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AID At:DOWNS ONLY: <br />FEE mr-o AliouXT RE3UTTO I CREJ:ICSICASH DATE PSMEISERVICE REOLIEST NUMZEt <br />( <br />gef 36p." 1 /3z 3 2_ //,0/76. 54 oo -INTL <br />Diva rCE RECECVES BY PI CODES <br />356 <br />JAN-70-199E 14:38 FRO ENV I RONMENTAL AUDIT, INC TO 55123212094883433 P.M <br />ENVIRONMENTAL REALM( DIVISION <br />P 0 Kix 3EPL US N. SAN JDAOUIN Si. STOCKTON. CA $5721.21113 <br />(20S) 453-3420 <br />11011•REPoiDAII! PERMIT EXPIRIS 1 YEAR FROM DATE irstml <br />fp/sublet* I Trigsrsolail <br />Asaplic.stion is here by made to the San Joaquin cxrry •.`r a permit to construct and/or install the or described. This ei:Plica'zien <br />loci‘ in cessoliance with San Joaq.:iri Canty Titl^:, Chapter 5-1115.3 arz the standarts of Sr ..tn..-rinczvy ic ealth <br />Servi cos, £iwirorens1 Neal th 9 ivisi an. <br />Jot Ad6f*Wor 5400 Pacific Avenue city Stockton Parcel. Size/APMO 2 ONO <br />Claner'SnWieMOnt. Ward & Co.. Inc. leArm:1331 S. Harbor Blvd_ _Fullerton, C6phonet714 -773 -6227 <br />cv.mrector. Environmental Audit, Inc—uldnu41000 -A, Ortega Way,Plawata 606348 phone* 714-632-8521 <br />Sut Contractor V & 14_ Dri 1 Ling <br /> <br />Attress Prix cl R1Vi Qt-A rA „itis 658786 Phone S 916-631-71 65 <br /> <br />TYPE OF VELLYPVNI>% X NEW ..et.t. 0 LEPLACENEHT VELL tl MCWITORING WELL X 7 , r.2 OTWER <br />0 DESTRUCTION 0 Ctrt-OF-SRYICE VELL 0 aOPKYSICAL tiELL i 0 SOIL BORING <br />R INSTALLATION 0 %.F....L. STSTEm RE_PAIR c noss-cmacT REPAIR '0 VAPOR. EXTRACTION IsELL <br />0 New 0 Repair N.D. DEPTH PUMP SET FIRST WATER LEVEL <br />(TTPE OF P(.MP) <br />CfrEion LITE TYPE OF WEL!. CONSTRUCTION SPEDTFICITIGNS <br />O INDUSTRIAL 0 OPEN EOTTOPI OSA. OF WU. MIAVATI 11 " DIA. OF CONDUCTOR CASING N/A <br />O DOKESTIC/PRIVATE X GRAVEL PACX/SM TTPE or CASING/STEEL pv Sch 40 DA. OF weu. CASING 4 " ID _ <br />0 PUELIC/NUNICIPAL 0 DRIVEN Derg OF GROUT SEAL Approx 48 1 SPECIFICATION <br />O IRRSCATIM/AG 0 OTHER GRC7ST ,....a.l. INSTALLED ST_ILLkultjaingacuT BRAM) NOSE Port-1 And , Type TI <br />O MOUITORIX4 GROUT SEAL PUMPED: a Yes 0 No CCNCRETE POE LL STAL EY DRIER: 0 Tel 0 Mc <br />APPSGX. DEMI 70 ' LOCXI NO CHESTER SOX/STOVE PIPE <br />PROPOSED C3NSTriCLICTIOXIDRILIND IMMO: MUD ROTAZY AIR ROTARY AL=R .X , CARLE OTHER <br />I rierirtry certill that I have prepared this axLicaticei ar that the work vitt be done in atm. roams with S.an Jcawcin Ookrry D.-tiriarx-m, <br />State Laws, arc! Rules sr4 Em.slations of the sun JOaqUirl Cokr.ry. gam owner or Heel-zed agent's signature certifies the followi rs: "! <br />certify that in the ;en:on:lance of the work for i.nich. this permit is issued, I shall mot employ persons sLioject,:to•wmc.uovs tnenus.vricia <br />Lavrs of california." Contractor's hiring or r...m,-controcting signature certifies the following: * I certify that in the per-%orsir..me <br />ai the 1:.crk f or which this perasit is isr.ua., 1 L'iatt empley persons sutject to USRiaiAlitS COMPENSATION Laws cf California.' TR! AFTUOIXT ' <br />RUST CALL le RC IN ADVANCE FieR-LlerEEDjLZ ILSPE-CTIOXS AT C2011462-3423. Complete drawing at tower .area provided. <br />Brent Mecham ritte Senior Project (klcgist <br />H H <br />I <br />I I I I I <br />I I <br />AppI icat i on Accepted By <br />DEPARTMENT USE ONLY <br /> Date //5.0 Ares WC/ <br />Grout Inspection 3)'Date Puss, In:MeV:ion SY C ate <br />Oestmction InspeCtionBy Comments: Mai <br />Signed X 19c1V --)1J-12bid °Q119 tr.1.1=a0-96 <br />•••••••••,imw .•• • v....I •