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� t e <br /> r r <br /> The Wayback Machine https//web archive.org/web/20160803193725/http//www sjcehd.com 80/docs/IWe11%2... <br /> J <br /> WELL./PUMP.PERMIT <br /> ;9 SANJOAWK jcfl IM EKVROAMEKTAL HEALTH CIEPAjr1lE#Tf l g6a 1=A3THAZEL'CON A4rECt1t� STnbKTtus CA 952D5-(203)488�,4,2Q <br /> Nt -RE urrD aF P ST CALL(1(#I.9,3-71587 FOR INSP-Ee- ows EXPIRES 7_YEA FRom ATE ISSUED <br /> J66 ADMa 64' -r_,_ 21R �'°"�"� ¢ • /���® q c <br /> CftO5:f•^�'lkF�T;. C.,r ��! .._ APN ®00 "Z�—I� EL.R E�LINS'ltj3£R?pLIC.i1T1CAN ` ' <br /> 1 .4417-r1'v.o '6f;vt) <br /> ' cxwNER Ham <br /> Crrris-irAT m,P &11"_A9,P4. <br /> CONTRAMIR 649S� . <br /> s <br /> COMTRACTORADDRessLK.JSO ,Ve-4 'A- 67" <br /> -��� ..... _ <br /> SUBCONTRACTbR 'FlllafiE <br /> A SUEtONt.RACTOR ADDRESS.C MSTATE/7Ip '=S <br /> I <br /> LICENSE. ;EIC-ST .:E-61 ,. D-G�J '_-.Otr1Ef, .N[JAiREA 0 d EXPmAncN DATE I� R2y- <br /> �'sE.O6Hh1?HICAL INFUmkn 7t4_: �°.00[i$112tm)",r�.9•/101 1 �.� Y-1��'P�17�9�:: Township_-mange'. Socxfon_ <br /> ' i:E XDomt,iri tPri ate '.trrfpt0ntRgricxr3ui21 n ijiu 1 U1Tater4uafityMordfarin� Soil SarnpOxliCharacterrzalia:i <br /> FubOc Water System A <br /> 7t�i(fereni'Ivxi U9.;rer <br /> /Y <br /> „ _. C / <br /> TYPE Or WORK `�lQW L',Ali a <br /> .:Re lbmieri t Wall W,eii A teratfoi11l odi VES <br /> A. p. �catidn fliher <br /> 4crn gn:,y fi`e�(s) hof IvNrs 8zx�eonng(s) ho js C tatech tical or�trgs 5I <br /> Qut-0=ServrLYall Qu[-OtSmn ce L\'sll Rertz�tial Crays Cannaeuor,R� acr R 2 2O?4 <br /> r <br /> New?utnG r PumpReplacement F u a Re 7r Raise Well.Cassr.4 SAN j A QVC C <br /> KEgL O'AJ COUNTY <br /> Drilling Method X&lud RotaIry _'Air Rotary Auger -, Cable'roo1 Push Poiw Gther EP T' L <br /> Pro ased'L*1eU Depth Og ft [cava r�r't 12- _iiy utarnct r opell Boa= Xflmyd PacWdi vei Siz � iameicr ENT <br /> .: <br /> Gorductor using In dinniateir I Conductor Casing DapLh <br /> Well Casing Diarnew �= <br /> �In ThidcnessiGauge/�T!f Shred 502 21 ;Stc�r �iast� Sf3mlc�ss 5fr:e1. ,.: Gtrtaa' �, <br /> GroutSaal Dcpt' l� f _MeatCenlem(941bbagv-5ri4 rjilxl7'gal'tYater g- <br /> gai:wari Sand Cemcr�' saot <br /> �(Bentende(206 sed ids) odlar <br /> C-tOutPlacemsnt ldathad XPumped . Free FallRelardantfAtxol NSY{masnn)___ <br /> REDESTA;_ Installed By. tJr1 eT _?ucnp Contractor C313zer <br /> Concrata:P4distal-.Drmhhsionckyctrti tt Lingr�s. <br /> ,t Thick to arhrtstg.Bialc" '• StowP(pe 4, <br /> ELC6°P :ubm�asiate Turbine a:.Giher HP R �Stan1f�r <br /> �ruy af�'Errrei' ft <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS A0'RUCA`fION ANd TKAT THE WORK WILL BE DONE-1N ACCORDANCE WITH SAN <br /> WOKS R COI PE qT1 E T0.TE LAWS AN{ _RULES AND REGULATION 1'ALso CERTIFY THAT MY,REQUIRED.LICENSE IS <br /> r GAWFORNIA CONTRACTORS STATE':LICE�SE'BOARD AN6 THAT IAM IN COMPLiJfFICE WITH ALL <br /> v MINI24 HOUR ADVANCE NOTICEREQUIRED FQE2 SFEC-nON <br /> . PLEASE-CALL t2Q9)353-7.fi 7 t <br /> S larsEO .Cdr TI" Da-TE..� �r 2- J,P 2- <br /> @'I <br /> MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR I\SPECTIONS-PLEASE CALL(209)953-7697 <br /> D PARTMENT USE ONLY <br /> Application Accepted By 1 A Date Area Employee ID#' <br /> Grout Inspection By i Date ❑ SPECIAL Well Permit <br /> Pump Inspection By Date ❑ WAIVER Received <br /> Soil Boring Inspection By Date Constructed Well Depth ft <br /> COMMENTS �. ica 6*4 0 \2 tt %I it II It iy°�� 33hxs�S. <br /> PE SC Received Check#/ Amount Permit/ <br /> odes Info By Cash emitted Date Service Request# Invoice# Well ID# <br /> 4 <br /> B00 <br /> 3-06 04/07/2022 787 `11.13 Page I of t Well/Pump Permit <br />