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FEE-22-1995 13:42 FROM PRECISION SAMPLING TO 4341365 P.02 <br /> APFUCATION FOR WRP M'AlIdT <br /> ""UN AAa= COMM PUBLIC 1(6ALTR SBRNICIS fir► �r — � �"] � <br /> EITIRONYIENTAL KBLT11 01=109 9� <br /> P Q BOX 384 44 1L SAY JOACUM ST.3TOCKT11L CA SGZ914XI <br /> 0910 4"3420 � <br /> Rps�sxnaslP oEA1fT F7LPiRE;<f�'FJ�t FWN DATE mum <br /> ?99 <br /> ��a is Tn;pfaseil <br /> Agplieation is here by aide to the San Jasquirt Cars►tt for a pasrwis ea cavns:ruer ardlar ifl6t3[t Ylne tii /4}Z16d�ep�iiV�a►.iLt�tsrim is <br /> wade in caaptimce with san daamen C=&M oeveioprent Title, Cisaprer 9-1175.3 and the stanesn�s eti'QCT«R��J� L lac deatth <br /> serviers, &Wi—v ntaL Heaton Division. <br /> Jab Ad&=Sfor AP119 -:IAM Id dils Dict, Z_3 - city '14mr sr Pareet s97elA?trC �T❑ _ <br /> are+er's :aroc Chyeyz-�� iP1=..�13z�z� _�acm�anyaadr ass 5(rl� ,a;fiaaa , ar),m_ �p,t Phone 0U 437 D 6r <br /> CorRsaCer P�6C�S�CIx! i+�1�T.. r�+��AddteSS��f�fST}40 �1�7C$ �l��j� ftwe <br /> tub tat+crarccor <br /> �ddr%S% 9 ""Ciel Phone <br /> rnp WLLIKW- : 13 New CELL a t&LAC91M QLL G )WITUt1Yi'i wiu �i� El Ursa <br /> El M72=70A Ea a ffl-ef-MVICs y¢LL 17 4EWWYSTuL %1ELL # Er salt. sally 22 <br /> 4 tOTALIATIOM B krL L Sy%,MW RFFAil< Q CWS^S-C O11ME-r REPAIR u VAPOR E7Rualas WELL f <br /> a Aa a Repair H.?_ aBPTx mw SET FT. FIRST WtER LzlrEl. <br /> (TYPE OF fAs1P1 <br /> Irrms utg 1WOTEiL SPIMRG7711RR <br /> 17 IMMMTx1AL 13 CP0 WTTCf1 au. OF #XLL WCAVATIt9 GEA. Of CLRDI.'CTGR CASING <br /> El gMsTIC/PRIVATE EI WAWL Patz/SIZE rYvs ag cAs=VS7a.ljV : 01A. OF YELL CASING <br /> (3 gSLjClMariC:PAL 13 oRltIEx OajT[ CF GROUT zu SPECIFICATICIK <br /> E3 iRRIEATIONM Ig anot soil boriings Gaarir SEAL DWALLM 9Y team 60PA WAW—� T <br /> {I MORITORIM QXVT SM MOW: a yes G No =NCRETS PEDESTAL BY DRILLER: U !es 0 Na <br /> 1Pmm DEPTEI 7 fermi_ L=IkG CRSTE3 s;aVnm PIPE <br /> AIBP tD i �TIIOas Ma ROTARY AIR 20TART AVGFR_ajL6_OTHER-1 \ <br /> I Pby certify d1at I have Prepared this appLicesion and that merit wail he done in a000r4arso V{tl1 San iotifin Coun[Y Oro irk-,es, <br /> rtace Laws, end Rales and F=ulatiaru of eke San losi}ew CORMY. NooQ owner or ticensmd agez+e's siynecure cm <br /> rcifies tl�e ietlerinsx •! <br /> ecrttfy chat in the psrfortrnce of the work far which this permit is iscmd, I sMLL not aptay petrSOM subi� tu-UWJQW"S CL71Pf SATItat <br /> Labs of cat Efemia.' contractor's hiring or M&-contracting signage certifies the fol Loving: " I Certify that in The perfvraran^e <br /> of the war>: for which :his peroic is issued, I swell enptoypersoetsSr�jett Ce ti10Rgti11'S cxrPsrsATld Laws of CiLifonfa_" TEIElFPUCAXT <br /> IWC c3Lt z} 1 ALL lE�ifa 20104"AT 02)4W 3411, eclnpiete dras+inq atyt�ak�er.,arae prorided. <br /> Signed <br /> x Title <br /> �V.t�6.1 Daae <br /> t <br /> e <br /> ae�tlTar��sser <br /> AMlisaiian Accapted gy MCC 13 9.5 Area <br /> arrunt Inspection aY cask pump Irtspwaian 3y Dace Da <br /> caste�ian inspeCtian 9y Oats _ - C3 <br /> conne" :, •�'� �T �D. 2)jw�tS V <br /> DD W ' <br /> FP1 <br /> YfI1RR an'Y RIs= fAGf rn)) , F- 11 <br /> == REE WO AUMM"iL TTEI C8 <br />