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Site Address: 11957 Jahant Rd, Acampo CA 95220 <br />Date: 5/13/2021 <br />PHOTO # 1 New Well. Well Loq. <br />Francisco Garcia Ruiz. Environmental Health Asst. <br />Record ID: WP0041963 <br />sa,I,lo,wgcDwne,Mrn„„gn WELUPUMP PERMIT <br />kNEA„n De...,,eN, <br />NON -R , E,s, N,s„w wv,xlr.Sroc.,nv CA 95106 i3]l lm.l abal+m <br />EFUNDAeL)i p!R T <br />Aport� // � w.sJUD_ry/ehd E%�IyRES 1 YEAR FRp DxrE ISBUEO <br />_•wssmrs'�[.G 07/ <br />LYw.xR N,Nr qPN 0 0�1{-op� PA,rrE. s,a ro uu A.nx.,,D,l r Z� y b�' c.l-•L�' <br />V/ ti PawE�3o yS ��S u <br />:T Aq R, ..ER. u' �s- s z - <br />Lo.,m,c,Dn APw,E33 a —. NgxE Y- 7zs S? ' 6-6' <br />svRcox,PncroPlcmwa,.xr .0 tiY� a-/uuS r %• as` //-V <br />sDaEON,nAcroP2oNrx,NrT Aooms3 P1O1C 317"3110 /• /I <br />011e,/� <br />BAUNn PaR,T' NwaEn37�3,tY Exvw,rrox RArE V-7. -� / <br />'��•a'-RCoxm,cmn Srarrxv,PA.roNCaxHAr,y, /� /S 71 .Sh �✓� <br />Dorrsnc WEU SARngq: Gene,at MmerRYCWnorm pAUma (n391) DManrcl,br <br />�—�� pmaNlM+,lvay o prlpelrnUnrjrrr uxa a"�� (d3B21' A,—(43Q3) <br />°.A.'u°n`..xxw�snunn =1m s.Nl <br />li W.der a,.RY an«wb,Py O`,:nl S,mPN9,CMr>Mnntalon 'llJ s �✓/'�/I l/t� j <br />irPE DE woRx ?FN.ww,y u ReryNmMml wel wex one "l"wnloulrw„Inl, 11 olMr ems., ••g•• 4 r,••,• _ l 6 �i lIS S- �� <br />U"a)_�_nMwep Sd pa 16151 xNlvey. OGedecMi[AI <br />MM Rol S��nceNYlRer,nval RC,oy.-Oy"eclMnReOan ' (O(/-� 9s--Gnnci& � <br />Weu C^•----BNmY ii OI+MJ�ge�ncenx__N°^Y �eP^^ OR..y&.c '_.___. <br />DrNI(nv NpINM�lItl RMNY ln"R � �v_ ��/� �� J <br />Prppo.cU Wsfl OeOM J� Y A+x. Ca0k 1v0 II n,Nh PWa rl ghsr - l/ <br />�__n E �L , Wa M -b, 1, Ope„ gpllam �rn"N PnrklG,nvN Siwe � � Z� • � <br />ncelxa,wr cn,mq_ o-, , com,elor p L <br />w.11 ca:lop D,an,Ner� TMY cA°"ro aDn, n-�_+.name�e, L"1l�-�t✓6 <br />crq,A Seal LYWq a1Nns rN suwaL� I sl..l wva.le CI sm.l _ /e <br />Mf01p0AY-DpN wNwl OOp,er �--a-� <br />' BeN ()D%r�', u-1 �+ro Cameo Jam ex mNn gN w-q,er �� �, Zy'r <br />Drnal PVicemgnl MWllo,l�,(ppnn� EW � "�Y6 - 2rr-4L ���� <br />IIIPEDE6 ,E IniIa�NDB � r -- II Ra1g0yNIMgy..lar (nAmal <br />I-�__C M. Pe�nnsl�jl �lDlman'�nP CW�rJa lNl,n <br />r �n Lnv�n,_P7 nTl.a Z�S�Z7/� G <br />Imo_ dnaU TurW,. u UN,er m (en Ory e 1p. <br />1 HEREBY CERRET THAT 1 NAVE PREPARED TMS pP LICnT O� THAT TIPIF�WORN MALL BE Dp DANCC WITH SAN �� a/ G,� <br />JOgOUIN COUNTY ORDINANCES STATE LAWS, qN0 RU E n SI"'"IO1n MIgNx leaf <br />CURRENT ANO ACTIVE S.ARQ REfr41LATN)NS. , AIS,Q C <br />iJriN TRECgLIRORMALONTRAL 5 STATE 4CEMB! BOARD AN <br />wORNERS COMPENSATION LAWS. � t�,11YREQUIREC IaCENgE IS <br />MINIM IB OUR_gDYANCE NOTICE REQUIRED FOR INSPECTIONS - AN�K LeaaPUANce MRTIIkaLL - <br />"y'40 L T,Ee 0LVA& PLEASE CALL 9)963-7697 I 3 e'j 2 33 S S� <br />-I L L J�-Fj'r I± <br />EPARTMLI <br />E N� U�pE <br />GroinMs l 1gr,1 DY <br />Gr <br />pv DAN SPECIAL Well Perm. <br />llnxq lnSPeUgn NY —� WAIVER Received <br />frMAMENTS Dole <br />Cu,ulrvgatl Wvn D.Up1 <br />Page 1 of 2 <br />