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FIELD DOCUMENTS_CASE 1
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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14800
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3500 - Local Oversight Program
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PR0545626
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FIELD DOCUMENTS_CASE 1
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Entry Properties
Last modified
11/19/2024 1:51:29 PM
Creation date
4/29/2020 1:31:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
CASE 1
RECORD_ID
PR0545626
PE
3528
FACILITY_ID
FA0000957
FACILITY_NAME
LATHROP GAS & FOOD MART*
STREET_NUMBER
14800
Direction
S
STREET_NAME
STATE ROUTE 99
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
19702004
CURRENT_STATUS
02
SITE_LOCATION
14800 S HWY 99 RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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APPLICATION FOR WELL/PUMP PERMIT <br /> AN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 <br /> (209)468-3420 ® O <br /> RON-REFUNDABLE ERM EXPIRES 1 YEAR RU DATE HSUEC <br /> (COMPlatf FR IFIPRrfIQ <br /> ATT.Fr.ATION m trrmt nY MAIN'TO 131E SAN JOAOVrN COUNTY FOR A rTr9p1 10 CONETnm7 mumn WWI ALL TIN VMM OFECR1RF0•TINe AMItCA7gN t9 MAOE W CO <br /> .ItlAU1N11 COVNIY 0[V[1 OTEAEHf FITr F,C/IMTFry B 1 716,,AIR)IItF,AIANOAn1C OF eAN lPAOUfR CO1N11Y Ant N:NFALIII HFOVICE 9.EF"mm NME NTAL I't AL 111 ITN E VAT 119AN <br /> Jnn ArNR9 pemn ATYI[ �L- /-/ (w f)rl // <br /> (� ,/ _ I crrr )/�I C /j-,�/ r•AI[CSt e1tE/AnrE^- <br /> OW nla NAME rs.1'-t7 i-- a• I1i�11�11'til �^ 'Z <br /> ATNIrc99 7- f;)ii <br /> , <br /> COIR"':TOR c ( - 6YC'- AnIN1[e9'� T , •' <br /> 1 .1—[Ic• L:4�.ng11E I kdr,7—,LL.4fG: <br /> nUe coNl n.Ar,ron AptlREpa <br /> ucE nWINE <br /> TYK OF WEll1l]lMr: f1EW WELL RrrIACEMEIn Wrll ❑0,40Te1 O19N111V[N-E F0 OTIIIR <br /> ❑WflTAILATION ❑WILL SYR FFM nrAln I❑CA,00-coMNCT nrAlb I,,]VATOR EAS MCTRIN]V[LL f <br /> _ Et J <br /> LJ I1wr❑n,.,.4 Il,r, nE1'f 11 nM11'e[T•_f I. FIM61 WATEn LFV[l <br /> flvK Or tvLlTl -- 0 <br /> ❑OUT-pF-9EnVN:E WELL 11 fltomtvcic7 WEIL f ❑ cork eari'm <br /> y-IDE d11111CImN:_ Fi Grrfy(f"FI. (��T [' �� <br /> FI'NI Eryb[p EE TYpE OF E CON TnVC IIpR CPECIFrCA110N <br /> 11 VNRIAIRAL ❑OKNROTlOM (A <br /> ENA.OF Wlll EXCAVATION <br /> IIIA.Of CONryVCIOn CA911m "1 <br /> 000F911CA]fVA1F �gMVEI VIA.OF WILL CASINO <br /> FACen1ZE_IV Ivri Or CAm1{pn FE[t 1 VC O <br /> -�L <br /> 