Laserfiche WebLink
09/19; 2302 1;:5n 269-579-2225 MUDDE.STC ATC PAGE 9. <br />WELL PERMIT APPLICATION FORINT SITE <br />SAN JOAQUIN COUNTY PUBLIC H'E'ALTH SERVICES MITIGATION <br />ENVIRONMENTAL HEALTH DIVISION (PHS-EHD) UNIT IV <br />204 E. Weber, Thifcl Floor, Stockton, CA_, 95202 � "— <br />(209) 468.3449 <br />ri +13LE4�6ALL a t LP. 1 d �g4htS� R IiF.R <br />4pU11 cr[tla6t Is f14Errb4 mace m San JoaolWA Cnun'Y IV tl permit t9 eanstrLCR arldrof lnataR & wolrk (4irfit)ed, SbIg nPOICaliGn IS iMACO in Wmp11$P0A with Sar <br />.Joaquin County Oeveiiom.eni hila, CI-.aptar 9. t 413.3 and the Stama ds Qf San .iacr Vr County Public Healer Seavrcas, F_nvironntentai Heg fs Clvision. <br />WiELL tncit(onr,�/ +� tinC[1Ci4,_Cross Street /'�N► i�. —Ci y ►lO. �L�ry �;os,;,�� Parscc'a �S-.----- <br />PROPERTY owns c ka5vt �: p►'� �, tkm tAdc; es 4�-�_ a?�t^j.� CttY?� ti�Z 4S3(rra�*,ongs`�.�► z, 3! <br />C. -ST Coninetar 4�►r0. t t��Atldrnss S � �jS7K 3 C{'v r .m V%I+% 110OtL;'? l �io2i1�'9e <br />Consultant SuD Gnvaclar � �. f f Ce ti��es Aaftzs U 11 f <AL k`i-, <br />- -- GIIy2.GC�t`+�1 . oll. Ph.ana# �J'i�1 z 2 L. i <br />Y <br />rAfT�}8GVl:1tFOftfY � <br />;} ,,Fix wEU.: Fjoriwc, (EPT. 6EQPRoee. HYDQIc PVNCH, FIP40-AUCCA OTHfut-) ��STRrICTit�f� ��0 7e type bety�} . <br />0§01-60A ING M , --___ a OVER -$OAC <br />Ell e�._2..-- r �..__. $$RESSIPttE GrtOUT <br />'C'atair: _ _ <br />COMMENTS: <br />r= -= WALL <br />tM1TAL6AD0N -r'cvE <br />COtli�[_�lS yl{i?WrN ECIFlrATlQtI� <br />MCNITOiglNG <br />0 roux ' STEt,t <br />GIA. CF ACRE HULe____„_„_„__ MULTIPLE sASiNGS? a YES (j:vA 'HELL ,-,,A iNi, 0Lk, ____•- <br />EKTRACTIION <br />Q AIR HAM.Mr-A CaRIVEN <br />CAS td 3 THICKNESS— "' l'E QF GAS'NG: Q &TEEL. a PVC 0--THF-4._ <br />a'lAPOFi <br />a \GLtn ROTARY <br />i EPTH C)F GF.OtJT'SEAL �^ TIRFMIE TYpE TO SE. JSF_U: () AJGEPS p'<)Se' <br />AIR 5?ARGE <br />a PUSH ---WT <br />S> AL PQKfPED: V-O*s Q Nq (NOTE. MAXIMUM FREE -FALL DEPTH iS 30') <br />a SOIL BORING <br />ALGSR <br />GRCVr SME„IFICAVCNS: <br />kbTHEF <br />if�iJT}+AP._ <br />APPROX, 8QR1�4[:i DEPTH- '� 8UL'ED TRAMC eGX ar Q STQVF PIPE — <br />C-ONr;UCTOR CASIfyG N,flP7SEo7 : If YES, list spec&*tAtj0rjs tori): <br />NOTE: OFF&TS BORINGS REQUIRE ACCESS OR ENCROACHMENT PERMITS. _ <br />CALL THE UNIT IV ;NSPECTOR 48 WCRXING .HOOPS IN AOV.A14CE FOR ALL REQUIRED INSPECTIONS. <br />hereby certify that I have prepared this app(leation and that trhs work will be lore►;n accordance with San Joaquin <br />County Ordinances, R!tfss and Regulations, and all applicable Caiifarnia State Law s- r <br />%^� <br />DEPARTMENT USE ONLY <br />SITE MAP IN UNIT IV FILE, AOCR;ESS:� <br />WORK PLAN OATED: <br />S <br />+�po'icattcn RP[ <br />4CCaC By� _Gate taauitl UZ Area top <br />'O <br />Grout By /nom/ � / __—__ tau ( "Z vrat .nspenlon 8y�a �_-___Co[s l! ZS z <br />OestraciJon ;napectla^ 9Y �.1K uB�X _)oes li IS71)�L -- ------- <br />COMMENTS J CONDI <br />ACGCl,NT1NG ONLY' AIGN <br />PC COPIES FEF "4F0 AMCIJNT REMfTTtiO <br />SSD 2- �O - <br />CHECi4 W ' {QAC -0 OY DATE—^ <br />G _ - <br />PERR Qt1EST N <br />, <br />SRI QQ <br />^iH�d a t3 <br />1-6r,7 WAIVEQ r C-57 Le -er of Ruthor;zetion rtl sign par�nit- ncroachment doc 9127100 <br />- z- —--��L,a_.9S-bl F- LUL- I P.zampoon oupen eC2:OT Zo 0 SnU <br />IN <br />n. <br />N <br />t <br />