|
k<
<br /> 1�
<br /> A1)T'1.1t:AT10N F'I-t1; IIE11I11'r
<br /> 3 SAN JOAQUIN (,()U1vTY PURIAC 11F:ALT11 SERVICES
<br /> [ RNVI1(0NNF.NTAi. 11f•:h:.T13 DIVISION
<br /> 1601 E. 11AZELI'ON AVE. , P110NF: (209)468-3420 2
<br /> F' U 13OX '.'.[)'f!l, '�I'OCKI'UN, CA 95201
<br /> PF4 .Y1�IE>!7:i_.l. I)ATE ISSUED
<br /> (Compl" f' in Triplicate)
<br /> Afr/Ica t:or. I GPrrty f de to San Zna Zu Ir r r••: rust and/or !no*All the work here!r. deaerI bwd. This
<br /> aDA11emic,n t. me ad :a clti�liarcr' with Sm .•naqutn•,',-.a:y Cr.!'r:•aa-. N°. 49 +red 1862 and Lhe FTulea and Ref[vIALlona of "ST!Josgt.In Covrtr ['O llc !I•alth Ser+rtcea.
<br /> 7 f .
<br /> .)Db AdI!•nat _ L'.•.T �i '� .__ / _._._--lC't+- -__ �_r✓ :LOt Sf Ew/FCrrage Dd/A/��_-- -
<br /> Qwner't ka^ ,'L�� �, Iia•�'C%'J 7r..,t..:�"4Z 'i� f_ _ ?.��fs-- Phone
<br /> Ce^.•.r;ta '��� � _ ` -- °-. _ t.tetse No.
<br /> I TYPF OF_._.t._ 4'U!111 t.(Y:V:ELL .'.!;.. ['•'. Lf'.4f`41 pLSSRUC'Ii)Y i' Out of Service Well 0 _
<br /> t Ptj!'r r!iSTALLAT;OY PEPAt[t OTHtR ;, Mon[tcrit* Yell E�
<br /> f —
<br /> pSSTA4CE TCJ*�F'ARES?—cF.��� p• _. ;r�_'•!n �.••r-, _ �.__�..+ t„SPC'Snl FLO.._—____.._ PROP Llf!° ..c-
<br /> ril FOUNL4TION — ACr:': 1 :.[il _ _ _07�4Ea VOELL-- PITSISULTP:i
<br /> INTMENU,vSF TN PF CF Yd(tt PtIC.PIfAnt I S1gC,[sC'1T10NS —
<br /> ■f��ww I L,dr,..[real . . OPw^7n!..,^, - '.',^ter• -. .'-*It F.tarAtr'I - _. __.._ O,a of Welt Casrnp
<br /> i1 C'i7�T`eaht Dr.va!e i 6•:1,01 PATI I'AcY ,.[M f,M"Cl . ...._--_ —_._..—.. 50E'C•+•tl:rant t
<br /> ,'t P„ht:L Ot`,e, I7c�,:e .r•I.... (;,n.1 `,Pat Teal of Grwt_..•__. } 1
<br /> E I i lnq�,rt,nn Apryn. 7nyrh f»',;wen i..r'P r aeel E•.Na'Wd 1'Y
<br /> i
<br /> Repair wo,t Dune TYfte of Pump - 04 r SIA14'No•k Jane --
<br /> Wa1:Oattruct,nn '? Wwn Ginn,.te•
<br /> *.r,^
<br /> T\'FE OF SF-I'f1C WUPK N[W tN',TAIf AIION ...u[PA"I At• i•,1'•': V I;l' !nIICIi,)ff IN Seri W.■Yale•^per—flet"
<br /> d P., ",We ra � it
<br /> ava•lihle wdh,n MJ feel 1
<br /> --
<br /> sey- `n
<br /> Sn11ir!ahan wilso" plt�denr! •-+^,r•LP' l"•.•.
<br /> Nun+ba•Of Lvmp un-- Nu•+,br•of had•ac^,. •^-• t
<br /> ChafWiff of sod to It drnln al 3'eet ,.. __.-__ w. __._.`.___........_.._-.waren table deprh —
<br /> SFPTtC TAN[( No. Cornpann+ants
<br /> PKG. TREATMENT PLT 1;
<br /> Method of O,sposal _. : 1111y1
<br /> Dist trine lar nwa,ewt Lti r'I I:. ::il , _. _.. f'rr•[,wnY l.:M—..._.._.� E t;
<br /> LEACHING LINE
<br /> ----iF •'to 6 L•• :'h n'^•+rt _- _.,r ., t,Ia''ic-w, Sita—,i
<br /> FILTER REO D•srancc r'rr.ra•Psl. t',wl�»G1Y;-t s� e.L,•, �C�f� P,at'eRY Line _��'>+ i
<br /> SEEPAGE PIIS I ["Olt, ._. .-•-•--- -`'v.. ,� ... N,.,•+Ire• _..._�.----— '—
<br /> SUMPS k (),,tame to nnalell Wit, - t• .^''n,a,n _ PfnftaflV L,rya
<br /> DiSPOSA:. PONDS
<br /> 1 harabY Cart�ly 1'•41 1 r-PVP•P,PP»•wd 0"t dl,til,ab[`^a.a, "a :•,� n. ., ."� a f•r�.l»••reit ,1,•San Juegwn County arTf•n�nCeL sHla I.,srs. antl
<br /> Wfes and•opuln+s•n}of it, Sn•, Jnnrue: L`curl
<br /> n+ a n :,rw rwrM et thw Inlh•M•.0 • , '•e•," .:ntn of the Arlrl Ion which this pem+rl IS ISswtad-I aM•'i nOt
<br /> Home Owna,n, !SEs•cnJ nfjn Q •
<br /> *!%ploy anY pafs,m,r such ria'•^e+as 10 Lr.,o,•`s 4ah.ar.''1•++,,•'..P`,• ,r•+u•r�sw t..•,�or Cninlroclor's hr'np at sub contrac1mq sl4rature .
<br /> eertd,tls the To11nw ng :I Cato,!ort,n the Oer'o„*,ar(a p!I' :,>,,!•, '„.�•.i”•''.'[,<'^'' y stv•il Sha=1 employ poisons aut)IeC1 to wor4man'9 COrtlpansa i.
<br /> tion taws rf Caldutn,a
<br /> The or"w.aor n.ut1 cap for ■k1It
<br /> ,w,tu�rwrl Wit tl cH..r+t l-nrn[a«•n.r».+�.� 'n•••re t its l
<br /> s,Yned x !.. ! '�.([a !.l . U�a1 �: bala•Gr
<br /> J X FORrF['ARTlS'il.�1T USE OHtr / p f [
<br /> /
<br /> Apnt,eat,or-Arc e[!nr1 Pr /.C-.-.._._- -fir----_►-r �.. - -----_... ..q ,
<br /> Pd w Grout Inaty'r t�nn hl "61 ,na'e:ncn t•Y lG�'� _ Oatls� �•
<br /> f,rpltcant - Pet:rn •11 code. •o: r F,,•:1t G�ur:y . .! : ?w�: .".
<br /> newt' .. `` :r ._^- 'n: !....:.. E'wr•�f!':•ry:,r••
<br /> ]ht',1 )'w ,ere.'%r. A: � i'•. .,ti<7:, S4•rnt n, C:p !i i.'.01 `y
<br /> \• PtAMIT k0 F
<br />
|