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- -- <br />- LUPUMP PE <br />... I . 1•. ,.. ,. DIVISION <br />. 1, .• .. , <br />1 . 1. 1 <br />.:... . - <br />�I . �.- rl <br />; <br />• •1 L lI V 1 . ' S r <br />crryfZIP OA -PHONE <br />CG�MZAC"MR ADDRESS <br />f <br />CITYrIap <br />►��� PHONE , /ice% ••.• �� <br />., INFORMATION: • COORDINATES • 1'SECTION <br />MONITORINGOTHER <br />INSTALLATION: . WELL SYSTYM REPAIR , • ..,. ■ VAPOR <br />TYPE OF PUNIP: 9"'N� ORPPAIR H -P.- DEM PUMP FIRST WATER LEVEL <br />I <br />arr�.tl13DESTRUCTION- <br />Evim Mg OF LL CONSTRUCTIONSPECIFICAjjQN <br />M-OPIN BOTTOM WELL EXCAVATTON DLA CONDUCTOR CASING DIA <br />--/.r <br />0168MESTIC PRIVATE LI GRAVEL PACK/SIZ_E_ WELL CASING T'YPF eat WELL CASING DIA-ZI <br />1 <br />I' • / Qr <br />i <br />0 IRRIGATIONIAG OTHER GROUT BRAND NAME <br />Ll MONITORING GROUT SEAL PUNVIED: <br />ro <br />13 CHRISTY BOX 11 STOVE Pipe CONCRETE PEDESTAL BY DRfjLJ-ER7 NO <br />1APPROXIMATE WELL DEPTH .J. r <br />i <br />PROPOSED CONMUCTION/DRILLING METHOD: MUD ROTARY- AIR ROTARY - AUGER - CABLE _Z�R <br />HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND TUAT THE WORK WELL BE DONE IN ACCORDANCE WITH SAN <br />JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS. I ALSO CERTLFY AT?4Y C.57 LICENSE IS CURRENr <br />AND ACTIVE WITH THE . BOARD I 1• O. <br />CALIFORNIAI <br />COMPENSATION <br />ADVANCE411NIMUN�41�4 HOUR 1 <br />-f <br />7�-�- <br />T <br />i A / <br />...MO...........u■..... a....i■.■i...s <br />..... lli7,�i.......... �... ...... ..... <br />.... �i..■�..�.��I�'---�'■�......C...r.. <br />_o <br />....i■I.....................�n�1 �lWAM....■.. <br />......I ................. R M AFA.laummn...■.. <br />.....�I................I.�` ►.m ■m�■nre.NIMM a <br />....</I�JMr-mm .00.11..i.Ciy..l't1L��f� ON am <br />.....ri���—��w■r�.��iirG'�l' i���iL:irs.l■...//...■I.. <br />SOON 1■i....m:=�==mm.mm==.®�...I�=Mmm <br />�... X11 .... ............. ...�s"`'�ii.... ► . <br />mmmmmu ...,I....=._..........0 ....ON <br />. mom •�. ........... I m . �►! . <br />�..... <br />.... �? i.C.................I■,■■i%I�-..r�sr;�nr�iiE...... <br />.....1=11.... ... .......iii ............ <br />...... I....�...�C....... .l11./!T►�,7...... <br />.. ■1. ....... . . IN ...... <br />..� ■ 1.......mi1m■i.imom ... . .. .... <br />.....■I .................... • •til -m �� .. <br />C....■,....................Ci� �R'�'�Pu RM ..CN.. <br />ON mm mmmmmm ga.."mmmmmm <br />.....■.... <br />f.N..■I..dO..r.ri:�JL�!�=MOMIN.....!y� <br />AppIfeation-Acc,eTted <br />y - <br />r • / .. <br />By •: <br />COMMENTS: _1Q2 _C1 <br />___ <br />-- <br />L <br />