0-T <br /> IJ n/R11CIM(FNICrrAI 13 MW" O <br /> form 11 Of ArmVT BFAL ^` CF[CHICA71ON_ �Lk i2S P- <br /> 1f-}I R <br /> rtN9nAlION1AO IJ 0TIRR Olglrr 1f AL 019TA1plm <br /> [EO n C � <br /> ry Vi 9nANO NAME � <br /> OTmr]� E <br /> IJ NOMrtlfvlln VT C[AL RIn11lO V C7 N, CONchCTE I[tnfTAL CY bnLLErI:❑r., fBl� <br /> Armex,nt►Tlf •7 <br /> IOCRnIO &TER VF ITIS <br /> moro"t)CONE TTIUCT{ONIDMUNO MFT[{OO;MUp EgFAM S <br /> AM Ig1ARY AUO CA9LE OTII{n _ <br /> lift'II"Y <br /> ift'IIeY cFR11ry 111Ar t FIAVF r11EPAREe TIN.ArrMAF10N Mq TI{AT 711E YMM WILL CE OONF Al ACCO /JOAE"N COUNTY vn] AIA=E f.p/ATF 1/LW9.ANO INI.F,9 ANI/ <br /> nFALNATIONC Of 711E AAN JOAOVRI COUNTY.ImMF LYNRI[R On L7CENf[R AAEM'■MONAlLr11E CEfn RfER FOLLO 1/"Y TNA7 M 711E KI40rwTANCE OF TIE W1OIF(FOR W19C11 <br /> 1111419 MATT I9 Ie R11O.I TIfANL NOT EI.N OY rfnlnNa aSr/1JECr]O WORRMAN'f COMKNCArytlN LAW9 OF CAkwr*vr pA.' TOn"'FNIYNp OR"U CONTRACTRIO INONATUM CFrimna <br /> IIN rOl10WN1A: 1 CFRTnY r11AT 111 7NE T7'IrtlnNA}R;E Or T11E WO/AL <br /> To <br /> WINCI{TING KNMIY n MAU{b,I d11All OY 1[nepNa aUNECF 10 M1en1Oa AN'f COM1ylE{AT10M IAWC Of <br /> cA1 Tf0111eA,' ryR!'�F�VCAMT M1/dT}'R }I Igl11d IN A1rVnNCF Ie <br /> f1 rl Atl REOl9nFn yTdr'R {AT I}pol Ad9-fA} CONI•LLYF OIU <br /> WINO At LOWER ATEA FMVWO. <br /> INF,w x n. •''��. <br /> TNN ... b.l, <br /> Or I""a% H 9..IN Ik.1. le <br /> 1.NAMIR OF Cr19FTC OR IIOAOC NFARERF TO OR COUTIORA7 TIN rrgKnlY, 4,LOCAI ION Or IIOUK CFWAO!OlffOfAl CY91EM On iTY11FUaFO <br /> }.O11fl Nlt A(111E rnOKRTY,ON91p pMfHaIONf ANp IgnTN bNttl:rlON, FAFANMpN OF pEWAQE OlCrpelll fYfAt ey <br /> }. 9. <br /> tAt"IN91OFRp 0WLnrF6AM LOCATION Or ALL FRINtrNo ANO"mroa[b {.LOCATION OF WFLLC VWTIAN nAONf <br /> 91RUCTUTF <br /> F1Le, CLUEmNI COVEMIT AR[AC 9VCII As rATIOC,MVEWAYa,Arm WAllla. OF ONE/Rn1OrIEb 11"Y FT. <br /> ON 711E IYfORTY OM1 AOJOft9rm{tgrERTY. <br /> 1 <br /> EJir <br /> om-. <br /> OC r 23 1998 ` H1rT'rl,1. <br /> AATMENT use ONLY <br /> A„aa.11M,A--1.4 RY <br /> M„A ImA'+1bn er 6.1. <br /> 81 +•sotA* Civt 424-51,V& -IDS�'(Louf j/)&.5 iso Lr.CLR / —%%0 vvg <br /> UOI,EC�r} •2y- 913/1<�1 .dJFp �8 w6Jc w tPF a e�Q�.Aear/o 4(sl • 72 ( a (9{lb9uwf <br /> ACCOURrmO ONLY: AME rAcr <br /> B�AGl13a1.rv6 71 �Nxe)11$�bgl'..rr, <br /> rR CeOEA ►EE INre AMOUNT TRAIIIEO CINCIMAEN RECEIVED■V PATE ►E1YHIf1{171NCE AEO1iEEr MUMCW 1NVO{CE <br /> - s-c-ojpp C�u`� ✓ �z <br /> nfb 11AaAh SAN.-FnYitp,173(1187) -- . <br /> E <br />
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