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From WEST HRZMAT DRILLING CORP PHONE No. : 916 638 7276 Rpr. 29 1992 8:40AM PO2 I • APPWCATION. AN JOAQUIN COUNTY PUBLIC HBALTLI SERVICES SNVIRONUBSTAL HEALTH DIVIVQN I 445 N SAN JOAQUIN, PHONE (209)468--3420 2561 Z l I i P Q BOX 2009, STUCKTON, CA 95901 'IRE6 1 xSAR FRMM DATE-L$-S= (Completo in Triplicate) /�lleatlN i. 1N74W oa6e_td �aP .roegvtn County for a pert to conotrnet and/or InalAll the work brtoi o'drxerl0ld, This epy3l real OY to sande to eoegr}karot vltn l$n Joaquin county Ordknanec Ye, 569 and 1860 arid. eke RN1,r and lkepilatloha of San Jo.gotn rovinty Lhlblit Kealtb Sprytaaa. Job ACdtoW rt..�.— --`'4 ^•^ -- Cary—�•-.o"_l_�. LOt dt ze/Aarenyo �.�..- . ...�__ AtlOrly ZI. - µ� aST� '�� k4At:�a1' Conttecler per..: �.LL Adaresl License No.4; a_ N Phot+e q{6•(38-��71 TY E OF VNEtI/RUM►; NEW WEII D WELL REPLACLMENT C1 DESTRUC ION CT out 4l CtrviSr Yn,ll Cl ��.. f - MonWrtry Vt11 PUMP INSTALLATI l/ p SYST9,11 EPAIA CI OT R �( '"" Cl DISTANCE TO.NEAREST: SEPTIC ANK IV SEWER LINES !.Tz DISPOSAL PLD. _ P%OP, LINE " � "� FOUNDA IDN AGRICULTURE WELI OTHER WELL .,,;PITS1 L)Kilnitl�� • INTEND90 U, R _TYPC WKkL PROOLlM APEA CON6TRUCTION $PEUFICATIONS 6T mauln4l Q Open bottom O Manteca Ob. of Wen Eaceyarlon _... Oil. of woo. Coling 'I De^fit o:Priven ❑ Gravel Pack 0 Tracy Tree of Casing_ Spec!ncotio"If 1'1 Pvr+nc 1.1 Otnet n Dohs Oeplh of Grout Sfol Type d,Qrovr..-rte I I Irrlpougn Apprba, Oepth I I Easierh Surface $!it Opened by Ropelr Werk dtnr U Type of Pfamp ,.,,.�_ M.P, . . State work Oona V11110 Destruction O Welt Ditlrttlet _ _, Sealing Ifettrtal 6 Depth Oeplh i Y111oP HalT.f101 ♦ Depth . ._.. .. y-•--- TYPE F SEPTIC WORK; NEyV"INSTALLATION I I AFFAIR lAD01710N I I DESTRUCTION I I {N6 etpplia tyalom ♦r milt 1 II puoYc tUwet IN r w►gabla Ei Ain X00 feel.[ 1 Inn214Gon will Sen e; Dissidence ;-- Comm/ttlal„_, Other Nvmbar of living vnigl , Number of badtoorns i Chverter of aprt to r dtlPlh of 7 feet: ,�,_�....,�.,��.........—WetN table SE PTIc TANK 0 Typal fitly capacity,..___ ` No, Compartments PKO. TREATMENT PLY,0 Method or Diapo ill _ Distance to nearest: Well Foundation . ►Iciptrty LIM C r LEACHING LINE ..__.L9 No. S lenplh of Ones Total ALTER BCD rl Distsnrte to nearest Welt Foundation Proparty Line %ttPApE PITS i I Depth � - lgise Number SUMPS LI Distance to maHset: Wen PovAdalion.,_, Property lint _ OlsPgPONDS Q ., I Mrabr CO!titY IMI 1 he•e PtePe100 (file application and that the work will be done in IrcerClnee with Sen Jeepvin e6unry Pry!nerl4n i, IIePo pore, ane 1VIe9 end ragVIE161'.3 61 IM $an J04guin eauht:y Home ow-ior or licensed apsnt's Upnatute cenitbs the fotowing. "I ,onifr Met In the performance of Me work for which this permh Ie Moen. I shed nr employ AAV person In such manner of to Ia oma subject to workman's compensation laws of California,"Cohllectort hiring or aub•e9ntrec0l; slgnatpe eonififf the fonowlnp: "I eon:N that In the parlotmence of Ihs work far which this permit ie Issued. I shalt employ persona subject to Norkmen's corhpEnfe lion Owe OT California", yThe apoll Cl ten faR rep red In;pgct{dnt, Complete drawing on/loyfirse Slat. wug2NYn-! peen X - Title: _L,IC�kIb[l �r .,.. Dole: FOR DEPARTMENT USE ONLY r Apprcanen .ACC ap red by ^-�w• . _... Date -1,. Arae Pit or Greul Intpactbn by A'^�� / 1 Dale-�]? 10.�2._ Final In/PeCtlD, by �C_ Addilldnal Command: eTT-L`1^..[("i�' L. (J `I : DWN2I NJ Lbk!c a( T z. +13-.1 Appi.it.ens - ►.crura n11 eoplao to: San Jongc;u Cotnty Publle Nrolth Dervacea 5-I l:nvlreamental Health Pormlt/$orvicto ' � C tab N Can JOaquln. P D Do: gocip, atk:h• CA 016% : AOUNT DUE AMPVHT RCteITTLD ASw oFLftVEP ey Daft PERMIT'NO. ,. sQ �sf