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APPLICATION FOR LIQUID WASTE PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O.BOX 3BB,446 N.SAN JOAQUIN ST,STOCKTON,CA 962014380 <br /> 12091 MR-2428 <br /> NONREFUNDABLE PERMIT EXPIRE$1 YEAR FROM BATE MSUEO <br /> FWW i.TTIpIWUI <br /> A ATMM IS XERWMADE TO THE.JOANCOUXTYFOR AFFNARTOCOFMRUoT RNOPOR INSTALLT1E...BL..Tk0..CXMRMMAGE NCOMRU Gt.BNI <br /> AAOUN.UNTY NWKONAEM�(04 T=CN ,.&IIM3 AVO THERNIOMp9 OF&nNJQA.W COUNTYRMUC K&TH B FFACE&ENVIPLWN HF TX DNBM& <br /> JOE ADDENY <br /> VOR A. f 0 0 E 1/Wy I;Ln LRY 94106n .T. <br /> OV/Non..ME 8e_P05i E4 FAFN'I'K AOME9e .CsMi morE S(3S-70'3 <br /> CDNTRACTDA m ,Le- F"Ila AODREN Po Anx; (,so IEL/(.nt<ssN R ,,, a35)773 <br /> MR CONTRACTOR AOORE88 UC/ RMNE <br /> .OF FVTC WOIFC MfW INETALLAIMN❑ RFIMMNMC0N OFITRULTMM <br /> M NPTIC WOW PFMNTEO IF MUM SEWER 18 AVMUME WITMN 208 FEET OF EMI1N0.1 REIN%T®TOI I 1 NDW M.WY <br /> M1iYNn! <br /> PMTA A MN..: REfMENCE NK co.wwAL 0 OTHER 13 <br /> NIN.aEI OF MUX.DIan:I RUMOR uOCAMCM: 3 .....wMXFMW <br /> A"jXMFLTER OF SOIL TO A NPT.OF]fEET: �1p C'ld R2iSu.,.,CXAM r WAT ER TAMP WPm <br /> FVIM TNWTwENE TRA, ❑TVIWfO CNACOY HO.COWA Fne <br /> ,NO miRm.MHT❑ M...To MARCO: WELL FOVNMT1011 ..SFE <br /> UPT SEATO.❑ GUM TYFf OFPU��WN / FANOOM1NPNMTORFNCU2EE08YOW)_ � �� 2 <br /> MA .INE p NO.\IMQTM OF... U, : bD CFMRNC!TC.T:.U. i6 FO....N�((``_PROPORY UIE� <br /> RL Em ❑WIDTH IER(1TX NTH OIBTANCE TO PERFECT:WELL FOUNDATMN PIMFE NNF <br /> MOWOEO ❑NWT. ItHOTX NTN DISTANCE TO NEhMST:WO2 MUNOATMN FRMERTY UNC `—'` <br /> F®AO[W. ❑DFTX_ CUT FaFaE1�OIBTANCE TO XEAKR:WELL FuROom P ,MW IINE JOV <br /> SUMM ❑YroTH IETOTN MIH_EeTANCE TO NlAIEMT:WELL_fMnOATMN�PI Doo,UNE O <br /> M[,OSM.M. ❑WMTX LfNOTX MI. C%TRPKE TO NENRUFT:WELL_F.NDATMN RMK.UFE <br /> I..F NRTFT THAT I HAVE nno, f TMe A FUCATMM NO THAT THE MAIM VAU M COME N K'LOFMMICf WTTN BNI J OU M COUnTY OFMMAE AND STATE UWO.NO RUA; <br /> NAK.IATMNB OF TNI UN AAWIN COUNTY.HOME OYMER OR UCMUC MCFMe MN UK CERTEYH TIEFOU-0 .0:9 CERTIEYTXAT INTNEPDFO.A E OF THSNTN(FORMON <br /> IMBiPMR131Rp DO IyNM TfMROYANYKRFONINBUCHAMNNERNTOUCOMEWRIECTTONOMWN'SCOMK ONUWBOFCMIFOIMIA• COR M TOR'BXNNOOR <br /> nMRUF T.a COMJNWIATURECMDIMIETNEFMA.' TA:'ICf .T MOO. NE PEAF011MMICl MCI NON PoMUOUMR UKTU`C@19M/EDIWN1fMPIDY KIEOMNEMCTIO ^ <br /> WONMAH'0.COMKNOATIONUWBOFEICM1F0r110111A' T'NE APRICNTMWTCALL'N NOW N/IWNC[FOR YL RfON11®NEKTONS..MRFlEd1AVAN0 EfLOW �J <br /> NOMFDA ��31a dA,✓ <br /> V� nor PI C MTAW TO BLMPI scAJE 'm <br /> 1. 0, Fl.on PoAN HEARECTDIMU TO S EOINIOWC TN CTM.,Y. 4.IOLATMN OF MOUfFNWNFMWVL%BfFM gINMMEEO <br /> 8.OUNNf OF0URMPDOY.WRCDTIONOf 9 MMXOMN CRONKCTMX. EXCATFONOFeEWAAINN GOFON. <br /> J.mumon,COWFUD T)NOIACATI PATFM, EIIBTMOAMO WAMC- BIMMNKB, E.IDCATMM Of VrEW'MTMN N.NV[OF NIE MVXCIED FlFTY T.OM <br /> INCUNMO COVEP`.➢ANFAB MAX N PATMe.NEVIWAYE,NO WAU[0. TK RMKATY OR NIAWNA PMKNTY. <br /> 1 L <br /> � O <br /> �wadv Doe <br /> _ 1 <br /> P-AYMENT <br /> gFf�.�2i "E3 <br /> JUN 181996 <br /> _ SAN J. 4c UIN tJvv.T _..._. <br /> i, '�:_ _.NVIPO^NMENTAL HEALTH <br /> O <br /> FOR DEPARTMENT WE ouoY r_ <br /> NRILATMx AccfarEOw r ,pN- DATE: AIFA:�� <br /> V L <br /> TANK,mOR MNW WEI[CTION BY OPR / / FNFI INNECTIO.EY GATE ,l g,4G <br /> ANfMNM..MMIXTE: <br /> /MCOUMIIXOOTF.Y: MOF FAC/ <br /> K COOL FH WPo M/OOXT RdNTT® CX6 NN IISMVm 9Y OAIE M/EMETR NMN. MCC <br />