My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SU0011425
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
F
>
4 (STATE ROUTE 4)
>
9355
>
2600 - Land Use Program
>
PA-1700112
>
SU0011425
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/20/2024 9:09:39 AM
Creation date
9/4/2019 6:46:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0011425
PE
2631
FACILITY_NAME
PA-1700112
STREET_NUMBER
9355
Direction
W
STREET_NAME
STATE ROUTE 4
City
STOCKTON
Zip
95206-
APN
13109021
ENTERED_DATE
7/18/2017 12:00:00 AM
SITE_LOCATION
9355 W HWY 4
RECEIVED_DATE
7/17/2017 12:00:00 AM
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\F\HWY 4\9355\PA-1700112\SU0011425\APPL.PDF \MIGRATIONS\F\HWY 4\9355\PA-1700112\SU0011425\EHD COND.PDF \MIGRATIONS\F\HWY 4\9355\PA-1700112\SU0011425\EHD PERM.PDF \MIGRATIONS\F\HWY 4\9355\PA-1700112\SU0011425\MISC.PDF
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
31
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
APPLICATION FOR 1VELLIPUMP PERMITS— <br /> SAN JOAOUIN COUNTY PUBLIC HEALTH SERVICES PAYMENT <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P 0 BOX 388,448 N.SAN JOAQUIN ST.,STOCKTON,CA 98201388 RECEIVED <br /> (209)4683420 J AN 0 5 10116 <br /> NOKREFUNDRBLE PERMIT EXPIRES I MR FROM DATE ISSUED SAN JCI ;'UIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> 1ONETR b h DIORMNI ENVIIANI�f Ef i EA I <br /> ARLCATION IB HERE BY MAOf TO THE BMI JOAOUN COUNTY MR A l£1WIT TO COxSTRVCT AN0/OR INSTALL THE WOq(OE6CPoBEO.T.AN'IICA N <br /> JOAQUIN COIXIfY DEVFLOPIAENi TITUL CHAPTER 91115.3 AND THE STANDAR M OF SAN JOAQUIN COUENT(PMUC"M/� TN BERVICEB.ENVIRON FNTJ.L HEALTH DFA I , <br /> SS 1 cm $IOCIC F CT q L <br /> OJONBMAEAOO'6PEBBAIR APNJ ./ 1 AOOIEtl(] FA r � PARCEL <br /> 81FAPHE <br /> NAME wL — PHONE <br /> CONTPA OR s gI-,ALIO hbM-'F gQGI'lzF <br /> s <br /> BUB OT .R &f`% (4 A VG PHON / <br /> TYPE OF W PUMP: ,❑ NEY/W ❑XERACFNENT N91 O MONITORING WELL B ❑OTHER <br /> IQJINBTPLLATpN L WELL BYBTEM REPAIR ❑CIIOBB{ONNELr... 11VAPoRFIRMCTION WEILP J <br /> �rE DrINw ORgYr <br /> Hp.J� DEPTH RIMP6E7ZQFT. POEM WATER LEVEL Q p <br /> (TYPEOf FVM% <br /> ❑OVTLFBFRVICE WEII ❑OEORN6ICK WMLI ❑ BOIL BOWNO <br /> ❑OESTRIJ[TION: I� <br /> W <br /> INTENDED U6FPE OF W¢L M6111UCT10N BR4ACAl1ONB A Lit <br /> O IMMTIBAL 00PFH BOTTOM DIA.OF MU.EXCAVATION W.OF CONDUCTOR CAMM p V, <br /> O DOMESTIC"WATE OGRAVELPACKISUE TYFEOFCASINO/STHVPVC W.OF Wf1L CASINO p <br /> 0 PMUC/MUNICIPAL ❑ONVEN OFPTHOFOROUT.M 6PEMMAT*R p�[� <br /> O IRgWTION/Ao ❑OTHER BMW BELL INSTALUM BY GROUT SPARD NAME ��T <br /> 0 Noma. GROUT DEAL mm m:0 V. O N. cowsuE FEOEBTa.BY oFQ,m O Yr [IN. s <br /> A X.DEPTH LOLXIN3CMUTERBOXWOVEPUT 5 <br /> RWPoYD CONBIeULIXIXRIWLIINO METHOD: MUD ROTARY AM ROTAFY AUGER CABLE OTHER <br /> I HE%EBY MRTIPY"AT I HAVE PRPA ED THIS AqL N ANO THAT THE VRIK WILL BE DOM W ACCORDANCE W VAN JMGUM C HTY ONEHNAACM E TATE LAM,AND RULES NO <br /> REGULATIONS OF THE SAI"AOWNCOUpNTY. HO O Ipl d(IX:FNBED AZI:% =NATURE CEIRIFIESTHE FOLWVYHB:'I CERTIFY THAT W THE PERFORMANCE OF THE WVIK FOR WMICH <br /> THIS W=TEM FM I yP l N88 EJECT TO WORAMAN'S COMFFM111 lAW6 FCAV(ORNU COMRACTORB HIRING 00.8UetONTINCTN1p SIGNATURE CEATFIEB <br /> THE fOLmWMO E TNATN iIAfY E•BOEF THE WOIK FOR NNICH; FPm RI^tl�FDI �KtCPpAPE MAWBhCT TGO WOAX�i„DPENSATON IAWBOF <br /> CAUFOpIIA' T AXT MV T CIAT <br /> Mo.X B aA I nn .. ,� 9.r�M o r�� D. r --5 96 <br /> WDT FLAN ROPIE.6wM1 6u'. DA6 <br /> i.OA OF TEETS PRORRY,O6NEARESTTOOKBAND RIGNOR THERCTION.. B. RIAMEON OF HOUSE SMA 6EWAOEWBPo&LL BS. OR%SIIOem <br /> S.NEN OFTHETUNES N LOCAMNE OHdIION OF AN8ANONORTH FmOFON. IXPNTION OFBflYAOE WN08AIUS OFON <br /> J, ,M TU)NFO O LURING AND LOCATION OF ALL F%IS PATM, <br /> ,D FPDR AYS. 6.LOCATION OF TY O ADJOINING <br /> MON6 OF ONE NVPpIm FIFTY FT, <br /> 6TRVCNPEB,INCLUDING COVERED AREAE BVCH N PATM)8,DW VEWAYB.AND WNXB. ON THE Rbff1fIY OR ApJ01 WNO PROPIXTY. <br /> wed <br /> _ 0 Pic puce, <br /> Ri,waj 4 <br /> JT� PAYME-Olt <br /> JAN <br /> - -- - <br /> .�NUBLIC.IKJSI.TFI S�HWt..ES" I <br /> rNiJL.HTk'I':'Nr.AL'I'H'1rl''3`Sit <br /> 'Ff' <br /> osARFMart EEE <br /> APO—.Aeae%N er <br /> Grpn lrrrpstlen By IDN PiRRI. M. lFy pH. <br /> Oatrulbn IrpwUon BY O.. <br /> c.n.rr,.r No ni. "(J?A2. <br /> AcmuxTWa ONLY: 1 AIOB FAG <br /> Ifcppu F!ytl <br /> ANouxT mm ASx Rmevm ar DATE 1lBAITIBEIMCE REpuELr x11WD1 WVOICE <br /> a s <br />
The URL can be used to link to this page
Your browser does not support the video tag.