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ry'PE of c.ANINORITFELIwC 4/4 <br />1NA.. DI WELL CANINo 4/4 <br />A. OF %YELL EXCAVATION 4/4 <br />O DRAT ROC TIVE.SPECIFICATIO NS g <br />CNA. OF cor•OLICTOR CAINNO <br />, <br />RECIPIECIly OATS <br />CA <br />P UC ATI 0 N FOR WELL/PUMP PERMI1 <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, STOCKTON, CA 95202 <br />(209) 4684420 <br />RIMIREFONOMILE MINT EXP,REE I MR FROM DATE ISSIMA <br />rhohists h Tthlhats1 SAN JOAQUIN GOON 't APPOCATION i NfP IIYMADE To Tke SAN JOAOHIEI COUNTY POR A PERMIT TO CO:NEM= AnwoR SWAM Tue wow DESCRINEV. THIS APPUCKHOFERBSIRCIEBACATIRIftqtIfVII fAM JOAottor couNTY 0EMOPmENT TITLE. CHAPTER 9-111 c..3 ANO THE ITTANOAROS OF SAN jOAOUlte cottony Rustic NEALTH sERVICEs. FEMPICHTEWORICAtitial4TOORINGIELTH DIVISION <br />Joe AOORERTion APPLE' r OTT title A tpe_ c,„ fyit,c <br />_ , <br />TYPE OF WIlL/91.1MPI 0 NEW WELL IIMACEMENT WELL <br />oNITALLAT/ON 0 'Neu_ IFTITTEPA REPAIR <br />CI Nov oCillepoN <br />(TYPE Of POEM" <br />STPILICTIoN! A15 5 1:1); t/ -KL;LtiCt t 141-(c- .41 <br />01/T-OP-IWIRACE WELL 0 OEOPNYSTCAL WELL. • *SOIL borallo <br />.1 <br />D <br />0 <br />R ct„.1 <br />yom04 re 4.11,,,,,,c rx' .5,) ' I ou-r Am. mon-Auxo ay ..De'dte r- irotrr GRANO NAME E N <br />1,7v,-ii S anotrr ma. eue.ino)Kr. Os. ooNcRErt PEverred. ay DPRI.Eik 0 YEA ON. s <br /> <br />CHESTER SOXATTOVE PIPE 1 <br />PROPOSED COFFITIRICTIONIDINUSNO METHOSIT MOO ROTARY AM ROTARY MG .X. CA 54 OTHER <br />i HERESY ctRTIFY THAT I HAyE PREPA1sE0 THAW APPLICATION ANO TRAT THe WORK WILL SE DONE IN ACCOMINYCE 'ARTI1 SAN JOAOIAN COVNTY ORDINANCES. STATE LAWS, Mao mass Amo <br />;IfouLATIoNS OF THE sAm JOAQUIN COUNTY. SOME OWNER OR LICENSED ARENT .1 NGNAT UM CERT:MI THE POIJAWAM: 1 MUNN. TNAT IN TN pERFoRmAkocE Of mg ',vow FOR ~cm <br />THIS PERMIT II rieLIED. I SHALL NOT Limier PERNoNe etio../ECT 70 WOREDSAWS COMPCSISATIoN LAWs OF CALIFORNIA.' CONTRACTOR'S HRISHO OPI elJs-cONTRAcTwa SKIMATDRE CERTIFIES <br />.1111L404&414, PI NOVANOS FOR ALL RIKIMIRE) *SP= a AT LsoM ReS4M23. COMPLETE ORAwodo AT LOINEPI AMA PROvicEo. <br />THE FO AMANCE OF THE WOW FOR VVHICM 'TM Moor Is 'swum I HAD. EMPLOY PIPIONS suasecT TO WORKMAN'S COMPENSATION LAWS OF <br />PI.OT PLAN cepa IA GANN <br />- MAWR OF STREETS OR ROADS NEAREST To OR souERNECI TM PROPERTY. <br />OVTUNE OF 71.41 MC/PERM WINO 13110ENINCNII ATV NORTH DIRECTION. <br />beAEIHNoNED mins*. AND LOCATION OP ALL EXT111103 APO PROPOSED <br />STRUCTVRES. ("CLUMPS COVIPEE) AREAS EMU Al RAMA, CRIVEWAYS, AND WAIXEL <br /> <br />' to <br /> <br />4. LOCATION OF MOVIE semArge LesposAL SySTE0,4 OR pmorono <br />IMPASSION OF WRACK CCIPOSAL SYMMS. <br />I. LOCATION OP WILLS ATMS,/ RADIUS OF OW HUNDRED fiFTy Fr. <br />ON THE POIOPIZFITY OR AOPOININCI PROPENrY. <br />PAYMENT <br />RFCEwFr <br />MAY 1 1 1998 <br />PARCEL SIZEJANN <br />owNER's HAAFE iin.10T1 124CS.L <br />CONTRACTOR De AI :1;1C- /777 it;te ik Li7r; leC, tics <br />eve cotrrnecTon C; r e5 805 f:Ii>5:1: AiLdikezue. crtioNt <br />f.0 <br />motarrosatio WELL • I:I OTHER <br />0 enottepcowsecT PASEAIR 0 VAPOR EXTRACTION WELL J <br />DEPTIE PUMP SET FT, FIRST WATER LEW/. <br />e <br />77 <br />ty .575- <br />I/5 524,2., <br />NTINOED USE <br />0 INDUSTRIAL o oomErorapmVATE <br />El PLIKICARLINICIPM. <br />o IRRIO.ATION/AG <br />t:X11.10WFORING <br />APPROX. DEPTH <br />TYPE OF NV% <br />OPEN BOTTOM <br />El DRAWL PAcicisrzE <br />0 LEIWEIN cePTH OF cnouT SIFVCIFICATION 4,i 4 <br />.. . <br />: . .. ... , ... ' <br /> <br />... <br /> <br />.... <br />(. • ; <br />. ; .. <br />' <br />.. , <br />• <br />APPlostion Aeoaceed Ely <br />Orow Inwoottoo Sy_ <br />eNott.e.ilon <br />Cc...meow <br /> <br />DEPARTMENT USE ONLY <br />57/ 74/1 <br /> <br />1-0.P • <br /> <br />Dote Pomo Pooyotloo ST <br /> <br />Or. <br /> <br />D. <br /> <br />ACCDomyipms opfiy, PACS <br />ME INFO <br />(C&,z.,& <br />Pt COOSS <br />z7c <br />11.11ART.Arr OMITTED <br />k(2 <br />*Ular NI/Atm thrvovE <br />‘,7i i---- <br />.....—.=__..., <br />poi. MAI t 1 i Cfic <br />o. HeaJol Serv,- 'Enviro. 173 (/97)