, (neiudin9 covered greet such as ,atcios, driveways, the propom or adlainin9 property. ' <br /> i <br /> and walks. <br /> rC. I <br /> � Il1111 . ;IIII � IIIlilil illllllll <br /> t 111 111111iIII Ililill I - <br /> E <br /> I II ilfllll i III til ll. <br /> Illi I .:.iII Iiilii 11111. 1 I II <br /> 1 ! IIiII I II iilll ill ! <br /> VC/L'l ej QFZ i q Q ar E G[.J� P 30-U Wff NSE II/L7 <br /> AWkiaetian ACrsated RY Dsce Z 114 <br /> - / 5 Areca <br /> Grant inspection 6Y Daea Pram Insowtion Sy Data _} <br /> Oestructiom Inspee:tion SY Date Comments. T <br /> IAxUIRO 07 47.• I FAGAIN! � } <br /> 1 Ft CODES I FEE INFO I AMOUNT iplfTTl31 I aIOWM&SH I R[Z8=IT I UTL I PERIQTfREMC$ REQUEST iuKSER I III UM <br /> IT IT, ooSSt3 ( I <br />