SITE INFORMATION AND CORRESPONDENCE

Home Browse Search

7-23-1997 3:47PM FROM P. S • APPLICATION FOR WELLIPUMP PfRM1T� SAN JOAQUIN COUNTY PUBLIC HEALTH SERV CE$ ENVIRONMENTAL HEALTH DIVISION FEM"90*OW 304 EAST WrmeeR AVENUE, STOCKTON, CAS (2091 480,U20 NON-REFUNDABLE PERMIT EXPIRES 1 PEAR FROM DATE ISSUED rAwq ifu%Tr4&Ate) APPLICATION IS HERE BY MADE TO THE SAN JOAQUIN COUNTY FOR A PERMIT TO CONSTRUCT AND/OR INSTALL THE WORK ME AHIIEO.THIS APPLICATION IS MApE IN COMPLIANCE WRN ea JOAQUIN COUNTY DEVELOPMENT TOLE.CHAPTER 9.1116.3 ANO THE STANOAROS QF SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES.ENVIRONMENTAL HEALTH DIVISION. JOBAOORES&Affi APNS 2829 W. Washington St. CITY Stockton PAP mwTHAPN&145-020-13 OWNER'S NAME Al Sanguinetti ADDREes 114 W. Mendocino, Stockton, CA 9,U94 ENVIRON Corporation ADDREss5820 Shellmound St. m, N/A PONE 1- COMRACTGR l}5 sulk CONTRACTOR Precision Sampling, Inc._ ADDPES0 c anon a f eo l t� ' LIC�_PHONE ah-9875 TYPE OF WLILLPUMP, ❑ NEW WELL ❑ nEmACEMENT WELL ❑ MQNTORHK WELL f ❑ OTHER _ © wSTPN A•LLATian [3 WELL SYSTEM REPAIR [3CROS4<0MECT REPAIR E3 VAPOR EXTRACTION WELL E3 Now CJ R,P•IP HP. DEPTH PUMP SET—FT, FIRST WATER LEVEL TYPE OF PUMR ❑ OVTopSERVICE VsEIL. Cl GEOPHYSICAL WELL I ® lO1L B01VNCi5 , 1:]oESTRUOTON; following drilling of soil borings INTENDED USETYPE OF WLT,L N/A CON& V CTION 6PECIRCAnONf f ❑ INOUBTRIAL DOPWSOTTOM DIA.OF WELL EXCAVATION 2-1/21' OA.OF CONOUCTOR CASING-X/A [ ❑ DOMEATIOHPRIVATE ❑GRAVEL PAOVS2E TYPE OF CASMiSTEELRVC N/A DIA.OFWELLCASMG N/A �1 LJ FUBLICANUNICWA& ❑DMvEN DEPTH OP GROUT SEAL 10' SPECIFTCATON_ N/A ro�tra3ype 11 ❑ IRRGATIONIAO CJ CYHER GROUT SEAL MSTA I�BBtY TT-�L1Driller GFOUT BRAND NAME �D E ® MONITORNG mw SEAL PUMPER. 0Yw L,INP CONCRETE PEDESTAL BY OPSIJ.ER:❑Yw INN• APAIOX.D H 10 T LOMMOI CNEf CR w)umTOYE PTFE N A PROPGfm CONSTMICTIOMIOIPWNO METHOD: MUD ROTARY AIR ROTARY AUGER CABLE OTME11 g Nvdranlivally—liven soil roring Rystem 1 HEOESY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK`ALL BE DONE IN ACCOPOANCE WrTN SAN JOAOUM COUNTY ORDINANCES.STAYS LAWS.ANO RULES Al WGULATIONS OF THE SAN JOAQUIN COUNTY. HOME OWNER OR LICENSED AGENT'A SIONAMPIC CERTIFIES THE FOLLOWING:"1 CERTIFY THAT W THE PERFORMANCE OF THE WOM MR'AmIT THIS PER IS ISSUED,I SHALL NOT EMPLOY PERSONS SIWECT TO WORKMAN'S COMPENSATION LAWS OF CAIIFORMA: CONTRACTOR'S HIRING OR SUS-CONTRACTING SIGNATURE C£R'TIM THE FOLLOWING: 'I CERTIFY THAT W THE PERIMPMANCE OF THE WOM FOR WHICH THIS PERMIT IS ISSUED.I SHALL EMPLOY PERSONS S CMT TO WORIMAM'l COMPENSATION LAWS r CALIFORNIA.- THE APPLICANT MUST CAL4 24 MAUI,.IN AOVANCE FOR ALL R[OUW W ILSPECTIOMB AT 12051 400-24'1!. COMPLrrE DRAWING AT LOWER AREA P OVIDED, p—1 PIC BklnRd%--(t6ET� 0 VIQN� TMa �1r\rL C`�1 Wt. � 1y/ 7 4 T PLAN .N N XkSwNI SeN:P w I. NAMES OF 0 ROADB NEAREfTTO OR BOVNOINO TME PROPERTY. 4, LOCATION OF HOUSE SEWAGE MBPOOAL BYSTEM on PKPOSED 2. QVTUNE OF THE PROPERTY,ORANG DIMENSIONS ANO NORTH DIRECTION. EXPANSION OF WWAOE DISPOSAL SYSTEMS. 3. DIMENSIONED OUTLINES ANO LOCATION OF ALL EXISTING AND PROPOSED S. LOCATION OF WELLS WITHIN RADIUS OF ONE HUNDRED FIFTY FT. STRUCTURES,INCWOWG COVERED AREAS SUCH AS PATIOS,OWVEWAYS.ANO WALLS, ON THE PROPERTY OR ADJOINING PROPERTY. .. ........... :..... - v .... : I See attarheli map ....:...........................:...........I............ L........, . . J.... v'......: ..... .. .7.. ..i... ............ ........................... ......I .............. ........ : DEPARTMENT USE ONLY ^� q Y-� AppIPwNR AwRPR•f B. / ` V �JL'� '" — D.M I+ A•.•! —y G:wR IMP,ttlon BY ,/V� 0•I• Pump trxPePAPn BY O•s• OwNwtlen IPpwebn B —4 I ` I O:H• l s Canmwrtr. ACCOUNTING ONLY; AIOf FAC& PE CODES FEE MFG AMOUNT RVWrr%D CHECSIICABH Plimem BY GATE P6EM/Tlf01VICE REQUEST NUMBER INVOICE 0 [3 [-2 D