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APPLICATION FOR LIOUIO WASTE PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ' 304 EAST WEBER AVENUE,STOCKTON,CA 85202 <br /> (209)466-3420 <br /> RON•WOnAlLE PERRIIT E)MIES I YEAR FRO■PAT[ISSUED <br /> MNRPIIte I.T4d@m l <br /> AFFMjkTWk M HERMY MAM TO THE MN JOAO.N COUWY f"A Pfls/T TO COMMJCT MOAN.MTAM Tilt WORK DSSCIMW-TMS APPLICATION Ml WM IN COQrUANCE%W M SAM <br /> JDAOUW COIIMY OSNLOfW D1r TIRE.CwnINA 9--1/1110.E AM TM I TA/N�Owfa Of sAN JDAAOUN COum ftMW w�LTH s[NWD.&WYON APKAI HMTH 0I41440N <br /> Jo.ADdENYDN APM/ <br /> -3'7&5- <br /> /&1 5- W 1^ �y/,, le �r LOT flLl�/�hA> <br /> OVRIIDI7 NAME Cf-(/ fL-k4- ADO . Z- D 82 Vil <br /> NMTRRCTON c K r L. �yy ADOMM W[,c / UCf <br /> Rlls coR/TRACTOR., '' S rj J��, ADDK..l 2l C- c k-'-c + t4 Sf4 ,O, Z5 <br /> TYPE or 867m WOW: NSW.ATALJAMN Wj PrAMA00ITIOW❑ DOTNUCTION❑ <br /> Sq.Dmc SYSTEM POSEITEO r NLSIJC nivel w AV WTIER 700 FEET of SIIRDSIOJ FISC TWTMI t I WJW(MANY <br /> SNTAUATION WILL ANE: NEW(IJCC� CMmutcLAL❑ OTHER❑ <br /> ENMrt or lr~UMTi,—L NUTA171 OF 11I001001AS: NLRw OF sAIPIDVN.: <br /> /�/A.'�A�CT�OP SO..ro A tIVTN of 7��/ PUMP+ w1ARACTOt� WATD1 TASL!OtPTI ' <br /> Tg fAI.T/OEAst TNAr a TrPIw.IFe u2�`' cArAcrrv� w.CarANrAIST. <br /> SIM TIAAT.AIT H/WT❑ OMTJ1NCt TO Nf1 mit: WQL�i O ' FMWDAT10N_++kk AgfERTY LM �Q <br /> LIFT.TATgII❑�+pp.QE TYPE Ci"J"' MRO L1 B4 <br /> oa WPANATOLOWD s1'TIrEMf <br /> LSAO/M.URN RA.•LDgTM Of LSEs 9- D'//tr1 DWMCt TO NE/UEST,VXUtC5V POLMOATDN PRIOPfM'TY(11[ <br /> MLTEt sm ❑VAM LENGTH_ DfFTH d.TAMI TO NEAREST,WELL_--AT--RROF6try UME <br /> RIeI.IGLe ❑WIDTH LPIGTH NC <br /> DFFTH DISTANCE To NfANST:WaL RCON YWN N !Egf6trY t <br /> ..rAIE MTa oR�rW m2E / .LII .7(y -NI/MtEJt _OIRAlKt ro NEAEE.Ts rYR1 AINOA. -N 1f."n <br /> s1.O. L13 WEOTN LENN <br /> LENGTH DTH DWAS CE TO NEMQL gTY ST:W _POUMATN FROM) LW <br /> OigO <br /> IMP04AL PS WDTW LENGTH—.DePrH DNIANCC TO HEAIE.Tt WELL_,_POLN DATTON MOMIFTY URN <br /> — <br /> I WESY CERTIFY TWAT I HAVE IRP THIN APPUCATgN AIO TRAY THE VWORK VWLL SE DONE N ACCORDANCE MM AM JDAMM CORMTY 0010""CES AND STATE LAVA,AND ISA" <br /> AND TYMN OF THE SAN HOAE OVA=Olt LIL1HNO AODT'S SIOIIA.TUPE CfRE1N TNR EOUP AIIO, IC6RNYTNAi MTKft7lOIMMLCE OF TiEWO1EL EONWMCN <br /> TWO Pbsfift■N.um,I LULL NOT D ANY PIMON N SUCH A UAM"AS TO NCOW Sua)@CT TO WoRSLMAr,TI COI/ORSATION LAWS OF CM]POOMM COMrNMCTOR.HN001 on <br /> M1ECO1 MRI. CUITI TIE POUOVANG:T CERTIFY THAT N T11E PElEO1MtAKE OF M WORK POA WIOCH,IM PEIWST If MRPED,I SKAU"WtDv■O WNS SUMJWV TO <br /> TYOISCMW' 1 q f OAPFIN'AAT ISNSI GALL JM MOMS N AOVANCS PON AAL MGUMD IMSPOMOOO.COMMETE DRW4"2WM- <br /> �I 04) DAn: �• IO 1 <br /> PLOT PLAN MAW TO SCALD SCALE P <br /> 1.HAMM OF STNl4Ts ON OW-08 NE MIT 110gNO M OR ONO "KWUtTI'. ♦. LOCATION or NOUN KWAOEW <br /> OOML VyWrW ON FNpOtm <br /> 7.OlrrLPE OF TM PROftWTV,WFTW OWADR OW"AND NO"OSECTON. ■ItPAN9KW Of SSWAOE DNFWK SYRWS- <br /> 7.OISENSIMIED DORMS AND LOCATION OF ALL EDSTWO AND"IOMMEO RINCTUIEE. f.LOCATION OF YI.LLS WINK PAORN OF ORE MIIOR IND mFry FT.ON <br /> SN UIOSIO COYIMD AREAS SLICH AS PATIOS.ORFV[WAW.NO WAMS. .......THE PROPERTY OR ADJOsolq PROROTY. <br /> ... .. <br /> i <br /> ...... ............... ..... .. <br /> t <br /> dd , <br /> .... ...o.... .. .... ... <br /> • i <br /> ............ <br /> uI�[ <br /> QT` <br /> .... ...... ..i..... ......e............. .. .. <br /> ... .. - <br /> i.....:....... <br /> .... e.......... .....I._ .. ..... - <br /> e.....: . ...b . <br /> 's•- <br /> e �............>......,.....i <br /> i <br /> i [ i <br /> .....i.................... ..._;.. �. ... .. ..... <br /> PAYJYIE�. <br /> � '. .. ... .. . <br /> .._. ... :.. ;. ....NAW"OLIN CzYJFIrT <br /> .uTti RfiAVIgIg <br /> .... ...>.. ....... we L� AL NWALTH.bMIhLtw. <br /> r F Fow ERr IRR.orLr `/�' <br /> 'APFMATWH ACCEPTED NY rl ��-/-�•� `�- _ MIA: <br /> TAML MT Oft Sus*MVW 10W OI' DATE I 1 MARL NSPELTION BY AAW 1 1 <br /> CWLSB Ts <br /> AOeouwmo ony: A.IP FAC► <br /> ve O A T@ Mi0 A/AOIAMT IIpNI TFD fr1EC (CASH ma. DAF9 PEEET RNSMEI NY0101 I <br /> 1I leoloo 110 <br /> .H..MI Sov-FL Aro.174(3/W S K <br />