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10/23/00 MON 14:41 FAX 1 916 1 0430 SECOR-SACRAMENTO 11-05--1997 1:55PM FPO' APPUCATION FOR WELUPUMP PERMIT SAN JOAQUIN COUNTY PUbUC HEALTH SERVICES ENVIRONMENTAL HEALTH DMSION 304 EAST WESER AVENUE, STOCKI'ON, CA 95202 (209) 468.3420 U002 P. 2 WOR-REiII10ABlE PFR1117 El PtRES 1 YUR FROM DATE ISSUED m mpLu r 7rTram"o —� APPUCATION Is IRRE PY UAOE TO TP[E' 4AAJ JpA4UW COUNTY FDR A PEMAT TO COHaTrgACr A1Q,OR NBT ALL THE MASK[ OESCR00ED. TfIM ADPUCATfOM m HAM w CO&PI IAwcF WRII V.m JOaO[AN COVHTV DEWLOVSAOM TM -F C"^JprEn U-1 11 r..j AMD THB 6TArfOARDS OF $Am JOAO" COIMrr rL'Kr NCAf.'rN sfs[vt-Ca fNVRW4 a99Tf'rAL W-ALTH OMrIrOM- . oe AOORELE+OR Afbtl1 10i IWP ` ^K e �-J 1 e G �, �-G ✓7L'-. c7rY _ (� Cy r� PARCEL MZrAYw, oy 5J PWOUE r Qw cONrhACTO-n✓1 � �d r , � AOD- rcomiRACTOR SI �_C5c71nP2[.or Qa,- Qs4 f t R -lu a F""crmzw \NTLI ❑ VO�Ric11D�0 �'�II -0 LYJ OTHER fUli� c: �"I ❑ rttfTTALLATPJN 0 VNTLL rrr6TEM OTPAIR ❑ CPOfr&- O CT WPAM ❑ vA.Q^ EXT'RAL'[pM WELL r ❑ pi— ❑ H9- Du -TN PVW OCT --Fr. Fm7r w^TiR L&vCL O (TYPE OF PV4PI ❑ OVT-*F-sfRv10E VVEU ❑ OCOp,,oCM. vrr u A ❑ POrL Somm W7 rIrTEl40ED Urri TY9f DA wFU ❑ WOUSTnrAL ❑ arm BOTTOM ❑ DowffT-m%lvATe ❑ *RAvEI-Acxewu [Q[ weucA.l[r+fcTPAi [-1 DEH U WraOaTn►yM ❑ 7THER ❑ uOMITO[aM0 d Apq.m C 077TH _Q� rs,o FvsED ww■T*0CT1OKiDRt tyh0 WIT1400. LEM OSDTAPY e r HAY ClMT THAT 1 "AVC PREP -AM THIO APPUCAT7UM AMID THAT THE --Of-, MnLL OE DONE M ACCOCCANCE WITH BAN JOAOUM CWHTY 000WANC'(O. 1TATC r.AL-WO. &NO M+LCL's AMD IIEc%&AT,ok1 Oe THE GAM JOAOUIM COUWTV- NONE ov^Mpt OR UCEw&M .A6LM's s1CMATUOE CEPTYWo INC mvA wn+V; -1 CU*>'IFY 7 MAT N TMC Pfff'QraAA►rC[ CTTHK vmfw FOP wvK" THr c EPUIFT rs (EHUFO. I 934ALL rvT RUMOY PERDOMI V-nLWLT TO WAYMMAW1 h- PO4.A7100d L.LVM OF CALIFOMA.' CONTRACTV" HR1N0 OR 9u6COf+rgACT1M0 MMATUTW CEA• & g WE VOUOw+MO_ ' 1 CERTIFY THAT N TIE PEF4'O LIA"CE OF TUE WOFR Fan VMICH ronA PffaM' re 15@uED. 1 smAu uApwY PE*apxf wLrwp-G1• TO Y►d[pAArs C0-4M6Ano6d LAV4§ CF CALIDOti+r 'Tq/�/y)Oq[CATr N T cA k z4 rotr.rs a AbVANC1 FOR ALL REOtarm (%xPVc O Ar 00" 4 -VOZI. CC vLL/M C AAvvrN9 AT LOWER AFW-^ pmwm X( 7-1 @word !! 