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WELLIPUMP PERMIT 1 ✓ <br /> StNJnt.p11:N G1,IN TY FkY14QNNEATAL HEAL TN DEPARTNt',- -'F."'tWELTDk A4ek JE-STS:K70k CA 9520b 121:•3'LGo-3428 <br /> NON-REFUNDABLE PERMIT —�-tALL.(209)953-7697 OR INSPECTIONS EXPIRES T YF AR DATE ISSUED <br /> /7 <br /> JDa ADtl11E 1[� _7 E- r' l r l v CRY/ZP _�p G� 1(Q��M/� <br /> V - { J '('(.v <br /> 1 X1.1 <br /> ICR055 STAE.-T V'• AP Psar.Ft Svr 1'04 Lalo UeE AnrucA-loN n R <br /> ONrIr-a NAME D r +I r -�� d- �(r{/,�' + ,pry♦ Jj {�� n <br /> DwN kAUCiE.S—I}" � 1 �1 �a G'r•!4n� �1 ` VKi f� Q <br /> ,41 <br /> CO%Tr.AC.TnP L• l Q `11 J 1911 Fr I1 1 _ P <br /> CDk•NAVOR AUUR'-5. V 1 '/1`J11�9 _ C rrIIIST/IVA-E <br /> i� n � <br /> S-imcimTpAr.mm FMCME <br /> Sunt]micAcluk ALIf*F55 r` _I (: <br /> �''/T J <br /> LICENSE C-5" 1-—.- !! l:',c'^' N,--ARcF C)� Y EXP KAT1Uk DATE `' 1 <br /> GEOORAPHicAL�INFrpM AnON. Coordlnates?f _ Township Range Socbon_ <br /> 1Wii;D[D Ust Drmgzb01%-a-.2 Ir•ig3bo-I•Agt tvhufal I10,161ml a'c k.Iain.,r t::rvmno 307 581r�.^.In4'f'tarar.Mrl,'1t�r _ <br /> PJop�Water Fq-pgn <br /> dCet'm•mn 0.t• V4%., <br /> TYPE OF WOgK Nevr Viell yOJlerf.•rrnt'.4r..1 Y.'dl Allc'o:ar,�1Lti1'-�� [.char _ <br /> hl.r'or nw Si'NhS; art'wers .%nil Bonngsflo-mit l_ ,iaMac-Inral <br /> gt;-Ut-sell r^r�s' 1 GttOrseaice'Nell fete+ial (;Ioss-ComactionReps, <br /> New P'Mr, Y pu-np Repwarnen: Pimp ReZeil_ _ _ Raise WWI Cry. <br /> FWiLl CON5TF 9no <br /> �Di ll ng klptnod ULd R_Lir. ASI rWtarr, AJST:r Cable T[xv PI.ur Curd DRer <br /> P'ocoseo Well Dom. P. EALn•raliat n damew :rte,i Qutwil 'irav?I Pack Gra-,mel Site_ "'• '� <br /> L0ICUCIO`Csc>+q Ir dnana!sr 7 CLncu_Itr Ca�irq D?0"^ '! f'� <br /> v <br /> WcU Carina Darnrr __in thtknas5:':al:gr.�AS'M ScRId_ NI"I Pbst1- S:al"IcSs Slea, "t'ir__ <br /> Groh Satl Dcp:-. R N!F Gemom f94 11;bap'. -J;a!we!w Sand Genn l _astk rttv,'7 pal u.2tr v' <br /> R1F,tnldR l7a%soldsl Other - <br /> i <br /> Grout Placernen!Method PLrIPS' Free Fall Oaten Ratefbarr, A..*)*eIerW/jf <br /> PEOEaTAL I•I�1sNled BY rIIr..- `Pimp no^tractor C'''e _ C <br /> onume Pedestal DirnanaiMlb 17 C:9 B L=roll _ `TRIC' m Christy Boa �St�o-vr��Pipe <br /> - <br /> P ry F-.:r.nr-::ielc Tjr`_i•.G :�•E• Fj rr- e7 _SrJPI]I Tg�•eF(vr Lr.•icl J( n <br /> I HERESY C.FRTIPY IHAf I I,IAYE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH 5 A <br /> JOAQUIN COUNTY ORDINANCFS, SLAT£ LAWS, AND RULE5 AND REGULATIONS. I A:SD CFRSIFY THAT MY REQUIRED LICENSE 15 <br /> CURRENT AND ACTIVEW THE CALIFORNIA C04TRACTORS STATF I I(:FNSE HOARD AND THAT I Ali IN COMPLIANCF WIIP ALL �•� <br /> WORKE MPFNSA LA'NS. <br /> I i1LIM 24 O R ADV A- "EOUIRED F�/INSPECTIONS-PLEASE CALL(209)93.76 <br /> SK;N!, - — _-. ITLE� � " r < <•'C � D4TE <br /> C f <br /> i . i <br /> E <br /> B 05 2010 <br /> - I 1 QGh y C <br /> CE t <br /> AN 2 9!Jrk At <br /> cUI <br /> _ -�'-ERMIUSERV,ICEES TH <br /> PARTME SE ONLY tfLIF <br /> AeaA"IApply-abon Accepted BYflats �-s"Grwr.Inspe,.kor BY Dox _ SPECIAL WBII PP-fmi'tPwro Inspector By _ oa2 WA1vER Received <br /> Sal Borng wspomm Ry— 0a a Constructed Wrll Dspth n <br /> COMMENTS <br /> PE SC Rauitred —- -�'+oun! Data Permit' Invo-e Y Well IUM <br /> Gadm Into 9 -Cath Ramittcc SarvieeRegn.eer+s <br /> T <br /> 43r 1 'os�, I � 7 7 <br />