Laserfiche WebLink
APPLICATION FOR WELLIPUMP PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> } ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 <br /> (209)468-3420 <br /> MON•REFOIDAILE PERMIT UMNEI 1 TEAL FROM OATS IlIVES <br /> MompistE In Tr}IREtx1 <br /> APPLICATION to tM4E NY MADE 70 THE RAH JOAOAIIN COUNTY FOR A POURT TO COHETIRICT AM11 11 MITALL THE WONL DESCNMO.TME APPUCATON IN MAOE N COMRIA m WOH SAN <br /> JOAOLIM COUNT`T TIEVFLLOF7AENT TTn1•CHAPTER 0.1115.3 AND"A ETANDMbR OF SM JOADUIN COIN"PORLIC HEALTH SEMMES,EtMOIAEMAL HEALTH MVIOMN. <br /> JOB AOORSSMA AMY 14800 Schulte R d. crrY Tracy PAr1C11 SIZFJAPIM <br /> OWNEIYS NAAE T r.a c y operators ADDRESS P.0.B o x 1 2 1 1 Tracy FROM• <br /> coHTRAc7DR Freitas Electric , Inc . ADDRESS P.O.Bx 16 Banta,., 453962 .Ow1835-2814 <br /> MIS C011TMCTOR ADDRSS 61 S-3�) UCI FRNE I <br /> YUP OF MLMNA► ❑mW wEu. ❑11EFLAcumm wnL ❑MoMTaRMO WELL P ❑OTHER_ <br /> AS[ <br /> S ll h ❑MOTALLATIOII ❑n rMA REPAN 13IP <br /> Cmovwco my ❑VAPOR EMPIACMN WELL E J <br /> ❑N.-ElINP.. H.P. -j U DEPTH PLh%w NET L FIRST WATIM LEVEL O <br /> AYH OF PUMP! <br /> ❑oLTT4RS[RVK(WELL ❑SEoP1LYBCAI WELLS ❑ EOG somom <br /> ❑OESTPAICTON: <br /> A <br /> ELATE <br /> ❑OWI 001TOM OM OF WELL EXCAVATION IIA.OP CoFIDucTOR CASOM 0 <br /> ❑GRAVEL PA7UERE TVH OF CAMNOfETEELTVC M&DF WELL CAEMO O <br /> ❑PVRLCAmnmc PAL ❑OFSVEN OEPTN OF OFIX"SEK SPECIFICATION R <br /> ❑OWMATMUAG ❑OT"m OItlUi PEAL METALLED n _ OROVT BRAND HAMS <br /> ❑UDWOM M O100T MAL nANHO ❑Yr [IN. CONCRTE HOESTAL En OIRLHI:[IV- ❑N. : <br /> APPROX.OOFN 260 LOCRSM CtEST01 SOITRTOVE PIPE d <br /> P1IOP'OSI!CORSTRVCRORRXVLLNPO NETH00: MIO ROTARYNII ROTARY AIIOtH_ CA/U! OTEEP__ <br /> I"MWf C'MT"THAI I HAVE PREPARED TM APPLArATM AND THAT THE WONC WILL M DOW W ACCOI DAA WITH SAN JOAOIIM COIRITY OISISIANCES,RATE LAWS.AND MRES AND <br /> APOULATIOP S OF THE SAH JOAOUIN COUNTY. ME HOOWNS#OR LICENSEE`ADEM►'S GUMAMPIE CERTIFIES THE 7°OLLOww10:•1 CERnA•THAT W THE P W*MANM OF THE WORK FON Wt"CN <br /> EIS <br /> Tfft PETT IN FSSIED,I SHALL NOT EMPLOY PE MNN MJECT TO SFOIRAMN-S CoWSMArWR LAWS OF CAAEOMSA'CONTRACTO"HRSPIO OR SUSCOPrMACTMO SIGNATURE CERTRRS <br /> lHl!RT%.IOYVSIS: '1 C NAT M T/IE PERFOMAANCE OF THE WT)RK POR WH"TMS I'ERGRT A 1EEUED.1 SHALL EMPLOY PE/1ROM 1UlJECT TO LFOIgRM'E COMFESAAR101F LAWS OF <br /> CALi01SRA,• 7 CAL 04 HO N ADVANOS PORI ALL IShTtA%M IN AT 1'!641 MM <br /> S-0417.COMPLETE DFMMAWIO AT LONP AREA PM V11". �yyTEy <br /> TRA.—�[I/ L��I-�- Ow. <br /> PLOT RAM ar..r 1.:..l R.-+.Y N <br /> 1.FUWES OF STREETS OR ROADS IIEARST TO OR SOIMORIO T1*PIOPEP". 4. LOCATM OF HOUSE MWAOE DISPOSAL SYSTEM OR PROPOMO <br /> E MONORTH DIRECTDIRECTION-E,OWLROF THE PROPERTY,ONStS DRAEMM AND CTN- EXPANSION OP SEWAGE L7WOSIL VY Wf. <br /> 7ILRIF. <br /> .00AFF S10Pt0 OVR MID LOCATION Of ALL EXI/THIO ANO"KH-CMD 1.LOCATION OF WELLS WWW"RAMA OF 011E WWXWP F?TY FT. <br /> STMJCRREI.WCUMM COVER"ARAB REICH M PATIOS,DRIVEWAYS.AND WAIS. OR THE NOPBRY OR ADJOIM FIOPIRTY. <br /> .«....�...: <br /> , I <br /> . .i......;...;.SSSS.... <br /> : . .. <br /> ,. ... .;SSSS i. . � ...• I t , <br /> i <br /> .•.SSSS ., ..-....:....r........ s.. ... i ' I <br /> LI) <br /> :... hhA <br /> r• yf'r�� <br /> oCT o is9a <br /> ar:4lF <br /> L'P,4iliC:rlap�anlr'f Ly..I,K:� <br /> SSSS.. .. .. ...� <br /> � ppARTMe1T w1 DEEM <br /> AMR.."-A..wrl.f w^ � O U A.- <br /> 0-6 <br /> br0—YwP�IF.,w_ O.N PI—P w <br /> i <br /> O.N.I.r..,.,....11P. <br /> NY O.I. <br /> ACCOVRTWO OMT- AOP /ACF <br /> H coo" FEEINFO IMI,STTFD ASN MCMV["■Y DATq POS,Sr14 1 RGLAMT NUUMN LMVOICI <br /> [' O <br /> SiZDC) <br />