|
PerntI t No
<br /> ?'I'I Date. I9st""l
<br /> .It• ,
<br /> "!, , ;'� r l i• t.. + I.• „If;, ( „ ;+I it 11 I. Ili ,t r Irt frr a hermit to construct
<br /> , + i„ i. ,I. 1 I I '• a1,;r l I I l i„„ I�. r Ic• {tl t',,lupl Lance Mlth San Joaquin
<br />' �. lt' , :r'. I+ ' n; i r l „1,! It.. •,li lr ;..!,-: „i I I n I"ruTrtln Local Health District.
<br /> CENSUS TRACT
<br /> tv
<br /> Phone
<br /> "I'V T ' I 0I.SItl ( 1lUN / 7
<br /> I I,i" i 1-�'Y I i"I? k !' I P 1'l"I I' it 1'I'LAI:I•:P11iNT v -
<br />.I , t;;l•I, w ' ,i ! Vii! .•I' 1' 11'. TA,:F �' 'I •' I. .1 11',I.. I l I Ill i IVl'. ....___--___ ------------�
<br /> I r ?!I;• . '.,. I I l.i L! 1 '. �I !' I+ { 1't'ACI: I'I'1' OTHER
<br />-_-- l;f'i 1" I111411(: U+("!Fti'1TC WELL _ '
<br /> I ;f!:1:1!I I+ ! .r I „I 1,'1 I I OV;1111h,i [ON SPC( I F ICATIONS
<br /> IScaVrtinit
<br /> I. ,' I'i. :011 ('aalnt,
<br /> iv. I: I.:lit,• 1',I I' l+• , ... ,// •�
<br />�- ✓- ! rt fh.tl i..l. t/' I,I I':•• !
<br /> I 1' IrI lI'' ,j"(h •'I t;l.�llt ',t,;-i1 __ •
<br />_. .- - '; 1'in , i, .,I• - :,ttl ,t t! i1-4tall0e!
<br /> !;! •1! . I:'„1•I it„tt,•
<br />'I'"ll' i'll'.•e I!t; / / '�( !t � '�I't l i)•.nle'
<br /> n1' , t11!I,r ximnte Depth
<br /> ~ Ih, ql ril,•• H,IL, t I I I ,tI„! I't I r e I I k I
<br /> L liclk•I,V a1',r00 t„ I:orilIN. WIt11 4111 ki an,! 10glil.;iti,u1s ul tlt•' !;att-.loatittin~Local Health District
<br /> tn,! t !,- `:f;lIc +�t 1',11 ( 1 Ini.l 1, 'rt.Itr(Ilt' 1 . .,I r,'gul"Itlttt; wtl "oI ;tructfon. Within FIFTEEN DAYS
<br /> if t e't , .Iml,lct f oli I,I on :I lww I.-,'l I , 1 wi l l ! uru ish t ill• Matt .Joatiu(n Local Health District a
<br />:I:l.l. 11kll.i,l.ltti 1'1 t',thl' .,I tit., %,011 Hill lw(t II V (lictil IwI,,re 1'ut illi” the We I Iu use. The above
<br /> i tf,rrrl-f•tl,)It Irt True' L„ till' Ili..•t ,I nv I:nce!I.•,1);0 ,till 1101101 . 1 WIIA CA! 1. 1'0R A GROUT INSPECTION
<br /> I:IL!toor.L4.. (iltltllT:l ;l. AND
<br /> / (I!IiAI; I'I.+)I' 1'I•At; (t;. Itl:\'I i;' I." 2;11) r]r
<br /> _ J lLM l)FVAJ(I'111'.1:'I U14'. +)NI,Y ;.
<br /> r l l 11, I I'l l'n it',' DAT
<br /> oll
<br /> I ,,, 1 I r I II11AS1. I I i/I'INAL _INSPECTION
<br /> I..';:il 1 I 1 III'; Ili - DATE
<br /> b'71
<br />
|