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APPLICATION FOR WELLIPUMP PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES- / � <br /> ENVIRONMENTAL.HEALTH DIVISION �,�� T <br /> 304 EAST WEBER AVENUE,STOCKTON, CA 95202 ploy <br /> (209) 468-3420 e p '9g? <br /> 11011 REFUNpIL�I PIIt trNff.�REi If QA4 DALE 1!;<UE4 FryIl/� 5gQC <br /> PPUCATION IB HFW NY MADE TO THE SA►!JOAOUIN COUNTY FOR A PEMPT TO CONOTRMT ANOpan INStAU THE WORK DEWMWD THIS APPLICATION M WWII SAN <br /> JOAOUM COUNTY UEVELOPMEMT TITM CHAPTER P 1 1 16 3 AN0 THE STANDARDS OF IIAN JOAUUM COUNTY PURM HEALTH WIVOICED WVMNMENrAL HEIILTN /�+yCv`C`S <br /> Jab ADbnESNrIOR APN, 503 A S r T E PJ ; S 7 R E T elrY_ T a A C Y PAnCEL DIZEMAPNI 2 3 S` I ib <br /> R9 NAME C0Vnlr OF tj T p q VI hl AnonEss 27.1 E WEBER AVE 6" FLOOFtAHO., 209 N 60.-7-910 <br /> S;CCkTV,?4 C^ 95'20'2 <br /> - coNTRACron F I TCH E rJV►Role}M ENSgt AMM86 1'S PLA ucr C- 5} PNOI�E.�4o9�i�Z 3S4Q <br /> — - - - - VAILLEV P l"Cr CA 01153 <br /> Bros <br /> coHtnACrgR AbOM&S 2 UCS PHONE/ <br /> APPLICATION FOR WELL/PUMP PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE, STOCKTON,CA 95202 <br /> (209) 468-3420 <br /> RON— UVORAAlf PERMIT EXPIRES 1 YEAR FROM DATE 1201 <br /> I u"16ts LII tryRnrl <br /> AMICATION I9 HERE BY MADE TO THE SAN JOAOIRH COUNTY I.OR A Perim"TO COHDTRUCT AHOIoR INSTALL THE WOwc DESCRIeED TTI$APPLICAIRM M MAGE M COMPLIANCE WITH BAH <br /> JOAOUIH COUNTY DEVELOPMENT TITLE.CHAPTER 9 1119 3 AND THE DTANDAr09 OF DAN JOAOUII COUNTY PUKX HEALTH DERWCZ:Y ENWhRONMENTAL HEALTH bMOM <br /> Joe ADamsemn Amu 503 E #1 S T T E N T A STREET CITY TRACY PARCEL IOWA~ '135-19-13 <br /> heNAME COUNTY OF SAW TOAQVIN Abbe '111 E WESE:R AVE bTN FLDOR mm"m#(10!)y6S-$910 <br /> tac oN, CA 52D <br /> CONTRACTOR F I S c H E 1.Ny I R o 1`1 M E W T A t- AaeIIFa-6S9 , Il 1'f P L A c Euc, c-5nowt(m)1-42-3510 <br /> VALLEY Spfkl" GA 11386 <br /> ave CONTRACTOR ADDrtes 9 51512 LICE meow• <br /> Ne . N4L8 <br /> 4 APPLICATION FOR WELL./PUMP PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> r ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 <br /> (209) 468-3420 <br /> ' @01f-REFONVaPLE PERMIT EXPIRE! 1 TEAM FROM_DAY E-ISSUE <br /> 6 <br /> 1ls wbh III 7IIDUnt.1 <br /> APrt.ICATKm lS MERE BY MAGE TO THE BAN JOAOIIN COUNTY FOR A PEFONr TO CONSTIDICT AHDIOR INSTALL THE MW VEDCRIeEp TIRO APMICATTOH ID MADE It COMPLIANCE W"It t <br /> JOAOUIN CbUWy DEVELOPMENT TITLE.CHAPTER 11 1116 3 AND THE DTAHDAIbS OF DAN JOAOUNH COUNTY PUBLIC HEALTH SERVICED ENVIRONMENTAL HEALTH DMIIOH <br /> Joe ADDI opmn APH. S D 3 EAST T E N T IA STREET erry T Ft A C Y PARCEL NZU^PNr Z 3 S- 19-13 <br /> OvvmnsNAME CoVWTf OF SAN TOAGyIW Amm@s %12. S WEBIF R A4 E, $rU L00R FENma(m)468-891 <br /> coNrRACTon F I S C H f WV I P,0 N M E N'T A t ApnRFrs 3 9 9 5 FSE t!i 1'S P w G E _ _tom, C PaIONE r 109 ;7 I-- <br /> it Er <br /> .__,. �-�►`' .r+i4..,"..+-,�"' .« .., ' .�.--. - ter..,. ��.--�-�'""'�:,..-''' "^P""'=y w a � �' -. .. r�� <br /> RAMAGE EENVIRONMENTAL�Z' •�-� -` -ro9TJut1 - ._O 8 T <br /> rmorffummm <br /> PH s19-3s4-=sv <br /> _ _ _ 4i�OpQ7pI7p1 _ _ i <br /> 14670 CAWOEIA WAY. 5TE 200 <br /> RANCHO MURI!~TA. CA 95693- ``»-,_�--••r,pa •'• '��"Wrh <br /> ItyPE OF PUMFh 7"-'.'*rr,.y <br /> PAY M THE, P``u1 _ 4[�j w ♦ �' �"`+.'. -...�._.-....+...�w.y_ <br /> U OfBThIltrTNON'�, ORDER OR n _ r _ —V D - �, ,ar �P•.,,r! ___T,,,` <br /> ij012` <br /> NTEIIDEh ui! _ ?C T `5y '(.ARS <br /> Oq+DI1e7aAL $ .`..-� -.=_-�.,.- - �. -'^ "`"j°`y"w..►`�,+.: �.., - - w," /��_ <br /> a OOME9fICA�NVAT . ELDORADO SAVii�05 BANK - <br /> ❑ PIlBLICIMUHIC9`,u _ <br /> ❑y P"GAT10NWAb Re teho Mudeta C lift mNT 96W -`� <br /> NtlEnTb t-VA�: 7 <br /> A.P�et< nrwrN�` <br /> I! ; 1 1709 781. 4 4 3000 70 4 ?Di11s �1DB 7 1 <br /> Yh^ Mr <br />