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24467 N. Jahant Rd <br />Permit # WP0041197 <br />WELL/PUMP PERMIT <br />HENT 1866EA TMAZELTONAVEN-STOC.ONCA962064232 (209)468.3420 <br />cmZe <br />A/D itM /%'Q J/�S PNONE_7Bz-6aas <br />S'A%71is Gn/STAT— Ac/�.'.I�y O/ <br />kA GA— LGL 11 PHONP..2_V_1-Y7-2.s' <br />�Eae �lf� 177 B n cmrsTAremr�/�,bl.�/4��'�' <br />:oN,uLTART ae'i[/I �i Rem /'vr�I P.. 327-3/'w <br />.ON,NLTYrt Apgtee6 _ OnlSTaTN2a• <br />xse 44(657 ❑ C-61 D vae o 0-- N11 —377781 ExRX M DATE 6•-L? <br />�xO PARn: DOWNER OCONTa—w D SUBCONTRACTOR/CO MTANT <br />DOMEsnc WELLSAMPIINa:xl General MlneraVCollbnn Baderia (4391) O(Dibromochbropropane (4392) D Arsenic (4393) <br />n1inaso USE slHPrlvals OlnlgalleNA9Noununl Olndusenel O Wakr OualNy MOnBorbg D S ll Sawpary/Charadene tk,n <br />0 Pubbk Ween, syelam <br />PAYAM <br />RS 'Laf <br />°"•• w.r sw•a td,�. cw+.nNmalww Nu�•r <br />Tra �YYORe'u Wel D RaW,pamenl Wen O WaIAMNioNMotlMallon D Orher <br />DMoaaonn9 wen(al_•ot..ene vson 9a6r9fe) •>xrxy, oca,lemnwl •$(�l9ab <br />v anorse 4 e weE ❑ Oul{HSeM a w,n Re wWe v CI—Connetlbn Rep Ir <br />e... <br />rlllirg Malhotl,9r Rogry 0 Al, Mery 0 Auger 0 Cable TON 0 P,eh pW,l 0 Other n � <br />ropaaetl WNI Daplh�yj�X P—aben in oianeler 0Open ❑OXdn pOl Pa<h/Grawl 91xe <br />O Centlarave <br />7Ce,Np_IndaamNer I Ce—l'Casing Deph 6 <br />S3- 5T 6AMt <br />P 7-IiS - c-ZA� <br />116 4151, 'g <br />ly6-lsl- cC� <br />Itz -16z- GnAv�l <br />GrzlVG l <br />Naseem Ahmed, Registered Environmental Health Specialist <br />-.,. <br />■■■■ ■ ■ ■■■■■■WE, <br />......■■...C■■■11�..,.n..IM49M.LE:a�za.....�...... <br />■■■■■■■■■■■■■■�■■■■■ <br />...................I.■:■::^.M <br />P: <br />a:■::....... <br />� :: 6i <br />■■ui6::MMM <br />:•9 °66 66 66666 <br />� �%� <br />M <br />:MI <br />M1101■■� <br />::66666:66E6MM MM E :66MM <br />- ...............■.....■ <br />EEE666�:6666 <br />:.�E:.E:6E6666666':66:6666 <br />.:6 .. ■....:■iii <br />.................■I�i■■■ <br />...::::::::::'m::. <br />Naseem Ahmed, Registered Environmental Health Specialist <br />