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<br /> APPLICATION FON PERMIT
<br /> SAN JOAQUIN LOCAL HEALTH DISTRICT
<br /> 1601 E. HAZE',.Toril AVE., STOCKI'ON, CA
<br /> Tclt;pholli; Q09) 466.674 1
<br /> PERMIT EXPIRES 1 YEAR FROM DATE ISSUED
<br /> 1Cnntplr'te in ITi111u.ill
<br /> AgtpLc;,l.nn ry hrnlLv n,.rrL:to L,e`.ian Jn.upnnt I oral il,!ahi,D,S;r�.,:Irl:..n•.......!rn rnnaauc!.tnr,'nr nt..cail t..rr v:nrk nr•rrm desrnhod-This appl,c;.non Is
<br /> mild.,el corned, wish 5'mJu.ufuur Co„nty Cir,b nen.a t:n '.::,i.r�..na.IC n,.,, i!ir.?in..+•,I1,p,rn.t.,.nd ni.•Hl,ty.":,.tF.equ Mnr,ns or trru Sen Jn.,q,nn
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<br /> t kL"Lti -�C7l:�1��L'• .. A.1.Ir,"«�5. /5.JI-}' v�1/'c� ,�-1'•I7L'w �:} hnnr,r?_!!✓_'/--�� -',U�.[_f� f
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<br /> TWE or VVE.LLIPUM-P_ ":F Cll4'I:L1. i. :dEil.Iltht.ACt%1i .T
<br /> PUMP IN5TALLAI-ION i. SYSTE:ht RLP:.IIi i' (?THtR ii
<br />{ DISTA9ICF TO FiEAREST, SEPTIC TANK: ._..._____. SL':r'H 11NES _ Eli5i'OSAL F'l Q .__. F'f'iOr' IJNF. ; )
<br /> IP:IEt41)ED USE IYVE Or WELL PFiC1ilLL67 ARk?:. COt:S1Rt:i ttO:l 5f IC1FtC%.11G::S
<br /> Inrlustnal 1 1 Ggwn Will rn.l I''Aiantrc:. ;3.a :A Wi:11 Fre:,alrcnt _. _ D,d.ql Wc!I -
<br /> !i Unme.shc l Pnvale f i Gravel Park Irary 1 t" of[:.1•.rr•.g
<br /> I-1 Public i(Till:, theta D.-$'O,r.l ,:.n.:S<'.rf .,- _ Type of Gti.ul
<br /> I i ler,tlsuun Ap;,,.. h1'
<br /> Repro. Wr•.rk Rnna E 1 7YIne at Punkt _ ..... H I' _ .. _.._ ._ `•r:n<:Ll'nrk Done: V e
<br /> Weil Destcuchon i 1 %Fell D,am wee ._..-__ •.hnp Ad.Itrr,al I;,r..'.:S't N
<br /> Depin _._..__ _ I'llc. h,ww,{
<br /> IYPF.OEC SLPI 1C,wflliK NLW IN SI At I AT ION i Ilk PAIN'.Ylef1{flu::� !�I':I HrJ{:Ii()N'• IN.r t I11-11fic .1'WQr i$
<br /> ..// .iota,7011 N!'.1 1
<br /> 1nSlallaursn wdi server ResrdnmeX
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<br /> Number of I. nlB...Ws: ._ ... f1,.m b.•yu1 lsede�ur•'' - _ i}
<br /> FCharact.!t U'soil to a depth nl 3 1ecl: �iL�`f .. _ _ Wal.: table dept,
<br />` SEPTIC TANK �i 1YM'l Mf,J SA•tr� �c71�.r L�GI r- C,I;..i,.�:v l'YI/y'-�'7iL.P:n Comionanw:n[s ___-."�---- [�`
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<br /> PKG. TREATMENT PLT.i I hlrrlhlxS of D.soos:I
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<br /> Ustance ht nedresl. W01Gf.Z) loun•t.r,.n:,1C} i'::,. l
<br /> E,EACHING LINE No ti t rnlrth of l.nr s iC Irl�� ,tlur,,t length'a! .7155 -
<br /> FET.:Eli PER I I Deila... to nearest We!;iC .r Fuund.t u.+n ICY T I',,.perly I.Ine
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<br /> StEPAGE I'll5 I ' Ilui'.[h ......_-- Suer
<br /> SUMPS I I De lan^e to.....uest, W'.11 Fn,.nd.,t:n,l - ProP•;ny
<br /> OISPOSAt PONDS ! i
<br /> pL I hereby cert lfy that I have.peuprale[I ln❑app6i anon and ih,rt In.•.v r,.nil!nr.1IL11-.r .,:...ur..u,..e. 1: ,..n JDaQu:n Ccwlly bn hM1anr.l:i.Slat'lawis,i
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