|
LtCFN8E ^! I Cl:• C -OT C.05 ,:Jti'.Gr NWIeEN EXOIRAilCN DA[E
<br />G£df:RtDNICAt F.Nraaut r04: Coordir 6 X y_ Townst o Ranaa� Sactlon
<br />tutrwo n lie i 00mexllUP^vate '+
<br />CYSon;Ay^Cu141f51 L ir,OuitrTn! ". ;N,St¢r �.u3•IN BAJh!lOf1Y;q _ .Sai jt^GL^�%Ch,Ydti¢ri27rin ,
<br />".Lk RM1ac Sprev+.__� '
<br />�rdl'!c+r so^.G�.a ✓ Yaa • • �T. a'f3�3'3"�F w a+�
<br />T- OF WOMB_ a'.w VV44 Replact hent WMl 'yV¢G WIar6lio'VN Gd,Fral:cr iltl+c' ._...... _......
<br />_.
<br />V„;nJonrg Weli(Si >yMwafle Snd l3onn6;s1 _ Po�omtyT - Gaotr. ehn.c�! AN"-'I'*W 7
<br />�'-01,Seniw :ve!! Gul-Oi Senna V%144 RcneAual , »aa CCAne tlonirepw
<br />Pump Repfacc�en: P.•mp ft.�i r False vVc:l ^atnr6 '
<br />u oNaTRLeno•,
<br />Onitin6 Ngtnod vd Rciary :Lr `t", C A: gv " ;'able T"I Pvon Po'nl Olr D' _ I
<br />`arrrpa,ad w¢8 - #i n EYcaveso++- !M1 014'rt¢ie+ �7pe++ 8ortnr,+ 'aw+ Par3r:Gr»vc� Siz- �n dran¢ia: I
<br />Orrdvao, ^: trmamer+ r Concu,ar'arJnpDaolr
<br />Well CaaMp q.amefef r Tk�,•�•�,naslrGairSA-ASTtt S�i+ed l y Q 5taul tosl:c „ :i+a feu $tact O Otror
<br />iabul Saal = Neat Vw"W,:yft'J pa 'i'� a: waKr'I Sono
<br />ItrS (ZQMa Ao36l Oir.er
<br />' •_.__.
<br />3 Tsuc PlXWrnant toad . PumoC ,as
<br />—wit"tIy.=''unuer ?Gomreaof = 00+a•_
<br />Coacrett Psdasui O nQanL- WAlt: h lc^6c1 K Tli:.^< _._.� m Chd&yBoz s bvr P,pe
<br />i� ,�•„_ ;Subm^-s+bk :' T.,�raY�n u Jy er uP__ Pu+r'�7 SM it I'
<br />_ Storaln6 Nusrat _a.�at +f
<br />1 HERESY CERTIFY TWAT I NAVE PREPARE[! THIS AVPIACATYON AND THAT THE WORK W:LL QC DONE IN ACCORDANCE MTN SAN
<br />JOAQUN COUNTY ORMNARCE5 STATE LAWS, ANC RULES AND REGULATIONS ! ALSO CERTIFY THAT JAY REQUTREO LICENSE Is
<br />ICURRFNT AND ACTIVE WITH 1$4t C-ALWORNMA CONTRACTOR£ 6TATE LICENSE BOARD ANO THAT r AM IN COMPLIANCE Yrk ALL
<br />WORKERS COMPCNSA now LAWS.
<br />r171u!ee111a ow antro Al --
<br />c
<br />so*co
<br />E — T5}.C�_ R�Z%.J J! RAE fD FOR INSPEC , IONS
<br />Tn'LA•-i-- rj -S
<br />>A
<br />20,12
<br />fN
<br />CoQ
<br />��%K2ia;vh�lirV E;k•
<br />P-EfAHTMENT UsE p Nt'Y
<br />fiafl''-a'ti"^ AeuaGT53 9y'-. C;, bate 0.r Errtoyee tDr /T Q LJ! 'f/'�
<br />ay �SPECIAL Wtf: iYPfC11!{ ! !
<br />Pump tntPea c++ 8y 0416 f1 WAIVER Received
<br />SBU BtlT'dp. 3n 1�n �1 a
<br />.lo?"IVEN'" q u Cr n3t+,rits'4,Ylcst ikpTiv _ h
<br />HENNiNGS BROTHERS
<br />"ra,:209-545-1729 Arr 30 2312 13.'Cam P0;1431
<br />wtLLit'UMr t L-KME i
<br />SA,4 JoAaA. CDUNT7 Ew mRow ENTwt,
<br />HEALTw DEPARYMENT
<br />600 EAS—MAIN STREET _ StocwT"C.A SS202 • (206) a63,a42Q
<br />NON-REFUNDABLE PERM;TT
<br />CAL:.'22DS5)953-?i.9iEXDIRE$ i YEAR fRON DATE 193:)ED
<br />jJOFI ALWRECLCTYlila
<br />`
<br />1. _:...e �k �,V 3 45 3n_.
