Laserfiche WebLink
ArrLs %;&KLVa rya r�vas <br /> SAN .AQUIN COONTX PUBLIC, HEALTH ' ICHS <br /> q V ENVIBt3�t MTi L HEALTH DIVISI <br /> — qM— / 2 P O BOX 2409, STOC TQN, CA 95201 <br /> (209). 46 :-3447 <. <br /> l ample a in 'reiviieatw) <br /> Applieatio to bare* ft".%G SNaa J*&Q48 Comsty for a p*Wt to constrwt wWor.inet*4 the work herein d*scrtDed. This <br /> ao"Gatitn is mde is emoudotei vttb Baa J*siwo County Ordinance Bo. '149`Bad 1862 ALIS Rules WA Aerl3.atio" or JA <br /> Jewwa Cataty ?ubile Realtb Be1�►seM. <br /> Job Addrea AA&)-4- 133- It G'o4. ",t City , ti.. � Lot Silt/Aeros,Se ........�.. <br /> Owner`s Name Aftess _g G S :Y• F� 'aln.�n st Pie :15—3 <br /> yLs-9712 <br /> Cwtrst:ISr Atldres: L,rt:iense IVo S r. + _Piton. i <br /> TYPE OF WILLIPUMP: NEW WELL O WELL REPLACEMENT C3 DESTRUCTION Out of siriics ell <br /> PUMP WSTALLATIOWC�-' SYSTEM REPAIR' CI OTHER 0 Monitoring Well Al <br /> DISTANCE TO NEAREST: $!P?IC=TAW SEWER LINE$ -CIMSAL FLO. PROP. LINE <br /> Ttf�f AGRICULTU !-WELLOTHER WELD._ PITS/SUMPS <br /> N. <br /> &TENDED USE TYPE OF WELL PIRGUM AREA CONSTRUCTION,SM601CATIONS b2ir4t <br /> � <br /> 11 Mdwasl O Opal Bottom CI Mangy Du. of Well Excavation tris. of Wad Catletq <br /> U DownstietPriwte O P O Tracy Typs of C••�+a Enfr . Specitications.,.�` <br /> C3 Public 1T Dow/fi f3 Delta OWh of Grout SAI Tree of <br /> G k"o~ QQ AW*a. Depth 0 Islam Sulfate&W Inswmmo av <br /> Aspsit Work Dons L] Tap*of Pump M.P. State work Oona <br /> Wap Destruction O Wag Dismatw Sealing material i papth � <br /> {+" Tiller material i <br /> TY E SEPTIC WORK. NEW INS ALLATSCIM 0 REPAIRIA06ITIDN n DE STRUCTON C1 (No septic system pen*t*d if public sliver is C <br /> svailabis within 200 feet.) <br /> wdtMe*m will slew: Residence._ Conwnsrcial Otha <br /> Nuntbw of#WAS units Nwnber of bedrooms.. <br /> C wacar of soil to a depth of 3 twe Water table depth <br /> SEPTIC TANK O TypsiMtp Capacity No. Compartments <br /> PKG.TREATMENT PLT.O <br /> OWA11 a to nWOW Well Foundation Prope=E1 <br /> LEACHING LINE n No.A Lensth of Maes Total(enol <br /> FILTER 990 O Distance to nearest: Wap Foundation Pr4p�ty � Y <br /> SEEPAGE PITS I I Depth Siaae Num <br /> SUMPS U Ostartee tonewow. Wee r.,.,...r.. FoundstiottProperty Line <br /> DEPOSAL PONOS O <br /> I hwWV tw*V that I hew prepared an 00scatlon and that the work wii;.be dam in eecor"with San Joaquin county ordinaness, Buie lows, and <br /> rww and re"wiene of the San Joaquin Comm <br /> Morels owwnsr or Ikwood s9wWs donotvn wtiflee the folowr":-1 cwtft that in the po6ormince of the work for whkh this pwmu is issued.I shsE not <br /> aftyby Mty person a such n>se w ss to bstAm subject to wwodmw*s comweation is"of California."Contrsctoes haring or sub contrsadnp si#Wkm <br /> COON the toMewkv;"1 CWWy the in the pedorumnce of*4 work for which this pemsit is issued.t snap smpicy persons vAWt to workman's conWwtw <br /> tion laws of <br /> The call for aNWK tions. Complete drawing on rwerse we. <br /> Sipn*dTip*: -71151 • Data: I Z- <br /> >+�� O DEPARTMENT USE ONLY <br /> ApoksbonAseepad .c�. ey <br /> Oat, - Y A,,, 3 <br /> Pit at Gran btspseSeh by a 9Z-Final Iempetfoo by Dais 2- <br /> Addkk"Catww"1: <br /> AmIleant - ReWrs Ail Copies 'toe SAN ,fpggt#IN CSWMR IC smart MVIC'm <br /> UVIAONNOTAL U&TH DIVISION PMI?/32*VICZS <br /> nib N SAN JOAQUIN, P 0 901 ZOOM, STOCKTON. CA 96101 <br /> CK I Spa AMOUNT Oull AMOUNT REtATTEO A N RECEN /r GATE lE11sA1T'N0. <br /> . IM 13-36 dWV.si• <br />