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+94c6 %TI..L I PUMP PERMIT <br />SA.vJOAQVINCOUNnENVW0NMtWALH6.iLTHllMOTMEW . . fto"TON CA %2w -(2611) <br />NON-REFUNDABLE PERMIT CALL. (209) 953-7697 Foo INSPECTIONS EXPIRES l YEAR FROM DA'Z'E ISSUEb <br />6 AUO#" 336 E. matters Road _ Crrvrzw French Camp_ 95231 <br />�,r > <br />Cw3s,STUCT McKinley APN � P. 5'. .0 — <br />Ovr*v* N*axx Greg Young ruont 323-4348_. _______._. <br />OwNta—va— 2023 V nit tan Dri x CrrviSrATrizlt „_,_ Srnrlrtnrt -'A 95207 <br />C4wrmuicrott _Delta Pum..___.._. rmamt 6 -.�¢7� -� <br />COWMACMA AiNfiWU 646 S. Californi rte_ Crrv1STATvztt Stacktox�- A__Q�_ <br />Ltraresr 0C-57 )imc.41 0D.09 0Other 24?78 EzrsaATa>rtDATz $�(i$ _ <br />GFOCMAt+911C,AL I"ORMATION: C86rd MU* X Y__ Twwraiip _ _ Rarsa Sodive <br />j eta 1J X Lkc:^.rstc1 ,wt ❑ ImpritiW iptultunt C1 Industrial 0 Water Qwlity Moniwrins iJ soil 5-159k410 etc i-lian <br />0 Public Witter 5 a <br />!!C TymOr WtiRK L] New Well Cl kepircmnent Wall C) Wdl Aittx�ttonrAt ydihtaonn r7OcMxr_ <br />fl Mogi tohns Wdl(a) _d of wtih D Soil 9orinatsl _ ' a tit g. fl ( *nxhydal <br />fl Out.Of-Basica wdl fl Out-Of•Serviet W411 RevA"i CI Croski, ntneetion Rquit <br />0 New Pump 0Atmp Replscarmt O Pomp Repair Lift pump, ramave bleeder <br />'Weta. COtvrrarx:�rtO!t <br />WHiap, MWbod 17 Mud ttotaty fl Air Rowy Cl Auger Cl Cable Tnot fl Push hum 0 Otho <br />Pmpowd Wa11 Jrpth ­ ft Esctwatiw: .in diameter fl Opm Potmm CI Gravai Pscit I Gmvoi S't= _in diwvxcw <br />fl Cottduttor Cininit _ in d amnter Conducw Casing Dcpd, _._...__.........__. _ _R <br />Well Caatng L itmeta ____ _ )n nu;knwlC;w4eASTM Sehed _. _ fl Stas a t dAw 0 Stain I-" Steel 0 Orlux _. ...................., . <br />Grout Sad Gapth.._ h Cl Not Cement (P4 tb btrg ! 5.10 go/ owner) 0 Ssad Caarns� ._� _. sax fwtx 17 $al watt <br />LCa <br />J Aeutmute (20% solids) O Manulsetum Spee %sMida % Nam__ ❑ Spars on File fl Spca &Ibnutttd <br />Pdarstarem Mt d*4 C! Pumped Cl Fran Fall it Other Cl ketrdani J Acedemtor (nam*) _ <br />ice' iraataW By D Driller 17 Pump Conuacwr fl Other _ <br />j t fl Ctwt*rata PadnW Dfi owns wt: Width Ittae _ - _v. ft Th)cla in Cl Y"7trloty bas 03sor t --PIE <br />I <br />Kn6;;;bl* TWbi. Cl O t, r ... 11P. <br />Cl NApump Set-„�i'1t� _ 1t ,Sti.Aft W.Ltwwti Nib it <br />1 HERE$V CERTIPY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br />JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND PtGULATIONS. I ALSO CERTIPY THAT MY TtllQUIRED LICENSE 16 <br />CUR"NT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br />WORKEA.5 COMPENSATION LAWS. <br />Applicaboo Amepted 61% <br />Urtwl Inspeturm By <br />Pump dnapecto" BY <br />C"*Iruttad Well h <br />COMMENTS :✓YPW <br />RTMENT US't 914LY <br />_ Dtda 2 <br />PE Sc <br />Cada into I <br />*ee-sysd Annant <br />�._. ___.. CaaM Rwniacd Owe lwrrrlcat� WtoTDO <br />s <br />f <br />-- <br />--- — <br />. <br />i <br />saxmme <br />1.4NNM� tvttlrtinut r'WtiVt7 <br />