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From WEST HRZMRT DRILLING CORP. PHONE No. : 916 638 7276 Rpr.29 1992 8:40RI1 P02 <br /> ' • APPLICATION. • <br /> AN JOAQUIN COUNTY PUDLIC HEALTH SERVICES <br /> VVIRONUBSTAL HEALTH DIVISIOM <br /> y445 N SAN JOAQUTH, PHONE (200)468-•3420 Z56� Z G Jai <br /> P U DO% 2009, STOCKTON, CA 95201 <br /> �w/ �� j�gUXT Fy1e UES 1 X FRf11( DAT 7SSITa <br /> (Complete in Trip 1cate) <br /> Awplteatt" L. "TAW Pae.,trt �a0 Joag4th country top . Peru to e6netruet and/or In.rA11 the work harolo'dc.-mrlbta. Thio <br /> eyy114Ft10'e to wsoe to COarltahe< vltn Dph Joegvte County ordinorea No. fog .,A 1662 aY�d tate Rinse .rA perll\tlena of 8pn <br /> Jpgv/p C(typ(y T1tb11eNaa1lh Sptv4au. <br /> (r.o Lot dt zelAorenP.n .�, <br /> Job A01444 r t..� - �...av+•^^R.. _.� Car <br /> / to>�•-'.4 -�� .. �� 6�=-`-' r.✓�.�rty� �I o�t1 Ln6 � Pno,�e -09 ^3��'K:= <br /> Owns a Nuv - y -r AddrefJ 1a /t �^�-. ��._.....�_,�.q. <br /> .�3 <br /> 1111 ' vT. d Cnrao� Icenze No.SS?-a_� 4q Ph9ne g16.638�"127( <br /> Conllattor�'�• �.1J..��_-..'AdOrest�.__��. <br /> TYPE OF WErV PUM►: NEW WELL 0 WELL RFPIACENIENT n 0E5TAUC 10N O out or 60rvi Ca 10014 CI <br /> '- IVMP INSTALlAT107 ,O SYSTEId FPAIR CI OT R CQ wont{pTtryvsli n <br /> DISTANCE TO NEAREST: SEPTIC `ANK SEWER LINES 1Y. t Y DISPOSAL PL. PROP, VINEV� <br /> .-..---*tet,--•»•--.:..• fOUNO . ION AGRICULTURE WILL sy'[/lei, OTHER WEL: PITS/SUMPS <br /> • INTENDiO USF TYPE 46 WDLL PROBLEM APEA CONSTRUCTION SPECIPICATIONS <br /> L1 ngvstfl �- O Opan Bottom 0 Manteco 04, of Wen Eacoy+llon T_._ 04. of Won Coiling <br /> .'1 Domef!'b%Private 0 Grovel PJcK C Tracy TYpe 01 Czsnp_ SpeClf CPtiogf� ..-- <br /> I.1 PlINhc 1.1 other 11 Dolle O•Plh of Grow Sell ,_ Type of SAovt.e,�..- <br /> I I Irrlgatinn ___Appfb4 Depth I I Eastern Surface Sa✓f IAPteYd by <br /> R7pelr wok Dow Q Type of ►�mp �_ M.P. ., ,.,. State Work Oohe ,-..r---.�•- <br /> Woo Dest;uclion 0 Well DianSoler � _ T Sca111`4 Matcrta4 DePth <br /> Depth : YkIlor f4Fffte1 l Depth . __ n-•--� <br /> `rYPE OF SEPTC WK ORNEw INSTALLATION1 I AEPAIRIADDITION I I OESTRULTION I I IN e eeprit �yriepm p�rm(IIt f'DuGYc so-o" b �r <br /> evaaabli «itNln 200 feet,l <br /> Irilg1,160r, will aWo; lRoeidence Cornrneralal vim,-, Other <br /> �y Nvmbar of IFving units: � Number of bedroo nt <br /> Chneeter of epn tv a depth of 7 bat: _Wefar able depth <br /> 9tpT1e TANK Q TyselMrp capacity..-- - - No, ra0>•tpanrttento ,tee..-- —_ <br /> PKD. TREATMENT PLY. 0 Method of olepoJFl <br /> DUranea to nearesil Well Foundat:on . PropMrtY 04 <br /> LEACHING LINE Q No. It Length of Knee Y •, - ._._._ Total <br /> FILTER BCD G1 Distonge to nooraat: Won Foundation____ Pfdperty Lino „ <br /> *tC?AQF PITS)^^ 1 I Depth �_Sire __ Number - <br /> SUMPS LI Distance to nattiest: Wen Fovndation.-. Property time �.....r�-- <br /> 01SPOSA, PONDS Q <br /> � <br /> I Maby Cartih-r.+IMt 1 nevi DrOPIreQ (n4 JpDllt atbn and that the work ,Of ba done in eccorGnu who Sell Josevin county orr)Ir,antie e, n!te lewd. mt <br /> Met and tepUleflDhi 61 Ifo Sen Joaquin Gwnty <br /> Home owgor or Ilcon"I aQonCf Vonature wnlflas the following. "I certify that In the De Rormenee of the wort' ler v.hlch this permit It 1 enJ"no, <br /> employ any pe4en fJ <br /> In sown trnner all to 1p"omo subJlCt to wOlkfnan't Compensation lawe of Camornia.-CDMfettort Ming or )ub•ggnlrecting flghaf'Pf <br /> (e!tififf the fonoWtng: "I Cart:ty that In the parformenCe of the Wolk for which this permit is Issued. I Molt erhpl"pelaens$object to workman's CompQnts <br /> lion Uwe of Cellfo(nlo." <br /> The It can for d rep '4P In;pepiont. Complete orewihg on/Mrovvarae ,�life. p <br /> Wes+ goon x Tine: —L .bI _r r. Dote: <br /> LlazNe,'�` <br /> FOR DEPARTMENT USE ONLY <br /> Appncenon Aceaptad by �„__..... ...._.-. __- Otte Attu <br /> Pt a Drevt Ina eticn byA Odle L� Final Inapec Bon by fin• one <br /> Addltlonsl Cpmrr,enla: rTr tv .�[[�:� V- _ le DWN2I T LUS <br /> Appl.le.ant - ►.,curs nil topica 607 San 3vnqu,; Co+.ncy pu611e Neslth eervlce3 <br /> 2nvtronmencal Nealth forTlt/Setvlcee <br /> M N Gan ,%ea4uln• p o boo go9p, att:h. CA 0"fil <br /> 4(JFC AMOUNT DUE AmouNT RCMITT(D As eSk RE6ENED By OATE M1 PERMIT'Np. <br /> �Qad C11�� ' . C' . <br />