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TWSAN JOACIINPDIISY�ALBEALTHDIVION 445 Y SAN JOAQIILY, PHONE (209)463-3420 a p� P 0 BOX 2009 , STO=ON, CA 95201Kh k DAEt TT EXPIRES 1 1EAR FROM DATE ISSIIED J7A 1 if 1902 (Complete is Tripllcate) tf.,I IRON i FN_. I—A ' .kppl.'cstloa is hereby made :° San Joagio , County far a per': t° coastnxe: and/or i°ataL` :he vacsr1 e1a�dt�sLc��y`3ed. F l �' s cstton is mde In c�_aace v,-- Sao Joaquin Cauat• O iasace 3o. 549 mad 1862 and tie Bttlesr i�w9.•rPX"'Y °t�t1C 4 f Pp- aequla Cauaty i'ubL'c 3eith Services. 2947 Diavy [)r re City Gtec'ctor _ Lot Site!Acresge n�^,r.�,? =mac JO° '6°f°aa 888 S. Figueroa St. Santa Fe Pacific Pl celine Address Los Anceles CA 9001 Phone ?� /aAF-70 " Owner's Name 2825 E. Myrtle St. Spectrum Excloraticn Address Stockton License Na.11 51 ??r8 ph...209/465 _ .anT:auor - -VPc OF WELL/PUMP 2 NEW WELL }{+ WELL REPLACEMENT Ci GEST RUCTION a Out aS Service ':e77 . PUMP INSTALLATICN C SYSTEM REPAIR C OTHER C :Aoaitorims Re_ L. DISTANCE TO NEAREST: SEPTIC TANK N/A SEWER UNES N/A DISPOSAL PLO. N/A PROP. UNE &50 FOUNDATION N/A AGAICULTURE`NELL N A oTHER 'NELL > 1on PITSISUMPS >I r O iNTEN0E0 USE TYPE OF WELL PROBLEM AREA CONSTRUCTION SPECIFICATIONS cc C Inausmal C Coen Bottom C Manteca Dia. of Wed Excavation u.L7 Inches ,oia. of well Casing 5-Tr^^ PVC Specifications 0.02" Slot (l Oamestic/Private C Gravel PIC; C Tracy Type o1 Casing I'1 Pupliq [l Omer, fl Ddu Oepm of Grout Seat �'3 Flet — Type of Grow Pnt•+1 an(T ��men- Soetruth Exa prat on I I Irrigation _Apaga. Death I I Eaatt°n surface S"Installedtry H.P. Stan Work Oane Repair Work Done ❑ Type of Puma Sealing ,yuri&L L Depth - Well CestrVctio rtt n C Weil Diaeter 1-=1er Ifater11 isl i Depth Capon TYPE OF SEPTIC WQRK; NEW INSTALLATION I I REPAIRrA00171CN l I DESTAUCTION I I NO ailab�e'wkhin D70 teeC System th it p"blit srwer s Instadation will sena: Residence— Commercial— Omer Number of living units: _ Number of bedrooms Watsr table dent^ Character of spit to a deom of I Mt: No. Combanm.nn SEPTIC TANK. ❑ Type/Mfg Capacity Method at O'uposal PKG. TREATMENT PLT.C - Oimnu to nearest. Wad Foundation Property Line LEACHING UNE ❑ Na S Length of lona Total length/size FILTER BED ❑ Distance to neeraaC Wall Foundation Property Una SEEPAGE PITS I I Depth Siz° Number SUMPS LI Distance to neued: wild Foundation Property lane DISPOSAL PONDS C 1 hereby cernty, the[ 1 haw prepared this application and that me want will be done in aet0rdanae wim San Joaquin country ordinances. sots'.awe, dna rules and regulatroro at the San Joaquin Cg vin Home owner at licensed agents signature toruli"the follgwing:"I certify that in the performance of The work fox which this permit is issued, I shall not amPlay any person in such manner as to become subisa to v.orkmen's compensation laws of California.- Contractor's hiring of subs ontraeting signature comfiea the fglbwing:•1 carbty that in the performance of the work for which this pwrinit's issued,1 snail emPI0Y persona sublect to wonrman's campensa ciao lawn or Calico ia." , The applicant f i squired inspPedo= Complete drawing on reverse side' July ],CJ, 1992 Signed � rtlr. Project Geologist Date: FOR DEPARTMENT USE ONLY Data XJ ��- Ana Appliudan Accepted by - 7 3l Y � 7 oats/aT Pit or Gratis Inspection by /„ - � Oats Final Inspection try Additional Comtneritm Applicaot _ Return all copies to: San Joaquin County public Health Services Saviroomwatal Health Desare lt/Sevics 445 it Sea Joaquin, p 0 Hwa 2009, Sun. CA 95201 FE£ Cz s AECBVED 3Y DATE PERMIT NO. INFO AMplJN7 Dt1E AMOUNT AEMttTED GSM q 4 /'�/ . WI12a IAV .I ! �O W resat