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V • ` V ~4 <br /> ~ � SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ['Or. OF ICL USE: 1601 E. Hazelton Ave, , Stockton, Calif. <br /> Telephone: (209) 466-6781 <br /> APPLICATION FOR WELL CONSTRUCTION OR PUMP PERMIT Permit No. ;fV_=_4_7_Q1&J <br /> THIS PERMIT 'EXPIRES 1 YEAR-FROM DATE ISSUED Date Issued <br /> (Complete In Triplicate) f 79'-//,o --Z3 <br /> Application is hereby made to the San Joaquin Local Health District for a permit to construct <br /> and/or install the work herein described. ' This application is made in compliance with San Joaquin. <br /> County Ordinance No. 1862 and the Rules and Regulat ons of S Joaquip Local Health District. <br /> JOB ADDMb5 <br />