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F An AGRICULTURE WELL ER Wc,". <br /> orTYPE OF WEU PROOLEM AR%Vj- M&U1))fVN SPECtt1CATt' S_ <br /> in ORCM acttom`:/ Q Mnnwk:. dta, of-WOH Excavation 0i3. of WCttczpm0 <br /> rr Ct GrdvCt JOAQUW COUN',tTYvASUC4 I-TIR SEA.VTCFS SpociiiCations <br /> ry Oth r J9MWNMENT14pe ffZ4"HsA1VISION Trw of Grout <br /> , • Mar+ ...._�pptca.�� �'Sl�a+��QUx�.tla����tst,�u �468-^3420 <br /> :r work oono C Typo of Pump P OHO% ,pp09, ST <br /> It t3xtn,at,a, O K:ret O:�rsGser seslisad Yaterias: a Depth <br /> UR&MR9 RATE -IMM <br /> YYP Of S PTI WORK. NEW IN T"LLATION I i E . rA � If i ! <br /> C S .,, tJ i (No arptrc tiyslem p rrvgt`d.t p r0 <br /> Ayplicatioa is hereby m4a,to San JotukuLn Costnty for a permit to construct and/or fa "Re"vorh herein described. This <br /> toUfttion is ameae in gat*lituseo with San Joat;uia Coa,aty Ordinate No. 549 and 1862 and the Rules mad R*aglsUono of San <br /> JwAuia Cavaty Public XmIth Sorriaco._ _ <br /> Ch ..,e::.t of TraAy,CQ1.d3 atQ _g9 --TrzaLC F:e�t �sieYartaei�a• - <br /> 'r�ri � f4 Scute 14.6 - <br /> "OwrGsot7*44 AV<;NTAI�ce Company Address Miami . FT. '4'4172 Mothodof 0 — <br /> Dwxm,:c to neerest: tc�dlt�A T���D�t0s1I3�i bra.' Properry Uro r- <br /> _12S V%ddieas No. <br /> MFIVIN <br /> L MP PU� tJ�A4Ci O WCH"""" SfAYR"l`�? piO 'laitoria� Wall <br /> Pte <br /> 'T16 vAmF. <br /> OIS p !TYPE OF WELL PROBLEM AREA CONSTRUCTION oteCl I ATlONS <br /> . tilt'that I novo Rf�°�Bplita:t t ho worAsis beo0nok <br /> t��tasrsalt t+ u WW or <br /> fn `� � w <br /> of ® Tracy Typo oCasi � r In �,V(T(4 <br /> -inch <br /> a ticcn:�enen,ro c7+irti:y�tifgl8wing: I cGptblTiVdR+tQt^�^ olfiBe�raric for +�f* ti�flfm�t slot <br /> percon in--may rr�r cs to omo a�� t to workman': o po t; r�-I aktottoro. ' Contrscto+'s R nnq ar sutrconrracdn sir,:,tg e <br /> WN-10:v, <br /> i�N-10 topow,ng: ^f�Ccr t�FFi4P�t�rmc'rtc f work for�ftrt4+i rsYr�t u , <br /> slgatbt dJ' Typa at Puma M,P, ____ State Work Dona_ <br /> oaCao 5l4wn CE7 fail tt zrts trans Comalota Fly a 4tr93�1l� d <br /> D:Pth Piller Ihterial 6 Depth <br /> .2 OF SEPTIC WORK. NEW INSTALLATION I 1 REPAIR/ADDITION I s OST UCT M 1 7'90 septic system pe►r*+itt Ruble tetwor+v <br /> I rt`: 9�,l ,:- rr .mac:r avabbbt*within200 foot.l <br /> ksstas sUm weft smrvo: Rode"co_ Commoreief_ Other <br /> Number of living Y4*c: Number of bodrooms <br /> *Mack"of SW to's ecpttt ouf=ui <br /> td�T-Ct errrncc: O Typo/Mfg CapacitNo. Com m _... <br /> PKQ. TA1AThQNT PLT. o oY-W <br /> Applicant - 12oturt, 1 co tcoa too::svn ��gq�s__.tglo Count publ c ticolth 9ervt�rgq_ Lino- <br /> i nvil tbrett�--kea�{�f Aph 9 �'=y <br /> 445 H San J009U1a, F Q Box 2009 9tkn rA X5201 <br /> LEACMNG WifC A�SOt.h1 Z A tjU 0 vto 0y F MEiir til NC. <br /> FILT@R MG Page I 3A <br /> EM t <br /> •y SIEPAGE PITS I I Own $iso Number <br /> SUMPS L1 Octamo to not: Wal! Foundation Ptoo*fry Lino <br /> DISPOSAL PONDS O <br /> I haeeby Corti y that I have peoparCd this application end that the work.will bo dono in aceordanea with San Joaquin county ordinances,state Jaws, snd <br /> rW=andiregulo0am of the Stn Jeowin Cviaty <br /> Homo owns a I betat's Comatur*c artitres rho foNowing:"I COW that in rho aottormanee of the work fw wtsich they <br /> permii is awed, i shed not <br /> employ any pvwn in such ncnnar as W boc*mo subject to wwknon's compensation laws of Cawarnia."Contractors tvfing or subcontracting signature <br /> 000U baa fisc f*tknwmg: "I C&tdy"in ft parfoanum of the work far which this parmit is Im adi,I thaS empioy pzrrorts supper to wo(ktn7n'a eomoonss- <br /> tion ktwo of CaW*mio,'• <br /> The apptioaret m as for G) Dir ior+a. Cornpicto drawing an t*verae side. <br /> Segned IL- <br /> Keith D. ColamaI eto:-. <br /> TiManager, Regulatory Affair ��*; -- 07/29/94 <br /> FOR OQPARTMEIBT U3tF tSAIly <br /> A001400O.A Aoc=tod by Dot* Areo <br /> Ph or Grout inspection by We Pmol womthm by Date <br /> Addhional Conananm <br /> APPiicant - Ilaturs all eaglet to: 90.11 Joaggio Cownty public Health service* <br /> 8nvirommatal Neaith PoratIVOervicea I <br /> 445 H Sao Joaauia, P O Box 2009, Stkn, CA 25201 <br /> FEEC AMOUNT OtJ! AMOUNT AEt,Wt t EO CASH RECt:1Ygo aV DATE pEAMiT NO• <br /> s�z� .)'Aso <br /> 0 Page 13A <br /> 10 <br /> TDTaL eo <br />