Laserfiche WebLink
APPLICATION FOR WELLIPUMP PERMIT <br /> SAN JOADUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P,O.BOX 980,3N EAST WEBER AVENUE,STOCKTON.CA 95201388 <br /> 1209)4883420 <br /> NONREFUNDABLE PERMIT EXPIRES 1 YEAR FROM BATE ISSUED <br /> AMECATION IRE UE TO THE SAN MAWN COUNEY FOR A P TO CIOONNSTRUb i IRATIIIREINNICITI <br /> ALL TMW L ROTIES ION IB MATE MdMgIANCE VAIN SAN <br /> JOAQUIN COUNTY OEVLOTEFM TIME.tAPTFI9-1116.8 AIA TNFrtANTNEB OF RAH MAMAN COUNTY HEALTH SERVBEB.ENRRONMEMµHEALTH OMN. <br /> . .A.NE.RNRAPN1 1YLG43 bur, GiNn PARCELEIEMAMI <br /> — OYROn A HAMS _ ALV(A/ ATDaee S.AMb FERREE <br /> coEFRAcronn AIEMn S/STJP A+ ma e-r Ix�/3 <br /> JEE.'I INONE 19�f'E'O(1/7 <br /> Me coMRAcroR .14.10 !7$' ADOMB✓-Fr"y 9�Z/S— ME PIAHE• <br /> _ <br /> TYRE OF WELE.R11ia p NEW VT.LL p 1,R OEAEM WELL ❑MOMIOMNO WSLL f ❑OTHER <br /> 9 byn.(7/Q pMAALATbN pWELL.11M REPAM ptro..-O. FCT FEPAEE p VA#O.EX N.T..WELL I <br /> IvJ <br /> YR 11—;?RO* N.P. j DENHFUMPBET—N. FINTWATENLEVEL O <br /> OYPYOFFVMPI R� e 1 LnCC 034VZV-^WGA" ❑OUFLRRERVICE WELL p OEORIVMCµWELLI <br /> p BOR ROIMb B <br /> — ❑MBIRIICTpN: <br /> IMENDE.OBF TYPE OF WELL CONtiRVCIbX tPFCNICAi A <br /> R13O/MDUCTMµ pORNROTTOM MA,OF YELL EXCAVATMN OA,OF CONDUCTOR CAEINO O <br /> pL OOMEBTbAMVATE 11 RAOM IACXM2E TYPE OF FASTNGAI"EI?VE DIA,OF WELL CA&NO <br /> ` 11 rbAR .AL 0ORVM DEPIN OI OROOT Rµ M£CNICATbN A <br /> p MSOAT.. 13 OTHER O-M BEµIHSTALLIO 11 OMNI OR NO NAME E <br /> p BEOMTORMp OROUT BEµPULARD:p Y. [I Hr mxcgETE PEUBiu EV DMELEx❑Y. pN. s <br /> APTOZ,ppTN t..CHETER e0X/BFOVE RM B <br /> — FROIOBfOCOMtTRUCMINAIRIINO MA1bO: MVOpT4RY AIR ROTAT' AEbER CAME OTHER <br /> 1 MEEY CEAXV THAT I HAW MRFAMO TMB AMLCATbN AND THAT THE VpRL WRL NMBE OOM M ACCOROA`RY'YON BAH MAdIIN COVNIV OIpIHANCEB.BIATf UWB.ANp MREB AMO <br /> MOINATpNB OF THE BAN MW <br /> AON COUNTY.HOME OFR OR LICFNMO AGENT'. <br /> BIOMATVRE CENRXWMMN <br /> A THE FOLLOO;'I CRv THAT IN THE FfRF.FNAHCE OF THE VAN(FOR VAMN <br /> rIM MONEY 10 ISEVEO,1 MALL NOT EMROY PERMMBB 1111O WOPXMA.F.COMgItAMN LAM OF CµNRMA.'COMRACTONB"NO OR Eu-CONMCTMO BMNANRE CERROEB <br /> THE FOLLOYANO: -1 CENFV THAT M TIR IFW.RMANRF OF THE Y .FOR N'NEbH TMB MMAR IB MEOTO,I MALL V OY MRgNB NehCT TO WOAIW ANY COMIpBA..EAYY OF <br /> TALRONMA' THE MINT CALL N IbWM IN AWAME FOR ALL REOUIEN MB NON.AT 1 Bp.NXO.COM11ETf ORVMNO AT LOWfR AREA IMWOEO. <br /> (X/g <br /> — N.ivE X ` //i/ f'�TNI.f� Dn. 2— _ • T <br /> nor THE n)w,e Ee.1.1 BeM._ <br /> 1.NAMEA OF NMRB PE FOATY, NEAREST TO OR AN..FII TIIF RAMRry, B LOCATION OF IbUM BFNApE 018q8µBYNFM OR AbIgBfO "D <br /> Y <br /> .O1rtLME OF THE NgERry.OMNO O1MfNSgM ANO NJNN p11[tibH. EXPANMON OF BONAOf dBPoBµAYBMEM, <br /> ].MERNMOMO ONNN.FMO LOCATbN OF ALL EXNFMO ANO H,TMSfO S.LOCATbN OF WELLS WRMH MdVB OF ONE HUNDRED IIFTY FT. <br /> — STROYMNEE.EWLMONb COVERED AMAB SUCH AE PAibB.DRVA ..ANO WNA.. ON HE PNJK"OR ADMININO RgMNv. <br /> — ^ <br /> Z b <br /> I't993 <br /> ur'r; '1 T l�79d <br /> DEPARTMENT VSE ONLY <br /> AFWenIen AEpgNB eY �ryoy/-�+-LL MM <br /> n:.M N.P.e,Nn Br OEN PREM I:w»nen er EJs Aa.+� DM. It" <br /> � Os,ne,lm hnev,M er <br /> 0.0 <br /> ACCOIMTMO OMLF. <br /> PE Coo" fM1NF0 AMOUNT ROMTIFO CIRC A.N PElfV...1 OR, P[MAITNOMCF REOVMT NUMSM IMVOIC{ <br /> o ne lqll iz a a <br /> Pub.HB.M Serv, EDVIA.173 <br />