|
APPLICA �
<br /> TI()N FOR PERMIT
<br /> �.� SAN JOAQUIN LOCAL H.1EALTH C)ISrAtCT
<br /> 1601 E. HAZEL i ON AVE.,i STOCKTOr1. CA
<br /> xelephorrg (2Cfj) 466-6761
<br /> PERMtT EXPIFICS �
<br /> APrLcalir�n it (Complete in Tri ltr�lel w4 �'
<br /> 'tiny made to fiq San J4a uin L
<br /> atlaUr ut camtN,arsCo wilt, u rx.al Hnaith f]i%1riC1 for a
<br /> lots! #16ah11 Da1rrC[. Sin Joaq,rin County Qrginark:e Nu.rig!or"v"Of,
<br /> lg CO'317uC! "lor 01"I" tisa
<br /> +Oe ar uo. Jcf0s . for,,!}I t rorty �Frg rs t7Csr ril�p4, This&Wiicalin
<br /> lt�rezfs a:a�tfw Hufos"Witc�utal+cuss of the Srrr.�o,�
<br /> .rob Address 2400 Airport pWa y
<br /> Qjr✓flr:r'f f>isme 1"1r. C1 yCC+SS 3+11 I jams - toi Sot 140x 17 J fes_, PM a-9--1
<br /> a+:rarrss X34 X11 ��i r. G i r --
<br /> Ccn:t�cror P ctr�,m Exploration ' c1 Stoe ;tin P � 94_$,8?. 1-- -
<br /> ACtd[[SgCi1 r f� f
<br /> TY-11L UF— PUfaP�.._. rlfvaivf�l SL - Liccme, Nd. 51226$
<br /> WLLL J4V'1-ACtM[-.r1�LJ `_��"' r.%TJ1T;.,w,,;.——
<br /> 1 PI3I44f' INSTALLATION �) DES71lLsC!'ff]N [,}
<br /> CYSTAl4CF 10 NEAREST: St p" Tgrlr� _ """STEM HP.c,il# Ll
<br /> —
<br /> L I ErSJ-u-sfrU--t —.-__. . Ffli1H, --- AS£GW13-1ECf-Ul4lTlhkf+t Ar .. ,.._ _SPfC7fil --OyT-HP,I -n
<br /> 3A110NDISPOSAL FLO, P1
<br /> 1
<br /> 0`P. LINE USE 0TH R WELL
<br /> Of WEtL A030M ARCA Ai75f51Ap
<br /> 5CQ;YSTgUCY#ONU Open Doticr
<br /> '
<br /> GA1fGi1S
<br /> I ! Ocrnesrk/Private
<br /> 0 f �f#v!a11tuG� Dom, of 4+r'iil E:er..v�rq;�" !rr
<br /> r�„rd Pack C7
<br /> t't Ptrtdre t 1 64h4v Type qr Ca$ng—
<br /> ' �.._
<br /> t 1 i7} JIH�1! � 13<iia `ry •••-.. � �, $D^t:L,drCalrCSlti
<br /> Fr}I>ear, Depttr Iii+�f*rA S - frFa of C,ra..c f1QdL-CPMQnt
<br /> tlefSa,,r Vvn+i Dont 1.1 Y ue#aca Ss�f Irti� j
<br /> rtu Ot Purnrr rt,�r�uc1 Ir✓_��J1-.�_r'..�....__i�.-.
<br /> vk�u Ciesnr
<br /> rLfrAn Cl
<br /> MUM tOri fig We 2 ' �_ `s�alrn.Q I9taicrt3l ltop fo'i',
<br /> 1rl'1 C)f' SlltitlC WUIIr:. Np �t�S1AL4A
<br /> �"- i,ttwr !�[aioria7lDssi4w 5�'ll��_ -�_ Y�
<br /> LW s T14N I I fI+PAi)?r�DDI7rOty I ijItUCTIC3 ; �.r -,
<br /> I fTku ar,r,lr+ ssrrarn twvrr�fr�+t1 Ifiwu
<br /> Inyttt7]riort wlii serve_ RUSiQ�nCC ..._.... a*Ater <
<br /> Of kw"tri fs swrirt►,� .
