Laserfiche WebLink
. tR WELL i EU;�r PExMff C le me►� <br />- R BAlx.IOAQIL-N COUNTY EK/'IRONMENTe.],M&'iHDxPARTMINr600E%sratAL'1STREEF- ti A9$202-(:09}468-3320 <br />WON -REFUNDABLE PEKNDT EXPIR ATE ISSUED <br />9.�aa� <br />01 <br />> <br />0f�s �f <br />CROs STREETAN Y APN l_XY y PARCEL SIZE U � <br />,7 r <br />OwVEaN.1HE /Zf[-/� p�E <br />Wee- <br />s A15 - r <br />CtTYPSFA•rFlLtr <br />lf/ <br />CONMACIOR r -�S' 1/ <br />�� //PIME2of-�r8� <br />� <br />CT/nTR�L7DR ADDRESS / ✓ Ctl17SiAYEiGP v J <br />9Szs 7 <br />St�ECO�TRACIOA PNO�'F <br />L <br />SU'WOhTRACTOA ADDRFS; CITY/STATEMP ._ <br />y(' // <br />LtCsn� 0C-57 -61 OD -09 OOtbcr ,JZ/ titfflER Et9tRtTIo�D.TrE O /�✓ <br />GvDGKUgUCALI%FOltSL%lw%: Ctwrd3Rates Y _. 49vmSh1I.-- Range Sectim <br />L -'TV -WW ME •c:Pris:u;: n lrsigatioe. Agttcnitumi nlD II nwamQoarey Sio-riRaing asoil5..rrrpisag Ctraracmteaitm <br />D Public waters7stert <br />udis�va sty: osa� -- • a.,. a,,.�,.. u�: ��.,�::.,. .�,m <br />TYPE OF PrORx G !herr Wail D RepLw-rec ,l Well 17 Well Almmiawhiediixslon O Tw Hoye O Other <br />_ <br />D Mcmit(ring Wellis) m:mtz�ni a.�ts OSoil Scrims) ec1•15ud- OCrCOtcth , <br />D Weil Destruction _ D Out-Of-S.-.16iec wal; D Orn.Of-Scn= Vi eft Rasa9 <br />a'EI.L Cw.,srllccrTc� - <br />DrIBIRS-Maked O Mud Rmary D Air Rvary i3 Auger O Cahk Tool O pest Poim O Outer <br />Prq--d Weil 'ycpth __ F Excalation ir, diameter O Open Bottom Cl Gravet Pack i Gravel Sint in diameter <br />D Ceaduotor Casing in diamxer i Condueler Casiag Depth ft <br />i <br />Well Casing Dj&.,m,tcr _ ie 7hickt,,ss1GM AST%j Snc�d O Sce_t O Plastic O StaiNe:s Surf O Qnc�r <br />Grout Sial i):otb ft O %cat Ccm=,YI lb'3.1U hater) O Sind Catrem <br />W8 BR sack znit: 7 gat water <br />O Rznuln,:(2M; solids) O Manufac-.mer Spm °; aolids _ a; %aac O Sp oa Fila O sasssnbmieem <br />Grow Piaceeaeat -"had D O Fra "I O Ouffir O Renrdmt : Am moor juante) I <br />PERF'STAL Installed Rc O rtril'ar Coetractor O Other <br />O Concrete Pedestal Dimeg inc, Width ^ ft Lco fh__ It Thick in D Christy Bas O Sbace Pipe <br />Ptmr ubnwsible O furtine DOther HP--'5—PUMPSOlq454ft StendiagWawLe-.vl B <br />WLLL D)-STRL:Crlo-% D Open Boticm D Grawl Pack 0 i xascd n Other <br />We11 c?:atasteT_ in Taal Dcpth 8 Depth to A'atcr fi D Casing ie Perforates! fcnnt R to ii <br />$eXI&C Material O %cat Can m (V41b &w 5-10;41 %ar r) D Sats! Ccrncat a t rw , ? EaF wets CS 3laatoaile Patices <br />O Srwoniw t'M. solids) O t4anttfapunr Sp c s: rolids _--- ; \amu CS Sptcs on Fil_ Ci Specs SubtRiR <br />PhetfoM Method D Pumped O Fre: Fall D Other <br />O Ca3tnlc:: %ith Mushroom Cup ft below grad. O Compt:w to Exislnts SurraecPad s <br />I HEREBY CERTIFY THAT i HAVE PREPARED THIS APPLICATION AND Tfl.;T THE WORK N7LL BE DO.N£ Lv ACCORDXNCE WITH S.., -N <br />JOAQGL` COU\iV ORDINANCES, STATE I-kM'S. AND RULES AND REGIILATIO\S. t ALSO CERTIil- THAT STY REQUIRED LICENSE IS <br />CVMFN7 A!D ACTIVE WITH THE CALVORMA CONTRACTORS STkTE LiCE\SE BOARD A\D THAT I Ail IP COMPLIANCE 14,I7H ALL <br />i <br />/ rsLCeVrt slL.W r U V_ LY . , - - <br />AppliarionAcacptedSy li pate Ara -!�I/ wo E tZ <br />Gran In die.*, Bj• � D- O SMCIAL We8 Fern* <br />AMP laww iat BY- 0Pte- i7atc. -Aff 0 WAI�-ER Reftked <br />Destruction Inspection By data. Constructed Well Depth It <br />COMMENTS 11� el /e. -,y.v <br />91,17.1907 carts remw and a�rrzrrA:�^ aaz <br />P-0 <br />RFq Y�F <br />cF�� Or <br />SEP D y ?0 <br />yRo " <br />�M?%T <br />yIN,Pn�t <br />ft <br />