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Gi;irnr r r �� P1.YCATION FOR PERMIT <br /> �-, <br /> r LINTY PUBLIC HEALTH SF w �� <br /> a BNTAL HEALTH DIVISION" ,J !a1 r�pl• <br /> b 0 STOCKTOH A <br /> Q9 r C9520I� <br /> ) 468 -3447 D <br /> FEB 07 1991 <br /> �Ii�plet� in Triplicate) <br /> b ` far i <br /> ENVIRONMENTAL HEALTH <br /> Permit io construct and/or insta►$E <br /> re p described, This <br /> u�ts County Ordinance No. 549 and 1862 srsd the !toles Rad Re*u3ationa:Of <br />`i �p CIA <br /> ! silo <br /> City Lot t31 se/AcrCmg d <br /> r / <br /> fTp <br /> Phone <br /> F Y. License No. --._ rte <br />{� WELL REPLACEMENT n DESTRUCTION 0 Out or o6rvtc6 <br /> we-12-0 <br /> a $ <br /> SYSTEM REPAIR <br /> alei?. CarsTANOTHER Maitto DEWER LINES DISPOSAL FLD._ PROP, S-V <br /> LINE <br />�II Tr r a <br /> 4RICULTURE WELL OTHER WELLa <br /> # ,4 PITS15UM�S..:L <br /> AREA CONSTRUCTION SPECIFICATIONS ' r. <br /> U <br /> of Wail Ex <br /> cwaiion Dia. of WellCasi n0 <br /> 1 Type of Casing <br /> r. Spacilicittort{ <br /> Depth of Gout Seal Type of Grout <br /> Sijrfaci Soul Installed by <br /> State Work Dona _ <br /> , iitna JlatertRl i1 Depth <br /> t rillli" Ifateriel i Depth n <br /> TYP A' `rA rTJI]N:i '}REPAIRIAO ITION DE5TR TION CJ INo septic aystarrt rm' <br /> 4y pa used if public sewer Is <br /> Wailable within 200 feat.) <br /> st:P w 1t <br /> t r Water table depth <br /> fy u 4 r t CaPaeity— No. Compa"rnanis r <br /> E ` Method of Disposit <br /> Property Line <br /> I FI! r Total length/elle , <br /> Foun tion Property Line <br /> � <br /> S, ' <br /> Number s <br /> DI icoundation <br /> f ,. —–�� Property Liner ; 1 <br /> rum° Hrtirk will be done in accordance with San <br /> H Joaquin county ordrMnCN, fjtjti Jititi{, Ind <br /> e t <br /> „ * birudY.chit In the perlormance of the work for which this periost It <br /> i . <br /> �n i coI bnsallbri laws of California." Contractor's Wing of iub•i:bnfritt3*ip�n� <br /> 0 it ftai which this permit is isaued, I shall emPloy persons subject to iNork ' Tetlii <br /> Thi rutin i st�ntptinli• ' <br /> S �' 'tl40Aw g On river" lids. <br /> /Lt. Date: „ r: <br /> A pEPARTME SE ONLY 1 i <br /> Date ! Aril 4;1 <br /> FlniI Inspection t:y <br /> V <br /> 1 xll r >ptl8L1C HEALTH SgRVICES � <br /> TII DIVI$ION PINIT/SERVICES <br /> V. 0 80X, 2009 c <br /> . S TOCKTON, CA 96201 <br /> r <br /> y CASH s; <br /> * RECEIVED BY <br /> ii-s�111tN1 DATE PERMIT NA.yfs t'1 F <br />