My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SU0013720
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
S
>
SOUTHLAND
>
7001
>
2600 - Land Use Program
>
PA-2000178
>
SU0013720
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/5/2020 11:53:12 AM
Creation date
10/30/2020 3:01:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0013720
PE
2690
FACILITY_NAME
PA-2000178
STREET_NUMBER
7001
Direction
E
STREET_NAME
SOUTHLAND
STREET_TYPE
RD
City
MANTECA
Zip
95336-
APN
21807001, -02
ENTERED_DATE
10/21/2020 12:00:00 AM
SITE_LOCATION
7001 E SOUTHLAND RD
RECEIVED_DATE
10/23/2020 12:00:00 AM
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
17
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
APPLICATION FOR WELLIPUMP PERMIT ' <br /> SAN JOAIlUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O.BOX 388,304 EAST WEBER AMAJE,3TOCKTOR CA 95201.388 <br /> 1209)488.3410 <br /> R4*11EFUNDABLE PERMIT[ONES I YEAR INN GATE IngIll <br /> tCllrwimilm 19 Tr4BrM1 <br /> AIPLICATM 10 HOW NY MAO!TO THE SAN JOAQUIN COUNTY FOR A FERATT TO CONSTRUCT ANSIIOR INSTALL THE'WORK DESCRIBED,THIS APPLICATION IS WADE IN CTAMLIANCE WFH SIN <br /> JOAGM COUI.RY Dr IRDPRQWr TILE,CHAPTER 9-1116.3 AN TH STARD R}DS OF SAN JOADUIN COUNTY PUSH{�/ TH SERVICES,ENVIRDINIIENTAL HEALTH DIVISION. <br /> JOS ADDFW* OR. CITY�ST'I'l-/ PARCEL SIMAMwo <br /> oSTlRti NAAEE ' - <br /> !� Z ! <br /> CONTRACTOR- ///, >ti ADOPESS UCf ��!LPI ff2 / <br /> SDs CONTRACTOR ADDRESS UCS PHONE S <br /> TYPE OF WELUPULr Wal. ❑REPUC!►IMT WELL ❑rror.ETomm RMELL I ❑OTHER_ <br /> ❑mSTA LATKM ❑WELL 9YSTEM REPAIR ❑CROIaCOHNECT REPAIR ❑VAPOR EKTAACTION WAC S �J <br /> rtrFE of rIR4P) <br /> CJ N.-❑Mw& H.P. DEPTH PUMP SET FT. FASTWATTJRLEVELEV .� <br /> ❑oUT-ORSERVICE"u ❑DEOP/WECAL VAU P ❑ SOS,domm <br /> WMLL <br /> OFEN BOTTOM DIA- WELL lKCAVATCASINGN CIA.Of CONDUCTOR CAS <br /> ❑INDUSTRIAL ❑ <br /> CK <br /> �DOMII <br /> lSTICRVATE {GRAVEL PACK1SfZ!_ TVP!OF CASNOJETFR/pyC dA-OF WELL CAMEO� p <br /> ❑WDUCAAUNICI►AL ❑DRIVEH DEPTH OF GROUT SEAL _ 91PECi1CAT10N <br /> ❑ NANSATIONWAG 11IN <br /> OTHER *POUT SEAL STALLED SY ALk,1kc GROW BRAID NWAE E <br /> (3 NJONITORNOZ 70/ / f ORDUT SEAL PU%4K' 6 ON. CONCRETE RDERAL,SR' 13 Y.tCkL <br /> AlRPL IDDS)T1N / �1 LOCKRM CHESTER S07USTOVE RPE_ f� <br /> F ROMM CONSTRUCTWNWALIN0 AWARD: ER/D ROTARY=\ AR ROTARY AUGER__ CASLL OTHER <br /> I HERESY CKWFWY THAT 1 HAVE PREPARED THIS APPUCATWN AND TEAT THE WORE WILL IE DONE ON ACCORDANCE WRH SAN JOAGUN COUNTY OROWANCES,STATE LAN7.AND Rum AND <br /> NEd1lAT10NS OF M SAN JOAom COUNTY.mow ow1EER OR UMtSED AOENIVI SIONATIAE CERTFES TRE POLLDYYNO:'1 CERTIFY THAT N TH!MWOMIANCE OF THE WORK POR V*SCH <br /> TWO PEMAT N MOUE'D.I SHAT NOT EMPLOY PERSONS NISIECT TO VM*WAAN'S COMPERWAYMN LAWS OF CA.IFORNIA.'COMPACTONYS HRWQ DR 9U54_ONTMCFIq SNSNATUIE CERrwm <br /> THE FOLLOIMN*: '1 CERTWY THAT N THE PERPORMANCE OF THE WOW FOR WMCH TMS PEPWIT IS ISSUED.I SIAL EMPLDY POISON$SUILIECT TO 1NOISOAAR'S COMlVNATFON LAWS OF <br /> CAUfOPMA' TFE1APfMWT MUST CALL� �lJ{ PN)AU.IN ADVANCE PAli.Iq*oL O INSM"ON1110 ATT-MWA 401114M. COMPUTE DAMN*AT LOA"MEA PROVIDED.. q�+ <br /> T — JA"T <br /> RAN 10 w N S.dd <br /> ST <br /> 1. NAMES OF STREETS OR ROADS NEAREST To OR SOUNDING THE PROPERTY, 4. LOCATION OF HOUSE WMAD!DISPOSAL SYSTEM OFR PN*POSIO <br /> t. OUTLIE OF THE PTOFETRY,6N"DIA nmom AND NNONRH DSECTION. EXPANSION OF SEWAGE DISPOSAL SYSTEMS. <br /> S. DS.ENSIOIED OUTLINES AND LOCATION OF ALL ETUSTI/q AND PROPOSED ■. LOCATION OF VVUL9 YYRTIIN RAORPS of ONE NUISNRED PITY FT.. <br /> STRUCTURES.NCLWSMI COVERED AREAS SUCH M PATIOS,DRIVEWAYS,AND WALPCI. ON THE PROPERTY OR ADJOSSNS"OPIRTY. <br /> RAS <br /> .;....:........ :.. ..... ..... y.. ri�J.�.� <br /> . ..i....:. .._'.. y <br /> ......i... i.. . . _ <br /> .:.....:......i. <br /> ...,y. ..i....:......:. . :.. <br /> ....:. . ... ....... <br /> .i......i <br /> rr <br /> ...r -a <br /> : <br /> ...:......:.. <br /> ; <br /> oy <br /> �i l.. <br /> G <br /> i <br /> . . . . . . . . . . . <br /> . . . . . <br /> . . . : . <br /> •I <br /> � . .....SA JEiAACCJII+r}L >l� 1fi <br /> :. <br /> - Dl........ <br /> PftB <br /> : f=NVtF10 E:NS11L-b1EAL••ZH. <br /> ...:.......... <br /> i....i.... . ... <br /> IL <br /> DEPARTbBR USE ONLY <br /> APPEa.d.n A...Pud By . _A— 2 f <br /> a—A In.-tw Sr_ D.1. I/WZ I-m hWooOSn M D.n <br /> D...un+ D.l. <br /> ACCOUTTNS oRLr: ADI FACE <br /> FK CODfi RI NPO AMOUNT RHRSTTED C ICASN F=SpVFo SY DATE PWNWTISMIACS RSOARtT NSASSII IMroIOE <br /> gryT -3 6 3 03aD.3 a <br /> _ b <br />
The URL can be used to link to this page
Your browser does not support the video tag.