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10-16-1997 3: 18PM FROM P. 2 <br /> • APPLICATION FOR WELLIPUMP PERMIT <br /> RADE SAN JOA4UIN COUNTY PUBLIC SALT HEALTH SERVI ES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 904 EAST WEBER AVEME.STOCKMK CA- <br /> as �- <br /> Mitchell Drilling Environmental Corp. 12091 4833420 F.2-rrn -1 5 <br /> EOEHREFDEDABU:PERMIT IXPIAEs 1 YEAR FROM DATE IaSDEb <br /> 10Bwpin,HI YHpAlsnt <br /> AFRICATION IS HERE W MAD[TO THE NN JOAOUIN COUNTY FOR A Pfl1iT TO CONSTRUCT AND/OR N1,ALL THE WORK MSCMM THIS APR•ICATION It MADE IN COMPJNIEE IVT,u <br /> JOAONN COUNTY DEYELOPSAPfr 11'r <br /> CHAPTERa l0 AN "DARDS OF SAN JOAOUN C N 06NC <br /> UZUC MTE1,ENVIRONMENTAL HEALTH OMRION, <br /> JOB ADNgasroR AHNR / /V •v/ PAEICEI <br /> S12EI�(pF <br /> OWNFIR'1 NAME cool N 7-bwo1 CI�fI I �/ A001ESF 150 / ✓ PeWNE <br /> EDNTIYE,DIL— C % �.I/1 uj V U • A111M •D• 2If-L ' �' FHOMItl&)g 1s5, <br /> SUR cONTAAGTDA ADOIIEIR / {.ICI RIME 1 <br /> TYPE a WOJJ AM O HEwwst O MaACEH.IENE WELL ❑ MGNTrom we W A ❑ OTHER <br /> ❑owxT1DN ❑ INEm ay m REPAIR CI anaaceMIEOT IEpwn ❑ vAFGH EXTRACTION Y+ai <br /> ❑NwFl3ftsk II N.p. DEPTH PUMP SET—FT- FIST WATER LEVEL. <br /> ITyRE DF RIIMN /IL' OGDr-OF-EIGTNCEWDA 13OEOPIYNCALWHLp ❑ IDE.eoIBM <br /> 36`b-1 <br /> INTENDED UFE ,vREawsL eON1TAUCTIO10 SPECIFICATIONS < <br /> ❑ wou"NAI 13 aFtN BOTTOM OIA OF WELL EXOAVATNIN DIA OF QONOUCTORGMEA <br /> ❑ MMEGTNVNUYATT LJ GMVGL PACx E TYPE OFCA&NDl1,EII,RVC CIA OF YIETL CMAC <br /> ❑ WBIJCIMWICIPAL ODPVEN 114 T OF GRDU MAL SPECSiCATION <br /> ❑ RWOATR,NMO 11 OTHER SHOW SEAL INSTALLyO BY GROUT SRAM NAME E <br /> Q MONITORING SNOUT SEAL NlWPEO: ❑Yw El NP CONCRETE KOrSTAL 1VDRRLEN❑V. ❑NP <br /> ATFMOx.OEPTN LOCANG CMESTPR SOXATOVE PIPE <br /> PROMISED ceNSiRHCTOARDNILIVO MrFMO: WO ROTARI' AM ROTARY AUGER CAN{_„_^�eTNER <br /> I HE.WY CERTIFY THAT 1 HAVE NIFPMED TNIe NPIJCATNM AND THAT THE Mw WR11E DONE N ACUONDANCE WITH SNI"A Rg"C01HlT/ORI NAHCEB,STATE LAWS•ANO BVup A,, <br /> REGULATIONS OF THE SAN JDADURN COUNTY NOME OWNER OR NEE42M A `S SIGNATURE CERTIFIES THE POLLONN 1 CERTIFY THAT N THE PEFF"DAMANCE OF THE WORK FOR WHtc <br /> TMR OEpA9R N KAUEO,t SHALL NOT MPLOY PERSONS 1IISJECT TO WOIY0.IAN'1 cOMPQ/S11TOM UVJSW CAUyo1N1A.' CONTRACTel1'a NwM OR BUStONTAACYIM RW NATURE EERTINE <br /> THE MUOWUIO: •I CERTIFY THAT THE P91OI1tANLT OF WOPLAOf WHICH THIS PERMIT N OVUM.1 SHALL EMPLOY PERFOND SUBJECT TO W WV OMAN'S COMPp1AT104 4m C <br /> �UFOWA.' THE CART MUS C HOA SQUIRMED IR 110101 AT }e, COMOIETE OIM.WIIG AT LDWER AREA PROVIDED. <br /> ea.ax <br /> PLOT ftA r M F W <br /> 1, NAMEB OR 9TRECTI OR 110ADe NFAREIT TO DA MUNONp TILE PROPERTY. E. LOCATION OF MUM EEWATIE dwpBµBySTHM ON PmaFUBEG <br /> , ODTUNE OF THE PNOPEIIIY.OIVNV 01W RIMMII AND MATH DI RECTION, EXPANSION OF SEWAGE DISPOSAL SYSTEMS. <br /> O. DIMENSIONED OUTUWIT AM IM.ATION OF ALL EXISTING AM PWROSED S. LOCATION OF WFL.e WTHN RADIUS OF ONE HUNDRED FIFTY M <br /> BTMKTURES,NCLWIW COVELED ARREAR SUCH AS PATIO/.NIREWAYS.AM WARMS ON THE FNOPEHTY OR ADJOINING PROFUTY. <br /> f <br /> . ... <br /> L <br /> .. <br /> ........... ....... ........... .. . }. <br /> : <br /> ' R <br /> _ .:... .: ., .... .: E.L. � ...;. ....... '.. � <br /> : <br /> OSNRMBR USE ONLY <br /> APPRNNMn♦fSnW,NI F. (/�-lL•/�. D.R. 6 R 7 .,� 9T <br /> Q ,SPLA IRwplatlRn er�.✓[/+y-�-- HIR. �PMRP� or 1>s. <br /> Datrutlen IANSrIMn M <br /> f <br /> I, <br /> A>] AcOOUNTGIO OM.yt AID' TAO! <br /> R C00" V... FR NFO AMDIMTRWTrEO CIISCIVICASH ROOM SY DATE FEINEFAELVIOE INOIi1T IHEABEI 01VvloE <br /> 3237 Fitzgerald Road P.O. Box 2231 • Rancho Cordova, CA 95741 (916) 852-9558 <br /> 2345 E. Childs Ave, • Merced, CA 95340 <br />