Laserfiche WebLink
'� APPLICATION FOR WEL PUMP PERMIT <br /> SAN JOADUIN COUNTY PUBLI HEALTH SERVICES <br /> ENVIRONMENTAL HEAL H DIVISION <br /> P 0 BOX 388,445 N.SAN JOAOUIN S .,STOCRTON,CA 96201-388 <br /> (2031481-34 O <br /> NOWNEFUNOABLe110flNIES 1TEAR FROM O T 133010 <br /> iCngYtN IN Trig tot <br /> AFPLICATDN K NEM GY TRADE TO THE SAH JCAQUM COUMfY FON A FENAFT TO CONO P LOUT ITASfALL THE MORN DEAD,TM APRJCATION N MALE M COMPLNANCE WITH SART <br /> JDAOUIIE COIMTY DEVELOPMENT TME CNAPrEN M-1 175.3 AD THE STANDAIOS OF SAN JOAOINN COVNTY FI K:HEALTH�,EMNM�HMEIITAE HEALTH OIVIMN. <br /> JOB ADD EMIOR AMY S-tnc k+FSI11 _ PAREL WWAPTM:31A_�-7C 3 3s 1 <br /> o1AT+eRNwAME 11Is.IT11 SfyY '1 rJSY --ADDREBE 4 t`' 71EDNF.Cl1�577�i5�INOU <br /> ----..__. 15,Mi l l�lwv.rn Mr Ni-Z� ADM u Z60G:a lags eslLxi-w-eRQl PHDNE &u2-&zv <br /> NDE CONTRACTOR ADORE ZZCr PTNDNe <br /> TYPEawnLonmN C3 MEwwEtL 13 mmAcPAEKrwas Q MDRMrowNawEu• Q on*R 4 <br /> LJ INSTAILLTION ❑WELL EreTEM FEPAINI Q crouccoaacT KPAR ❑VAPOR E=TRACiRIM WELL P J <br /> ONwC1Rom HA. DEPTH MRAPSET. Ff, FWATWATERLEVEL O <br /> RYK OF PLINBI <br /> ❑OIJT-0P•EfT1MCE WERE ❑OlOFMJEICALWELL■ ❑ FON SOIMIID N <br /> �OFBTRNCTIDM: I <br /> I1,111twom USE rTP4 OF%VnL CON97RUCTION M"WA910ME A <br /> ❑MwSTNA. Q amm BOTTOM OIA.OF WELL EXCAVATION CIA.OF CONDUCTOR CAOIp O <br /> Q Domes IapWATE Q GRAVEL PAMUaQE TYF!OF CANRID/NTEa/PYT. OIA,OF WEIL CASH O <br /> Q M11MMUTIRVALTQC mm DEPTH OF OROUT MAL GPFCFJLAT0P A <br /> [3 IIMDATOWAG Q OTHER GROW VEAL WMALLED MY I-T ONOUT WLA D NAJAE t <br /> ❑MOMromm CAROLSBEALPUEEPED:(3 Y. T.Jlb CONCTIETEPFDWALSYDNLLPIDQY- ON. Jr <br /> APPROX.DEPTH UMMING CHEIITEI I MOXffit"/VEE S <br /> FRDFOETO CONISIFRRT10M1D/plllNG RNMT .MID ROTARY AIR IwTANY AUOFN CABLE OTNER <br /> f <br /> 1 HFIEGY cOrtMY THAT 1 HAVE PREPAR M THIN APPLICATION AND THAT TM WONT WNL M DONE MORDANCE VAM SAN JDAOUM/COUITV OIOINANCEL STATE LAWS.ARID RULES ANO <br /> KOVLl7ONS OF THE MAN MAOLAN COUNTY.NOME OWNER ORLCENMED AGENT'M 810NATURE CEM FES THE POU910AM:'1 CERMY THAT WTNR PEFFORKANICE OF THE WINK FORVWMCN <br /> THS PE ANT N WOUEO.I SMALL NOT BIlLOV PENEONE EIRJECT TO WOIMBAWS COMPONATION ILAY 08 OF CAUPOINIIA.'CONTRACTORS ZOOM OR BVMCONTRACTDNG SONATLOR CpR61E4 <br /> TNF ADUM%V111D: -I CTTTEY THAT M THE POIFOISAA/NCE OF TIE WOIR FOR WHICH TNN PERMIT 0 NRJED,N WML MKOY MtIONN KIM•IEC►TO"RIMA"WINFBtl►TION LAHN OF <br /> CAUPORMA.'TIR APPUCANT L"NI7T��CALLLL�K NOOU�R IN ADVANCE MR AIL IISGURL9 HM MCTIONN T USAN)VSSJiT9.COWLM DRAWMD AV U FRIM AREA PROVIDED. n <br />' 94-4 X` LG[.IMM•G {4A r►UW..L� Tw. — �1 Z-�.76 <br /> SNOT THE E1.w,NR NeC.".MI.�� �, <br /> 1.NA1A[S OF Sf1EETM OR FDAoe NEAlST TO OR BOUNDING THE PROPEIITY. ..LOCATOR OF HoueM llYAO[ONEPDNAR 6Yf7ON OR PIRDFneEL <br /> 7.OVTLME OF THE P/OPERTI'.IRVIN16 OIMFNNONS AMNORTH OSECTCH. IXPAHM1 M OF EEWANJE IMMORAL NVOTEM. <br /> I HAZELTON AvENUE <br /> MW3 4. <br /> a � <br /> I sNEo ISI <br /> m <br /> pq <br /> M Ik! <br /> t <br /> � MWSR <br /> J *a: - FORMER j <br /> 4 7 � <br /> O 2 <br /> MW2 RAMP <br /> k <br /> TRUCK <br /> TOM1TuL <br /> P- <br /> w <br /> W <br /> ccr <br /> k N <br /> *D%RT%MT USE way /y+ <br /> APNRRNir,AerFNr MF Mb �'� !� A,r <br /> rAwA F.ewliNn M b.l. P1AwF M MI. <br /> OwOUCFn hw�FeNA.eR ORh _ <br /> AccaurfRMO ONLY, AID/ FAu <br /> PE CODES FIX TXFC ARNOUHT ROWITm CNITCNFICASH NECENm MT DATE pfP S IxOWICM MIDWEST MUMNDI IIIVOICE <br /> `{ 315o <br /> I <br /> 4 - <br />