Laserfiche WebLink
r <br /> • f �' 1 1 1 <br /> I �• I11 •.• .�j <br /> f <br /> G <br /> GEOGRAPHICAL 1 ' ! 11 ' 1INATES X- Y TOWNSHIPI RANGE SFCTION <br /> INSTALLATION: ■ WELL SYSTEM REPAIR ■ CROSS-CONNECT REPAIR ■ VAPOR EXTRACTION <br /> 1 # NEW ■ REPAIR DEPTH PUMP SET FIR4T <br /> ■ • • ■ GEOTECHNICAL ■ SOIL BORINGA ! / � �S• <br /> INTENDED OF WELL CONSTRUCTIONd • <br /> .13 INDUSTRIAL 11 OPEN BOTTOM WELL EXCAVATION DIA_ CONDUCTOR CASING DIA—I�X29 <br /> 0 DOMESTIC PRIVATE 0 GRAVEL PACVJSlZE.— WELL CASING TYPE WELL CASING DiA <br /> PUBUCJMUNJCIPAL [3 DRIVEN. GROUT SEAL DEPTH... SPECIFICATION <br /> rIRRIGAIi OTHER GROUT #NAME <br /> 13 MONITORING. GROUT SEAL PUMPED: 0 YES 0 NO <br /> 0 CHRISTY BOX '13 STOVE PIPE. CONCRETE PEDESTAL BY DRWR: 0 YES E3 NO <br /> APPROXIMATE WEDEPTN <br /> •'• / • • I' I f •• 1 • I' ROTARY. OTHER <br /> PREPAREDI HEREBY CERTIFY THAT I HAVE THIS APPLICATION1 E WORK WILL BE DONE IN ACCORDANCE <br /> JOAQUIN COUNTYORDINANCES, 1 RULES AND REGULATIONS. I ALSO CERTIFY <br /> 1 ICALIFORNIACONTRACTORS BOARD 1 1•, WORKMAN'S <br /> COMPENSATION <br /> 24 HOUR ADVANCE NOTICE Q <br /> M RE UIREP FOR INSPECTIONS <br /> 'SIGNED D. <br /> lllilii/!/��I.��ir�fliii■iliiii�iiiiii�iii <br /> llllilil il/iliii�!Jll�Ol/l���Jiriat�>.►.ar,�''���i'r�1�i3�� �1�?�i <br /> lily��'"��;171��ii■!!i,':IJ�Gliiifirir►/,l��r.��.'���;�i■iiri <br /> illir/s�,�,1��1:L%[moi i�.".CilllR�lllllllllr�llllliliiii <br /> ilii rEi}'e�i■1i�S A©_ffrl_��_�f_iliii�_�iiii■ii■iiiiii■i <br /> �lli�lU.Cr;'�i�llCi�rlar■r�t�i/�.•, .'�R��llll■llliliill■i <br /> ill�li�71f1�1�.Ilialll■llrlfilliMAislll!lllllllliillii <br /> lil/llrll�ll�iillL!�I/.T�i�i�L11;`���::1J+�1►��'illll■illi■i <br /> ill llllli:7lll�ll■ll lil1011ll■llllillllii <br /> s=i=�lllrsll■l�E.lr'l�f�!lll�IAlllllllll■illl■■i <br /> ■ll llllll�►9li llll� llllllllllllll�;llli�'+Jlil�il�C� iii <br /> 111 llllll Ii±ll�>•llllllllllll�llllii3�l3�3�iii�ili <br /> illlllll �1_Ill■�l�l--iiiiiiiilil��s����l�i��� <br /> DEPARTMENT USE ONLY <br /> Application Accepted Bv�//;��W/ <br /> it■l■NN�/�!!I■lull■lllllll■lllllli�ll�liu`7li <br /> illllNl•lll ill■lllllllllllllllNll�li��t9!!li <br /> %L! 1. ' Area <br /> Grout Inspection B / •. #. <br /> COMMENTS <br />