1� _ _ T", X. I /�-I S7 O� rCOT OEM {Ar b Pkv Gay ' b 1, HAWK OF STMET8 OR ROAM WEAOrtYI' YO Oft EOfJWDWO THF f MfTY Y_ 4. LOCAmol OF RW6( stwAM OLWORAL s'YSTI;m oft PFVLV GED i OVTt1NE or Tub PSOKAM arvm a O[rwkmv 7 1 AArp Hgrr17L aR(c TfOw- UMAMPOU Or WWAAE Dr*MUAL e'r- T 4s. T. OsfEN®OArEO DITrVwir 8 AArO LOCATiOn Ca ALL MSTtNO Aro Ppiu-ji Co 6. LOCATION OF N%TUA %%MMM RAVM9 Of Ot4 WhdtbwO rsTY FrT. CTIVCTUMS. NCLVOIMO COVMV AAFAH MK -H AS CATR4 VNVFWAYB- AND WALKS- OK THC PNOPE+rrY OR ADJOPM40 PPD'P(RJ T. i D I eEr,uttrm.r Lr[Q axLY /� 2�liU AA.Oy G0p Aos.o.rtL7. Af/OOPId sI O—A 1 -ea 0- ,, O.1• C [ D O r+..o rr.P.aa+, ST O -[- D.1. D.y„cr6- L.-44- Or /ivL S- iia- �-3 Pub. KaaB h SON. - E-iru 173 (1197) A DLA, Or VYM EXCAVAr1OM TvPE OF CAn[HWLrEEVrNC_ 6Li DErTff DF GROUT SEAL_. /1•'ji3 _ DIA. OF CONPVCrOR C.MNG_,/L O O[A. OF viva C&SZNO D SPECIn ATMw R m>OUT SEAL pllTAllm BY W cTFP X OAOlJT MlAkO NAA!! F OYDUr r.[A. PkMR EO-- ❑Y- ❑ W COAIC'JIGT'C F'G'D'C6T'.AL rrr E." -VR Q Y� ❑rA, $ _AM p77.7tY V/ A4QR CAW -r, OTHER r HAY ClMT THAT 1 "AVC PREP -AM THIO APPUCAT7UM AMID THAT THE --Of-, MnLL OE DONE M ACCOCCANCE WITH BAN JOAOUM CWHTY 000WANC'(O. 1TATC r.AL-WO. &NO M+LCL's AMD IIEc%&AT,ok1 Oe THE GAM JOAOUIM COUWTV- NONE ov^Mpt OR UCEw&M .A6LM's s1CMATUOE CEPTYWo INC mvA wn+V; -1 CU*>'IFY 7 MAT N TMC Pfff'QraAA►rC[ CTTHK vmfw FOP wvK" THr c EPUIFT rs (EHUFO. I 934ALL rvT RUMOY PERDOMI V-nLWLT TO WAYMMAW1 h- PO4.A7100d L.LVM OF CALIFOMA.' CONTRACTV" HR1N0 OR 9u6COf+rgACT1M0 MMATUTW CEA• & g WE VOUOw+MO_ ' 1 CERTIFY THAT N TIE PEF4'O LIA"CE OF TUE WOFR Fan VMICH ronA PffaM' re 15@uED. 1 smAu uApwY PE*apxf wLrwp-G1• TO Y►d[pAArs C0-4M6Ano6d LAV4§ CF CALIDOti+r 'Tq/�/y)Oq[CATr N T cA k z4 rotr.rs a AbVANC1 FOR ALL REOtarm (%xPVc O Ar 00" 4 -VOZI. CC vLL/M C AAvvrN9 AT LOWER AFW-^ pmwm X( 7-1 @word !! 1� _ _ T", X. I /�-I S7 O� rCOT OEM {Ar b Pkv Gay ' b 1, HAWK OF STMET8 OR ROAM WEAOrtYI' YO Oft EOfJWDWO THF f MfTY Y_ 4. LOCAmol OF RW6( stwAM OLWORAL s'YSTI;m oft PFVLV GED i OVTt1NE or Tub PSOKAM arvm a O[rwkmv 7 1 AArp Hgrr17L aR(c TfOw- UMAMPOU Or WWAAE Dr*MUAL e'r- T 4s. T. OsfEN®OArEO DITrVwir 8 AArO LOCATiOn Ca ALL MSTtNO Aro Ppiu-ji Co 6. LOCATION OF N%TUA %%MMM RAVM9 Of Ot4 WhdtbwO rsTY FrT. CTIVCTUMS. NCLVOIMO COVMV AAFAH MK -H AS CATR4 VNVFWAYB- AND WALKS- OK THC PNOPE+rrY OR ADJOPM40 PPD'P(RJ T. i D I eEr,uttrm.r Lr[Q axLY /� 2�liU AA.Oy G0p Aos.o.rtL7. Af/OOPId sI O—A 1 -ea 0- ,, O.1• C [ D O r+..o rr.P.aa+, ST O -[- D.1. D.y„cr6- L.-44- Or /ivL S- iia- �-3 Pub. KaaB h SON. - E-iru 173 (1197)