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r. <br /> � APPLICATION FOR WELUPUMP PERMIT <br /> JOAOUIN COUNTY PUBLIC HEALTH SERVICES VF <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 <br /> (209)468.3420 <br /> RON REFUMOAKE PERMS EXPIRES 1 YEAR FROM DATE ISSUER <br /> AFFMATION IB MAT er MADE lO TIRE RAN JOA (CBOIPMu M Td div F) <br /> OUN1115 a AEOM..ft.,,TO CONITIOUC!ANDIMINSTALL THEWORLOLBCORID.!1110 APRbATXINIS MADE IN COMRIANCE Wrlll BAN <br /> NAnUp<OVNfYpFyfLOR.1FN!74 Lincoln <br /> CHATTER <br /> TIIE BIANDAMB Of SAN JOADUN o-MlYRIRp DEµIN RER.E..MAWNMENAI 11w.Onint". <br /> Joe AooflEaeron NNl 374 Lincoln Center CITY Stockton 1 <br /> Se n t, <br /> ovnlER'e NAME c/o Dona d T. Bradshaw t, <br /> 0. <br /> Emeryville, CA 64608-11, �510Jb5'L7;Od'-- <br /> CONTRACTOR Rbxf I <br /> ADgI[N RbNF I <br /> we CONTRACTOR Gregg In-S1tN, Inc. D'"'e �B--T510)313- n — <br /> ADg1E„ Martinez. CA 94553 uDI CA-656407 nbxel <br /> TYRIVFO of MI ❑.\YELL ❑ ..OM..Wrll ❑MOINIOPoINI WElt <br /> OTllfn <br /> ❑bBIAILAiION ❑WEII BYBTfMRfFAIR ❑CIY]BB COIMECIRPAIfl ❑V/JVRFAIMLTpH WELL/_ <br /> ❑Nwv❑gePYr H.P. ON-D PUWFSET J <br /> NYPF OF RIMS _FF. Ay FIRST WATER DEMO <br /> ❑OV!-0FRPVICE WILL ❑OFDAIYBICAl M4LLI L'J an.ROItlNO <br /> ❑O[RTgVCipN: R <br /> CDOSTRU <br /> HIWDFOV <br /> IJ T.4 ❑ORN BOTTOM ON,Of MCI EXCAVATION JD-i,,IAF A <br /> ❑OOMESICA•MVATE ❑OXAVEI PACFlSNE OAA,OF CONOUCMM LAMNO N/A D <br /> TYRE Of CASINO/RLEWVC��A OIA.Of WLII CABIIq N/ <br /> ❑ILRLILMUTAO ❑OWVEN D <br /> ❑MNOATppAO OFRII OF OMOVI BFµ_TOte1 D¢DCII BRCNKAIbN C¢Nent-B¢ntODite R <br /> ❑OTHER OPDUT BFµNOTAIRD BY Ccotractor DROVT eRANO NAME N/A <br /> ❑MOMTOPoNO — E <br /> APPROX <br /> pROur efu RIMRD:®v. ION. CONCRETEFIDISTAII DREAD E11. []NN B <br /> Fit... ... RO f t I... D CINn[n BONITOV,RR N/A <br /> ROroIR eoxeTRucnaxRRwxD MRNOO: MIb narNR E <br /> NR roreflr AWES CART on¢n Nvdraulic Pueh <br /> I NFYBY ZRI V THAT III; 11 RRFZ E TIXS ARIICAIpN AND TIME THE V.ORL WRL R DONT R ACGOMOANCf V.IIN SAN JOAWIN COUMV OMWANCLL EFATf TAWS,AND ONUM AND <br /> REODEAT O-0 OF THE MN MA`—N COIN"NOME OWMEn OR LC[NREO AOEM'8...AT.M CERIMIER THE MLLOW RXE:•I Of.'INAT IN THE RWOIWANCE OF TIIE MO1R I.,WNIC11 <br /> TI'S FORMAT NR XEINI.RIAIL NOT EMROY RRpNB tRA JECT TO W NO(Alm'B COMPpI/ADOM IAWS OF CALNORBON <br /> A.•CIMCTOR'S IIIAXO OM SUS COM-CIMM MONAlUM CETIIES <br /> TIII FOLLOYWNO: •I CITTIFY INAT M TIEFONOM1R IANCEOf INE WOFOR..C.1NM.,T IS ISBOFO,I."ALL FMROr SAXONS IVeJECT TO WOAWANY COMPENBATpX LAW.OF <br /> CAA*On11A' THE A C tNOMT Cj."ZoNa IM ROVANC�fMALL MgR.M.FCnONSAT1.1400ABBB.CCXNMR dUVMb AT LOWER AMA PRO <br /> .4—1 X_E7 T11N_ Site Proi,,t m,n,-Er 0.1. [/ <br /> ROT RAM 0-1.4YN avM •1.�� <br /> I.HAMFS OP BIIEEIS Oq ppRR NEARER!10 On eOVNgNO TIIE npl'FRry, A, LOCATION OF IOU/F RWAGE..M.µRYBIEM OA RbA)BED <br /> E...I"OF RIF IOJRRfY,RV,O DW'N....AND NCl OWECl1O4. <br /> T.OIMFHPoNEO OVIUNf/AMp IOCAIpN Of ALL fXIRXb ANp nbPoRFO "WANEON OF RWMf btPoSµSYR[MR, <br /> BTRIICTIXMB,INCLWINO COVERED AREA,OWN AS PATIOS•DRVfWAI.,Ao WAIXS. S,LOCATON OF Witte VAIMN DONS OF ONE NRXMO nal FT. <br /> ON TIIE PROPERTY ft AD)DWOO RpRgT F <br /> LY <br /> RR"i ...... LI 0,1 V\. ATL ,liffi�_-•' 'r,.., 1 •!r y-`E,'u1 <br /> - .. w A1.....- <br /> -.- <br /> > <br /> ,y 1 ( a <br /> } 1i <br /> —_.61 <br /> oRRmral DR ORE— <br /> .. <br /> DN. <br /> d.Y bPrlxn BY D.0 NnP MyrWn BY Dm <br /> u.N..uln F:..INn It <br /> DN. <br /> L. .B.:C�h1 oF5facLton �L voacyL.Wa } Vev,�v , (ot132(o cxp IU 1 g <br /> DUNIIXD DNLp AID/ TAC/ <br /> P...... FEE IMO ...T.."ID CII[CXITASII RECOVEO BY DATE P D OAIINLRWCE ROURTMWS61 IXVOICF <br /> VI �BSo3 9L 013 <br /> Pub.HealthSMV. EnVITD.173(1/97) <br />