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89b0 "N WdEb:R 910b 'll '9ad 9w11 PaAiaaaa <br /> WELLIPUMP PERMIT <br /> SAN JGAUUIN CGVND'ENVNICNNENTAL NE VH DEPARTMENT 1865 EASTHALLiTGN AtrE1tNE-$TOCKipN CA 95205-(209)44gd20 <br /> NON-REFUNDABLE PERMIT CALL 209 963-7697 FOR INSPECTIONS EXPIRES'I YEAR FROM DATE ISSUED <br /> Jos AOOREIN 4806 E Mariposa cNTawStockton CA 95215 <br /> C'sTIUEyCarPenter RD APN 11 010 PmmLSotE11ANoweAPPCATGNs <br /> OWNER NWue „M '5KA(A,W 1.31viin, _ PNmE209-406-1731 <br /> C ERAMR- 4806 E Mariposa RD crwsT...mPStockton CA 95215 <br /> L-pN =R Purviance Drillers, Inc. PRGRE209-887-3554 <br /> cc RAcrcrt Ov St P. O. Fiox 64 CITNSTAT MP Linden, CA 9523 <br /> SUNGON1NAcrgt PRONE; <br /> SUBCONIAACrost ADOREss CITY/$TATEQIn <br /> UcEWs6 u O57 a c-e1 a D-09 u Otter N.,MER 37792 3 ETNnAXgh DATE 7/31 /17 <br /> GEoawpmaAL INFdRlMTnN: CeortgNOssX Y TOWffihip_ Range_ Section_ <br /> IINrUNDED WE aP DaatesetlPnvata ❑hiigatWAgtiNwral OInbcblal 9 Water Duality Montnong ❑Son SemplingichameteAzaem <br /> u Public Water System <br /> u dnsmdnom oma x vn .n d �. um <br /> TrPEOFWoRK U New We9 _Replacement Wet u Wag AteraliodModr9®tm J Other <br /> r.Moniloring Welf(s) it of wens n. Sag Bonng(s) e4° "ta rGealaMnlol <br /> I Out-0rSerNte wall nOut-O/Serace wall Renexnl nCresv-Connection Repair <br /> 13.N.%ry 0 P=p Re YLanad G Pmp R ar 0Ral"Well Casin <br /> WEIJ-CONSMKMN <br /> Drilling Method a Mud Rotary �Air RGlary J Auger a Calls Tod J Push Pont LOpfer <br /> Proposed Well Depm R P ,nfllon In diameter 0 Open Bottom O Gravel Peck/Grevel Size in damaler <br /> u ConduaarCasing_indiameler 1 Canduuot Cssing DLldh R <br /> Well Casing LVameter_N TMtlmesslGaugeJASTM Schell O Sled D Plastic r Stainless Steel 0 Other <br /> Grout Seal Depth—ft D Neal Cernerd(W 0gal webq 13 Sand Cement aaAY ffgalwaNer <br /> F,Bentonite(20%sdtds) 1 I Other <br /> Gmut Placement Method c Pupped O F Ee Fat C Other G Retardant/Aeeelantto(mme) <br /> PEON Installed By O Ddger 0 Pump Cml UG, Ofher <br /> I,I Concrete Pedestal LDlmeitsionC NfitlN ft Length ftThcY In : Christy BUK a Sime P-1pe <br /> 120m, ■Submaniblsu Turbine til Other HP—L—Y� Pumps D n Standing NYaRrLevel C fl <br /> I HEREBY CERTIFY THAT t HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br /> JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES ANO REGULATIONS. 1 ALSO CERGFY THAT MY REQUIRED LICENSE S <br /> CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT 1 AM IN COMPLIANCE WITH ALL <br /> WORK COMPENSATI <br /> MINI M 24 U AD ANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 <br /> SIGN TmE Corporate Secret ,y a <br /> RE <br /> EW <br /> PERM <br /> oV4LJ1 �o��u <br /> F,yl <br /> DEPARTMENT U E OINLY <br /> APplicali A ,tsdl6 Dae Ama_� C EmPlcyee IDA_ <br /> Grout lropedon By Dae ❑ $PECWLWEII Pemtit <br /> Pump lnnpecflm By Dae 0 WAIVERReeeiVed <br /> Sol Boring Inspection By Dale ConaWeted Well Depth R <br /> COMMENTS �i7 CGYArYL� 1�4 <br /> PE SC Received CheeN#/ Amount Case PemuU Invatra# Wefl IDA <br /> Codes Into Cash RemlBed SaM¢ oast# <br /> u3?.l 0-50 S3 7I�a6 SRt�o i <br /> E �O/g'L/'T� wuurcarm�leNrr <br /> �12u <br /> Z d e89 40 I,0 l L DIES <br />