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NOO-24-2008 12:48P FROM: 2098873574 TO:4640138 P.2 <br /> WELUPLIMP PERMIT <br /> SAN JoAOUIM COUNTY F*VROMMENYAI HEALTH DEPA,RTyENT flats EAST KWR,TReCT-BTDCNTONCA FROM <br /> 15A DAT�'UE <br /> DATE <br /> NON-REFUNDABLE PP.1asIT CALL 389 953.7697 FOR INSPECTIONS EXPIRES 1 YL!aR FR0 <br /> 15857 E. Baker Rd. G,TY,-cP �n <br /> Jon Amu Bea T� �t p Q '7 <br /> Duncan Rd. APN OZ�- oq0-�`� PeNCEL SSEe (• -^LAND US[APM1IGT1oN a-- <br /> CROSS <br /> l�� <br /> CROSSSm9T p.,,,, 209-931 —2789 <br /> O.VR NAMe Francis Bognuda <br /> 0TY7SIATE(ZID <br /> Q—tR Aneacsm --- PNONa 09-887-3554 <br /> CONTRACTOR Purviance DrillersInc. <br /> ILinden, Ca 95236 <br /> P.0.Box 64 <br /> CONTRACTOR A00st"S <br /> Crtr+sTATfluv_ <br /> PIaNc <br /> guscoNTaacroR <br /> Ci1TYlSTATHIZIP <br /> $URCOXTRACTOR AORItP.ss 7/31 109 <br /> NuMeER 377923 ExwliAnoN DATe <br /> UCANnE P C•57 ]C•i31 n 17-8U u aTer Range— sectlon`- <br /> Y�_� Township, <br /> C.EObRA9WCAt INfORµ/rtION; CooTQnatee% �SOA Sett'+phn8lCMratter1188cn <br /> t Noeo Use • nl <br /> UOeaVGINr Ste r l IingalloNAgrituAural ❑4tduttTlal 7 Vfalm GtrnvjY MOnilorng <br /> C Pubic Water <br /> ReQo—n; <br /> n WWWn <br /> 1 AIwfit +Mc101CaGo^ 7 Olher eW � <br /> nar�or WoxR CNew Wolf O PIe Well ra+t�rrp ��t�nlcal <br /> C Monotonnp Woll(sl a 01 wed U 8c3[lotinp{e) ion ROPaIr <br /> C Oul-04Servioe WeA 0 Oul•Ot�Serdre Wall Rarwwol ❑Croee-Canneet <br /> ❑Pum RB R '.]Rnlae Woll Caen <br /> Naw <br /> C Pun R Pum Re Isco &w `1 <br /> ��rot�TtnlcnoN <br /> Wiling Method C MUd Rosary 0 Ai Rotary _I"or u CnbLe Tpd L Pueh PdN J Omar In dianlelef <br /> Proposed WAN Depth fl pacu.atian M dlmveter [_Open Bottom 7 Grevol pRGWGrHV0I Siva <br /> r CmAxlorCRenq ndlemeter I COoduaarCarinp0eph� rR <br /> n Steil n Plastic r Step Steal 1Othef- - <br /> Wail Cessna Dlenetor in Trfrkneec/GwgalASTM SGtmdC,Send Cmnen--��-mo�xR gal watef f <br /> Groot Ss■I Coplh� ft C al Cement 10 twtt(94 Ib begl5 0 � <br /> C Sentmile(20%11 ") CI Ohar LI Re11m1aW f Ac^lerator{name) _ 1 <br /> Grout Plaeemnnt Method UPumvwd a Fred Fill Olhor <br /> o Installed Hy Il Driller n PIAnP Cpn1iQd r n Other h ❑Chrlery Sex 7 Btove Pl s <br /> R Letg4t �Th� <br /> C Cancrata PodssW D4nens ons.� ' p F <br /> liP r•_•„ca It slendingY`mlerlarel <br /> Nv Q Subm"ben Tufb'PO r OIneT NE IN ACCORDANCE WFrH SAN <br /> I HEREBY CERTIFY THAT I HAVE PREPARED ItiIS APPLICATION AND THAT TOi1:WORK WILL BE DO <br /> JOAQUIN COUNTY ORDINANC CONOTFkULEII A140 RAGTORB STATE REGUCATIONSLICENSE BOARD AND THAT AM INIALSO CER THAT YCOMPL COMPLIANCE Wlhl ALICENSE ll <br /> CURRENT AND ACTIVE WITH THE CALIFORNIA <br /> WORKERS COMPENSATION LAWS, y, <br /> --� wi N4U s4 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS 11 /18 <br /> 1 /1s/08 t' <br /> soNE� Corporate Secret�Ty <br /> «l �«�„- Ttrls �tl <br /> f - <br /> e <br /> a '( <br /> DEPARTMENT U E ONLY <br /> Ooto <br /> Appfcntim ACCepted By <br /> Data SPECIAL W 011 PBITTII <br /> Grout Inspodbn WAIVER RaeeMad <br /> Pump imps W o Dato n <br /> Date Cat atnt p I • <br /> ,no I 6, <br /> So110or _ -� <br /> Amount PcrrNU lrInvoice M Wog IDA <br /> Cod �7 <br /> PE SC R►ulrsd Rwnln.d Date sarvlce asks <br /> e. tfe 8 J f Gl OL- <br /> flt O SLS 1 �FSO•c121 {�� Q <br /> WEU NUMP WER,rt <br /> E�.$-W Co Inc t5 a 2 G <br /> rru�oa <br />