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[ 1 <br /> APPLICATION FOR PERMIT <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1901 E. LIAZELTON 4VP-, STOCKTON. CA <br /> Telephone (2091 466-M! <br /> PERMIT EXPtR_ES 1 YEAR FROM DATE ISSUED <br /> iColnpiete i7I Ttip6catel <br /> Apvs:ation a herebq r1a7e!o the Sen Japwar Lout M-M ChsTnct 1-a perm to craw nxf ar►�;or i�tha woA t-a th tleserlba�TRI!applkaAEer is <br /> "title to osnpfimr"with son josouin Count,Ordrnanca Ys.541 to sewn"or No.1467 far w-q,VL"V and thb%k.%end Pepulbbom of r"SenJolgnln <br /> LocA Haaith District. <br /> "f"d)C <br /> k Job Addmo i;;!t, Lot Sire pfN <br /> Onmsrs Nemo !✓�f1iL E � , S.4r•t <br /> Cmtranw,Name <br /> TYPE OF WELL/PUMP., NEW WELL L, WELL REPLACEME-W •_ DESTRUCTION ti <br />+ PUMP INSTALLATiM C SYSTXM REPA14 OTHER 0 <br /> 1 DISTANCE TO NEAFIEST: SEPTIC TANK SEWER U.VES _ OISPOSAL FLD- PROP.L14 <br /> f FOUViDATION AGRICLILTUK WELL OTHER WELL PirS,SrJMM <br /> INTIaIDED USE TYPE OF tM1/EL1 PROBLEM AREA COt+f3TR11CT101 I SPECIFICArMS <br /> Intluetrial 0 Open Bottom ;>riLe oce D;lL Of VMd Eacaystlon_ Die.01,6W Casing r� <br /> L]DornestieiPrlvsls C Grrrrel P# C Tracy TV00OfC-k <br /> 6 -- ., 5pat:illCstlorrs� �•. <br /> Public G Dttrat ,=:DaRa Depth or Grow Swl ,. Typo Of Orwt <br /> lJ lrrigatipn _• AW",Dowth v Entem swftm sew frutaled br <br /> Reprtr Wor#Done ❑ T"M of pu" H.P. State Wart Done <br /> wel DaOvucfiom C Web Din"teter <br /> See6rq FilrMtid ltep:�'1 <br /> ' Depth Fier that W 18don 5 n <br /> TY?E OF SEPTIC WOgK: NEW MSTALLA: ON:1 REPAIRIADOMO-•1._ CESTRUGTION rJ iNo spot:svatsnr pe*+Atted M <br /> poetic eeww is <br /> a+rsltehiR wref-in 2p0 Ieer1.1 , <br /> Ir lt6sttun salve: Raalrlarroe! teora+rwe re _ One. le E V/ <br /> ldurteat a1 a,+np rMNta —L Numb«of tardraonte Y <br /> chwaa0r of coil to a dept* a fallr____ dt-'a <br /> LEEPM TANK iY! L� -- L <br /> w �� � h; <br /> roeIllMpr�Caueetftr_.!_�r1J� tvo Canpsretreerts ,. <br /> grow <br /> PKG.,TREATMENT PLT.a Mathod of Diepesal <br /> O1tw"to neo OM vww F.-Ow.r.w ptop"u- 120 <br /> L E%c"MO LINE r.. Np,i Lanett ce!tree r Teal <br /> FILTER BED L] Oisprroa • • _ <br /> to rrsneu: W� <br /> �,r�. Fetndaeat,(o Llns �. <br /> .Q. Prvparly <br /> SEEPAGE PITS --7 - Sue <br /> SNliitP S g ,10W"W nov WO, MAf Fea40@n .100 .. Pro"IV t.mo. 2ne_ <br /> DISPOSAL PONDS in <br /> I hOrrW PRAY ew 1 flag orevowT thio sims •x-t"and drat uta,tart."be*"n accord w"wMlt S.er►Joetpdn eerlrrlY a"i�fllgCesy peD!At+tw.Ind ` <br /> n11e0!lend ropiAeTiOrre of tfre Sen Jestluer LOosl ItOlr1lh D�ea+ex. ..� <br /> Homs owwer a fioatwl agsnl a eiprweow.atvxrt�as tM tlolewwra;'t aesllr tl'rr M ties Isrrtsrnw,oa al Il+s wed 7nr tdrfeR thio ps►nMf M Irrutd f eRNI ON 'is <br /> t vi w"aw parom M Nreh tw~as to become eubfat to-ft—'s ec+epeessew ww Of C&UGmi&'Ca+aaesers Mrft Or p,b.Ootenelslq.IpnNer. ' <br /> croon 00 MZftv*w.q oatflfY ow M on prM'wormwm of v"-art fQ WYRfr f s ownrt li bOMdL I shw ert+pl"pos ox wl im to wolimaws comp~ �'^ <br /> thn 10we of CamoR+b,' i <br /> .ha apok ere Rgne 4011 foram rowiNw,ertripecx CM99% erlurnp Ott!wren wd& <br /> SOred <br /> MTIHENT un ONLY <br /> Applk8400 A00slwed br Z='. ._sa '-,=�.. .._ Dao _ Am n <br /> On).GaaA MapMc M Aia,..'��-�r,���.� -21-Y—1—f bW rtepac by <br /> Ad. olid Cep ittwo st <br /> O Set *64M Cl Lodl 3916WI a Awsnta a M7101 0 Tracy M64SM <br /> A PSCO l-Agtw t alt ODPWG toe BSI 16601 Pw"WSandors MM L Kamileon Ave_P.O.Bas 3MR SdL.CA 96 '1 <br /> Fff 0 Ata7JN!C" AMp19MT pLterTTtD CK 4�Sr t>E[D►[D RV DAT! An <br /> we tee.rt1.r 0. <br /> pSle 77 <br /> r 1 <br />