<br /> CornMwtc1&I 04hof s sEr. w,ut,n 1L* lim.1,
<br /> Munn tit _ "
<br /> _ Nurn[zer pt btrdroams
<br /> Chatactot aI "NI IG a depftt of 3 fart;
<br /> SEPTIC TANK Y
<br /> 1�Y PLTy *IMtr�
<br /> . —_- _w CIk,crcY..r .. 45/xr�r talatn> Psh_._ --�-
<br /> FY C,, 7'ftCkTMf ---
<br /> - - Nu: C6rnp,snr.k,nrs
<br /> Disti!x4 in na:,rtst: Wats_ Mvlhoo oI t},s{ypaal
<br /> i FACHthG PIOP- rfy LNre
<br /> L 1 lti:t A Ltnglh of Lnts -`""--"--- -- — ,
<br /> f1f.1I R d:EC1 Total!engin
<br /> �:;tt.. .,,,.
<br /> StfPnCtE PITS � �....__� � --�-- ,-.-.-. �-. f'tol5ariy s.u•.e _ ,.�._
<br /> k f J,starsCw to hear�st: Wr;t
<br /> DtSF'g;Al flOHi)a 1"1 ----- Xtwrri,t�an .� ^'
<br /> i 1-"aLr1 cortify ltlif I h-l" r
<br /> V ptNftR?r#.,# ]p(drCiEign arLt1 Ihsf lits at+pr yr. _ ..
<br /> rc,irs atxt,oUu41K1hs Of thi Sir,4(4;t'J.n Lucid ii I Scsnv Nt i[r;u+drru
<br /> liprrN; p+vner or eti ttl {)kove t, -c:'rYHll $rrt 1c>s�uHs r=tK.nty 0.JJWir.CeS. army Crws, p+u1
<br /> Lcwts4d 8(!i'rJ'i 1-�r�rure crrn,lrus the Iona.,,
<br /> army¢rrriU,-r in such Ir«innar as 10 p.s+grew s4 r'i} f cd^!p that 0 t1w cxrlt?trwnf 4 of thee, w.;fk 1 , .
<br /> eun�f eS 0.4 f04awing; "I Ceftrly Ihe!a1 the L'MeCI la :NfrkfiWn'R.GOrsSta®nsst.t>n teas uI Cap#S7+ 'Cisfilritl4fws h,:�fl>aG Fprrr.I is dsu44. ! !hall r?7
<br /> trap Uwg of CAildamia." t�rtarrt�rx a of itW wt;rr Iw wruch 11w fwrntrt iS iisr.,r(j,f b+wa tm d Ov +wDeuntr.c! Sie
<br /> i I.sy y'arSAAs sarG t � Jr+.tt U1tl
<br /> 1 Tisa at�MKxnr rrlust tali for �sw� ,,j , i� !d+�Urkm,en's tanp,rnsa•
<br /> twcri4na: Cornprotf drawing on:*v*1*e silo.
<br /> StprwLI x T
<br /> Tidal 1
<br /> FOA DEP E
<br /> ONLV
<br /> Appl;[elierr Aceeptod by
<br /> Pit w Grout Inspection by ml
<br /> r bate"'-„ c3 ' _ Ea
<br /> --�. bats �� ---------,
<br /> -�.,� Fide!Irx3pectiaq ay
<br /> Add,finn&1 C*ffwnenti: I{ Vale _
<br /> f] Stk 446-&7$1 U Lpdi
<br /> 1�inlor�
<br /> Appuranl • return ■!f copies to: En�ir�ynrnent•I Heetth Permit/ ces�IEs`-
<br /> } -
<br /> r
<br /> 1►iSS} AMOUNT DVE At.i(0)UNT ttCsRrITEn
<br /> /371
<br /> r
<br /> 4 ftc$174 1Aty,Ie by
<br />
|