<br />ICynoA Sheet* f -- l • =�
<br />iK )L j APN f,.+l^'� Q 2-0 41PARCEL 3ZE LAND Liu A—GCAnrN`R
<br />'ONI4ER YA4£q
<br />PNC.4IrrrI4Ie:E '2�_ �•7(
<br />C.TvBTAffJ'Lf �\V YC C N j�345Si yi
<br />I C000"w?CM
<br />CAW1sTA6TpN A5oAiaE..y�.__.Q�.'r.-
<br />i•
<br />LtCFN8E ^! I Cl:• C -OT C.05 ,:Jti'.Gr NWIeEN EXOIRAilCN DA[E
<br />G£df:RtDNICAt F.Nraaut r04: Coordir 6 X y_ Townst o Ranaa� Sactlon
<br />tutrwo n lie i 00mexllUP^vate '+
<br />CYSon;Ay^Cu141f51 L ir,OuitrTn! ". ;N,St¢r �.u3•IN BAJh!lOf1Y;q _ .Sai jt^GL^�%Ch,Ydti¢ri27rin ,
<br />".Lk RM1ac Sprev+.__� '
<br />�rdl'!c+r so^.G�.a ✓ Yaa • • �T. a'f3�3'3"�F w a+�
<br />T- OF WOMB_ a'.w VV44 Replact hent WMl 'yV¢G WIar6lio'VN Gd,Fral:cr iltl+c' ._...... _......
<br />_.
<br />V„;nJonrg Weli(Si >yMwafle Snd l3onn6;s1 _ Po�omtyT - Gaotr. ehn.c�! AN"-'I'*W 7
<br />�'-01,Seniw :ve!! Gul-Oi Senna V%144 RcneAual , »aa CCAne tlonirepw
<br />Pump Repfacc�en: P.•mp ft.�i r False vVc:l ^atnr6 '
<br />u oNaTRLeno•,
<br />Onitin6 Ngtnod vd Rciary :Lr `t", C A: gv " ;'able T"I Pvon Po'nl Olr D' _ I
<br />`arrrpa,ad w¢8 - #i n EYcaveso++- !M1 014'rt¢ie+ �7pe++ 8ortnr,+ 'aw+ Par3r:Gr»vc� Siz- �n dran¢ia: I
<br />Orrdvao, ^: trmamer+ r Concu,ar'arJnpDaolr
<br />Well CaaMp q.amefef r Tk�,•�•�,naslrGairSA-ASTtt S�i+ed l y Q 5taul tosl:c „ :i+a feu $tact O Otror
<br />iabul Saal = Neat Vw"W,:yft'J pa 'i'� a: waKr'I Sono
<br />ItrS (ZQMa Ao36l Oir.er
<br />' •_.__.
<br />3 Tsuc PlXWrnant toad . PumoC ,as
<br />—wit"tIy.=''unuer ?Gomreaof = 00+a•_
<br />Coacrett Psdasui O nQanL- WAlt: h lc^6c1 K Tli:.^< _._.� m Chd&yBoz s bvr P,pe
<br />i� ,�•„_ ;Subm^-s+bk :' T.,�raY�n u Jy er uP__ Pu+r'�7 SM it I'
<br />_ Storaln6 Nusrat _a.�at +f
<br />1 HERESY CERTIFY TWAT I NAVE PREPARE[! THIS AVPIACATYON AND THAT THE WORK W:LL QC DONE IN ACCORDANCE MTN SAN
<br />JOAQUN COUNTY ORMNARCE5 STATE LAWS, ANC RULES AND REGULATIONS ! ALSO CERTIFY THAT JAY REQUTREO LICENSE Is
<br />ICURRFNT AND ACTIVE WITH 1$4t C-ALWORNMA CONTRACTOR£ 6TATE LICENSE BOARD ANO THAT r AM IN COMPLIANCE Yrk ALL
<br />WORKERS COMPCNSA now LAWS.
<br />r171u!ee111a ow antro Al --
<br />c
<br />so*co
<br />E — T5}.C�_ R�Z%.J J! RAE fD FOR INSPEC , IONS
<br />Tn'LA•-i-- rj -S
<br />>A
<br />20,12
<br />fN
<br />CoQ
<br />��%K2ia;vh�lirV E;k•
<br />P-EfAHTMENT UsE p Nt'Y
<br />fiafl''-a'ti"^ AeuaGT53 9y'-. C;, bate 0.r Errtoyee tDr /T Q LJ! 'f/'�
<br />ay �SPECIAL Wtf: iYPfC11!{ ! !
<br />Pump tntPea c++ 8y 0416 f1 WAIVER Received
<br />SBU BtlT'dp. 3n 1�n �1 a
<br />.lo?"IVEN'" q u Cr n3t+,rits'4,Ylcst ikpTiv _ h
<br />
|