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NOV-24-2008 12:48P FROM: 2098873574 T0:4640138 <br />WELLIPUMP PERMIT <br />BAN,IOAOIBN CouNTY 1;-O1IMEWAL HVILTHDE►AMMONT ON FAST MAI43TRERT-BT00KTerr CA@6209'(209)4B!'3si0 <br />EXPIRES 1 YEAR FROM DATE ISSUED <br />oe AODRaae <br />15857 E. Baker Rd. CITYmP L n ca 9 -- <br />Duncan Rd. APN 0��0� PAKCCL51TEl.t:I-N+oUBI!avn.lunoNA_,._,.�--- <br />:NOsaSTRIN't_ PIroNe 209-931-2789 <br />BRNA,wa Francis Bognuda <br />CiTY/BTATC%�M' <br />Jv,W eR AOU N"¢4 ,,,,a09-887-3554 <br />:.ONTRAGIQG Purviance Drillers Inc. Linden Ca 95236 <br />Ca NrT1ACTOR AnoalaB <br />P . O . Box 64 C.,STAT¢1Ztr_�_.L— ---^ <br />PHONe .•�--. <br />SUeGONTAACTOR <br />CrtrrB+ATdLP SUBCONTRACTOR AOORESe 7/31/99 <br />IJGSNR. 9 C-67 1 G-81 U 0-00 1 Oa,er�� <br />tWN.BEN f 2 E)IMRATION 001 - <br />Towrohlp Range <br />GCOORAPHICALINFORMAl10N: CW linArex <br />IlIIRN� Ll&E • Oomesl cJPmato 1I Irr Ont onlAgf cullurrd D InWlwinl 7 YYeter Quality NoNto ing ❑ SaN SemPlplChor¢do <br />t' Public WOtar Symon, <br />If dtMenl In,, 0.vw' <br />TYPE OP-YY9BE r.. New Well 0Replacemam Well U VYW AllmNMw <br />allaod'alutlon t0tim arGooWdu lcOl <br />tvtmmp• <br />C AAonllonnp W09(e)^----;"r CRs ❑ g°B Donn91 e) . <br />C 0u1-01•ServlcA WaB(T Oul-OhSarvlre�M¢=Ranev.'d U Crae-CanneQlBnRepair <br />rd.. VJdI CAelt,a . —. <br />dlCAkldtCStl�L++Nn <br />nr111ft Method r. Mud Rotary 11 Air Rotary J Aupar U eWo Toot L Pueh 00IN _I Other — cGcunatm <br />Propod Well Oeplh n Eur <br />nrolion In dl¢rt,eter 1: Opus Sotlom <br />ea'a Gravel PedJOrawl Sha <br />In diameter / CtmdudorCaeing0apth —h <br />I Other <br />I- CorxludorCsah9 n &teal n Plwllc r- SfNlin¢¢STael <br />W.@ CssinO Diameter in ThicknaeelGwpo/ASTM Schea O Bend Cemord_..^_�---- sack 007 02I w Iw <br />Orad S"i Dapth-;.__It r. Moat Comore (9* Ib b9W5- O Rai carer) <br />C Bantonue (2091 Bol4¢) U ft LI RatardenL f Acco"or lname <br />n.,,..r o,..'....n•e, IAm <br />emod U PuPod rl Free Fall j Dlher----.--� <br />C Concrste Pedoet+d DlrnenSIMS' vr,aln - <br />f ..NP Pump So 9 StlrrtdLtpVYator l,nval <br />IPYMv N Suornalsllilefl Turbine I OO,er NE IN ACCORDANCE WIT71 BAN <br />1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS AppLICATtON AND THAT THE WORK o cE Bl DO <br />JOAQUIN COUNTY ORDINANCES, STATS I-AM19, AND RULES AND ATE LICENSE <br />1 ALSO CERTIFY THAT MY REQUIRED {.ICENSE L <br />CVRRENT AND ACME WITH THE CALJFORNIA CONTRACTORS STATE L]CENBE BOARD AND THAT I AM IN Cfri1PL1ANCE WRN ALL <br />WORKERS COMPENSATION I -AWS. <br />MU 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS 1 1 / 1 S O 8 <br />,zlt�.z • <c T,TLECor orate Secret,Y T <br />Appitcrition Accapled By <br />Grout Inype010n Ijy <br />Primp InApecnO�,,/Y <br />Sall Boring IyptNdily, B' <br />ENU sYlYl <br />ael,¢e <br />ti <br />0S0 <br />P.2 <br />DEPARTMENT U E ONLY 5q 441/1 <br />---'— <br />Data 1 U AM Cmplayne IDM__ / <br />Date _ $PECIAI- We11 Potmlt <br />WAIVER Rocoived <br />Comtructed V oePUr <br />DSM+„_--•--... . �-rwd/MnXJ/ 7� <br />Amount i Dalt/ <br />5q <br />C13 h � tF () �: () 2.- 1� G <br />Invdco0 + Well IDM <br />WELLNNAPPERMIT <br />[CIP <br />V <br />