Laserfiche WebLink
` WELL PERMIT AP <br /> PLtCATIQN FARM uNlr IV <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES — W-- +' <br /> F-NVIRONMENTAL HEALTH DIVISION (PHS-UHD) FILE <br /> 304 E. Weber, Third Floor,Stockton, CA., "202 COPY <br /> (209)468-3449 <br /> ADMcation's t+erECy rnade M San Joataulrt Court foraEMU!'—Y&AR FR AA GATE IS$UED �: <br /> ty tlermll co tanatrua sedrbr WIMP;ne work Oesvibea. This woccarton.s'rta:fe in Cot, itz j wi:.r, <br /> San Am-'Ufn County Develaotnent Tlfle,Chat:tef R•1115.3 and the Standans Of San Jaaduln County PlWc Healer SGNICes.Env ronrrental"earth k:ivis nn <br /> WELLLo"fl -115 L3• LPItA ✓ CrrrWStrnel C� �1�};ty�lRpG Asge�sors <br /> PROPFR7'Y ALrf`-Lp�LYL_Vertble <br /> bnroes 120� �� r e� d.we Ciky ?.i @t►q ZfiL��,Ph•vro#7liL/���'q�,S Z..- <br /> C.57Contrdcw' <br /> ActdreaslLoq,5'Li9A1tas.dIJ—.�CitY-�Q�C�a��lrcx„��3�",onex ��• 6c�'S'�,�l� � <br /> Conauitant;S tb C9N12acr R-,t R IAddreas. /33/1 Nr+r 3���Ci y Q� � r <br /> Phq"B_ 7c7 _?7Y <br /> 61$Coadirtnes;K Y� Township Ra e <br /> _ � Soft-On r <br /> WORK TQ GG PiFiFORUE12 <br /> 7 NSW tl1ELL r BORi►tG(CPT. GEOPROBE,HYDROPUNCH, <br /> HAND-AUGER.OTHER' <br /> SOIL BORING E)E$TRUCT1aN(choosta type tx17w? <br /> QUELL toDEC 1 1999 C ov1R.eOR2 <br /> "Other. ; 3 0 PRESSURE QROU_ <br /> GOMhiENT9S --•--•--.- - ----- _ <br /> TY OF WELL I LLATr&;rTRUCTI0N9PEMQVA'Wtt51Q' T" <br /> li MONITCRiNG 0 HOLLOW STEM DW.OF BQREMgLE_ 9 P iAJ7C/A@EF4(;i'iFhNO WELL C:ASIN(;QtA_- <br /> 0 EXTRACTION 0 AIR HAMMI=RIaRIVFNi CASING THKXr4<SS TYPE OF CASING; 0 STEEL D PVC D OThER <br /> VAppR 0 MUD RorARY DEPTH OF GROUT$EAL,�_� tTtpr4iE TYPE T08n U9EP fl AIyQFA$ f].,{pSr' 4 <br /> 0 A R SPAF2GE r PUSH POWT GROUT SEAL PUMPED: 13 Yes y No (NOTE:MAXIMUM FREE-FALL DEPTH IS 30" <br /> I SOIL GQRING 0 KANP+USER APPROX.[1OF4NG DEPTH 2-!;" a BOLTED TRAFFIC BCX or 0 STOVE P1PE ) <br /> a C--HEA D OTHER- cokouCY4Ft CASING PRCPOSEL» AJ O r H YFg. 18t"MIleaDont here), <br /> COMMENTS! or y� <br /> NOTE: OFFSITE BORINGS REQUIRE ACCESS OR ENCROACHMENT PERAMTS <br /> .I ft".by tartly teat I havA prf"10d We 4PpII00 r'and MAID,*wont will be donStmbe La*i.trd Rules <br /> 1"Rapulatbns Of the San Jr]agin Caurty "On+ Omer or kemsad apertt's$-gnatute con#*&the foll6w419, 41 cardffy thm In th•p•rforrrrancinof the work <br /> for which arts permlt is iscurp,I snarl rtflf orttpfpy pmano 2la3Je[t fo WORKERS'COAWEAW-aTlpX Lows of Callfornla:' Carl molar p ha=ng Gr sub <br /> r,4ntratting fiarlatuAt certifies the fiyluwing'Y Mft lhatin the PWfprMRW6 OfUN 4wkf0f w1MCh IAm PC—RAR xsaueti, i shag*a3pkyPafFau as+b[xt k <br /> WORXERS'COA,MENSA710N Lewy of C*4rnio.` <br /> THS <br /> Sigte.,l rTide Ct9t4 <br /> SEE SITEM NIT 1V WORK PLAN DATED: <br /> f <br /> OVARTiMENT USE ONLY <br /> vr> eon p,ri:eF+ttd dy — Date bsuad <br /> f e0ut J'Apedion Br Day °inal iltspeatlort OY <br /> Arrstradren Lection iky Data <br /> GOMMNTB!CONOrtfONS: II' <br /> ACCOUNTING ONLY: AION <br /> PE GORES; <br /> Firm INFO AMOUNT AENMTTEU CI•IECK 0 RECD BY DATE PEft[MT f SEf3VICE REQUEST a tnvatce 1 � <br /> su 002-/5 7-'o .._ I <br /> UtiiT IV-61Z3/99/sign bk <br /> S oq/AAI <br />