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<br /> .inri 1h;ot ruin;
<br /> ,)9,1 pp, I,I.,,. f t r Ix,
<br /> 4 % b'.;I vt ton N I,rw
<br /> (a n t ra c t q r I; sjH:ne
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<br /> T Y F E I)r WILL PUMP W')t'. pit �iZ i Pf PL Ai f 1j 1,
<br /> t_. (iESTLUtilCthi.J
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<br /> illi I Ar-1*1 1Q NI.Alii I 11'. TA
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<br /> INTENULD U%(
<br /> PROkiM AAFA ot:;'I
<br /> inouitrIAj
<br /> Ij t of ii?l I I cazaI inn
<br /> t C Pr Iva I l' ;AC I
<br /> WA VO I
<br /> I— rutIl ic
<br /> ,''thee
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<br /> (A thild L PI 0!0<t i 1)r -aLlont.
<br /> r (If �oqul 'wal
<br /> k-opl'j I ca I
<br /> Other
<br /> (A'O !Io-11 ;11lC41
<br /> Peph ir Work throe Tyro I
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<br /> wri I ��•—t�='�_" _. ___ _ •t: _`_ ..� _�.y�_. �
<br /> tW%,(ru,!i-Inwl-i I 111fi Nat or int stop
<br /> I.,. KI tor ill i
<br /> TYPE Or SEPTIC Wr)kK; 1`41W ;N1,TAkI,AT;0N kfPAjR/Af)OlTJl1,N I— Ot Ic
<br /> _j ONO w, 1.jnk or si8;,,.3q1 p4t pVr.vt,,tv,j if pu!.jjc
<br /> I njta I I at lull wi I i AV.1 I 14blf- wl thij) UC;
<br /> 5erve: �jr-fjc p (URIIIA'If.14 1 Othor 4 TMS
<br /> Number of I ivillij units: sufflipor of bedroomi;
<br /> Lot %i.v
<br /> Character of soil to 4 drptn 01 1 feet
<br /> Maur t),',Ie depth
<br /> S(Pl I C TAhk ry PO Im f"
<br /> UPdc NO, C.mparth*nlil;
<br /> PKG, lKAIMENT PLI, r:rIltav ty "
<br /> hi-0,I)d of DI
<br /> %[WAG( SYSTfM 014tan(- to near-Iitj Wv I I
<br /> Ot. I'luf1dation Propoct; Lire
<br /> T vur.T I ON ❑
<br /> UACMING LINL NO, A Oingth of llnp< Total lienyth/019
<br /> I JL%k DO Dwamcot tis nVol-O"t: wvl I P r o p t-f—t y-
<br /> StRAGE I'M Depth lf'oriber
<br /> SUMPS f_-1 01%lince to tir.i.-rilIt: Well FOunddtiOrl Pruporty 11nir
<br /> UISPOSAL P(MOS L-1
<br /> I hc rob.v certify that I have pri,N rvil t I,I I nppliC4tton AIIIJ tho.t *.k-I:- Para will be in OCC orkjAn%:f, with ;4n joa;ju I A coI'Jn Z y
<br /> ordlinance%. SOUP )awl, and rule: and regulAtion% of the 5,4n Joaquin Lnc,at Health District,
<br /> ROC-le 0'*rVr 0C liCenivill agent's Oqnaturp certiflat the ful)0i"In— "i certify il-st In the p4wformAncn of the worl, for whijj this
<br /> rwrmit Is isvit-ol, I shall not k-Ploy any oe,%un in such inannor ;' ti) w0j,,-cL to e-,rkman1% componsajin!) IAWS Of CAllforniA."
<br /> Contractor's hiring or 5uts-co0trae.iling signature L?rtjfio*,
<br /> � the tj)jj()wjttq: "I certify th4%t in tho I'ItIt-forTmoCr of the work for whiCh
<br /> this PC"Ot is issued, I -hall ovr;,I(vv pp—011t SubjOCt to worknuin'% o:eAmjK#nI,.atIan law, of Csilifornta."
<br /> Tfiv app,I rwjul,od injp&L t jImI,, Coopletv dr, wing an reverse gide,
<br /> %ignod A Can ilt C Title, Claw C J.
<br /> 04 PUA.,rMENT kiSt i'NIV
<br /> A,-,PI (At�OA A SC4466-6791
<br /> Additional Owiment
<br /> --------- j Lodi 36'4.3611
<br /> Pit pr Grtiuj InsiloIctir... by.1 sate Manteca 813.71f14
<br /> by J,Iit- I'a t 0 1-L Trary 835.63E
<br /> Applicant Return all (apies invirme,m-itAl Health Pormit/Skirvi(os 1601 C, fla.rolton Avt?,, P.0. 111) 009, Stk., C 1,
<br /> Vii pAiE prpIqly III).
<br /> iq i,I irl jq
<br /> ANk-111.1 i,i I'lim;i:ii;
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