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APPLICATION FOR WELUPUMP PERMIT g�Ito <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES 771I <br /> ENVIRONMENTAL HEALTH DIVISION 2.2 � V a /n Q/) <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 OO �J w� <br /> (209)468.3420 - <br /> ROR'REFURDABLE PERMIT EXPIRES I TEAR FROM DATE URUEDANO I 3 CJ I <br /> RbWTAM M TTMA INSTALL <br /> AIAOUM COUNTY <br /> INTO <br /> DEVELO E TOY MI SANCHARTER <br /> nN COUXFY FOR A R1[AIi TO CDN[TRIICT AWgN INtIALL iNF MOIRE CE[C WBfO.7I113 A(RICAigX Ie 4A0(W COM0.1nNCl VIII MN <br /> JOAWIN COVMYOML0111FM rr11E CNAR[NR�111 .1M TI RANOAEOE OF FAN JOAWIN COUMY we CII(ALlll (nNCFt.ENVIRONMENTAL HEALTH CMMIN. <br /> JOS ADp1EIWnAX1I A cT 1.11 M!!/ARN <br /> O,AHM..Arre MVRet warty[ <br /> it COMMCT011 AOOR[t O i� 11 RqR r717t�� <br /> .MFCOMMCTOA 4)ORE[ MY MONS, <br /> NRR Dr WEIt/wAl" 0 Nrn.SIL 0 REIIACDMlM Wnt 0 ANNAMNW vrtu• ❑oIMN <br /> .� ❑.XT IT.. ❑W6t Wo,.RrAM ❑C..e .AAVMT RVA. ❑VMOII[AlMC1gN WlIL•� J <br /> O N...0 H.P. Of'.RYr' . w1OWAIENLEML PAYIVIt.IV O <br /> nvR DF wMn M .r <br /> ❑ovrowrelcnL WEur [3 wrteDRW <br /> RE001E ., <br /> b np <br /> f nFy ?pq 1 <br /> Lxr41Dw w[ nR OF'FOLyoxarnlCyox N,1FICAiwNJ <br /> ❑INOVerwAL OORN EV'.m OM.Or WELL EECAVATNIN dA,OFCCNTOQUAONLIRC FArI7'1IL—LUI NFfSIE,0FU06Nf'I.', <br /> , OW " <br /> ❑CV(nKMYVATI OMIL F..NWE OFcASYMNWIIPIII .orW(ILC <br /> O <br /> ❑RIRCMIMICnAL ODwMN VS..OF OMvr TIAL [RcxKArax .E <br /> 0 IMOAT.. co,m. ONvr e(AL WrtAILLO BY OroW eMW NAME E <br /> 0 MOMrO. OMvr E[AI NMFFO:OY. ON. coNCRre RO[ETµEr DNLLFROY� 01M s <br /> AFE ..SEVEN L...CMRIS M.AROVE PER, J <br /> AFOwE[O CONETNYCTgMIMLYNO ANSI MVO MTAV( AM MTMV AMEN C.tk OTMx <br /> I HERON COTTON THAT I,UN FRFARO TMC MA)CATRN AND THAT THE WORK WIIL Of MME M ACCORDANCE MfM[M.gAONX COUNfY OIpXAXCN.RAI!LAWS,AM AMSC AND <br /> ROU .OF THIS VAN MAORIS COIMTY.NOW THAN ON M[NwO AOEM'E IMMATURE CERNMES TR MLLOMTa"1 CERVY THAT MTM!RNEOIMM<!OF TIM MOR MR WHOM <br /> FOR RwRI 1t 1JMD.I NIALL.1EMROY RNwMt"OV7T TO WON.MAN'E COMIMEAOON LAWS W CMROIMLE:C.N`.M.E XRENO ON M<OMMCiMO.MANX CIWOR. <br /> THE,OLLOMM: 'I CITL THAT TR SO MANC[OF TM MOR FOR W H TMe RMw IV ISww.I MML[Mr1.OY RRVONe N CT TO WO MR'S COMFMSAOOR U O OF <br /> CAEIFOIMA' r[ FrER ALL N MIW M AOV.(IICV FM ALL NEOUIIEp 1\NS/reC `1,T 11%S'I AMi.[E,COV.!OM'MM AT IMARM AREA FI(NOIO. <br /> M".rA TIM. , <br /> ROI MN ON—,.0H.1.1 H. N_ <br /> A4le OF ETRRe ON MADE MAReT 1.O1eOUMM1a THE IFR10Y. A. LOCAraNOF NOUN...PONE.EV EVEN OR N'OwRO <br /> ].OVrLIM OFT.wDR1wY.OMa gMENNONV MN MRfN PAICTaM. tAPANW).Or SEWAOf WORDS.VVIEV V. <br /> 1.WWMN OVTLMe AM LMAIDN OF ALL IAIRMO AM)rMAOIO e.IOCA'..OF N[LLV MIN..OE OM HVIVE X.HWNM <br /> STINCIVRt.MLV W W CONERD AREAS MN AS RATIOS.WEVOWA.,ANO WMR S. ON THE MVAHV Y OR AVAMER a wDFDEry. <br /> � N N <br /> C) <br /> PAYMENT 77 <br /> 7 <br /> Q RECEIVED (C <br /> tv.�Q,cQE,, p MAY�12Qt77 <br /> - SAN 30AOUIN COUNTY <br /> -E�MMN.R)HEALTH S5 RWES <br /> A1ENiA(HEALTH(Mgglpp <br /> E //\(—n I )^/�� 'Jr`�lFMTNE",YVE—Y y/ <br /> 1 AE ( 1/W" [MSI ' 0.x `� V Mr ZIL <br /> nrw.n,..AwWIr EY <br /> 0..�...IN..I,..I...MN.e. oa <br /> xIINO e.r: <br /> re caval Frt MSD <br /> LOT..I,. cNecE MH Rtcpvm er Onrt r[T11TuwNa AM—NIMSW NvomE <br /> 05/8 3F p6 k5-2 <br /> veEltn SON.En WO.173(IMT) <br />