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APPLICATION FOR PERMIT
<br /> y. BAN JOAQUIN COUNTY PUBLIC HRALTh. w.?RVICRS
<br /> n RNVIROMMTAL HEALTH DIVISION
<br /> 1601 E. HAZELTON AVE., PHONE (209)468-3420
<br /> P O BOX 2009, STOCKTON, CA 95201
<br /> PERMIT RIEPIRW I YEAR-FROM DATE ISSUED
<br /> (Complete in Triplicate)
<br /> AppliftUm Is tw"by mm to Us JoRI Caaftr.'or • Perdit'to i;metraot a,War Install the YvrY Eer.le Aesrrlhed: Thi• %
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<br /> OISTANCE TO NEAREST: SEPTIC TANK SEWER LINES DiSPOSAi I I'll UNE v..
<br /> FOUNDATION AGRICVLTURE WILL ._— OTHER WILL PRS/SVM/S ;
<br /> INTENDED USE TYPE OF WELL PROBLEM AREA "CONSTRUCTION SPECIFICATIONS '� 1
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<br /> 'NIA' s r PIE - AM'JtINT PNJ'E AMOUNT R[WTTfP AlGEI.IO FY � .A'tf f Maw P�
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