HomeMy WebLinkAboutCC Reso No 1960-1024
[Do...f,"" 'Yater S"9p1;., Form A2.Mu.ni.ei".1 Corporatlon or Civil Jd.di"itioa 1
~tt1l ~
ST A T OF CALIFORNIA
BOARD OF PUBLI<: HEALTH
Certified Copy of Resolution
[To accompany application on Form AI]
"Resolved by the _ __.om___~~
__e_
{City ('MUlen. b~:ard 01 tn1lt"" or ~tlK(" J;oytffliDI ~dJ')
of the__mr-_0!'_'RT8~_-_n-- .--- ---------
(Ciry. town.r C01tftt1. .tc.)
that pursuant and subject to all of the tenns, conditions and proviilions of Division 5, Part I, Chapter 7, Sections 40 I 0 to -4035
of the California Health and Safety Code and all amendments thereto, relating to domestic water supplies, application by this
am. be made to the State Board of Public Health, for a permit to~__.4_1'IJJ_11:_._nU.~~~_
(CIcy, ...._ or
~tf,_.)
_tc..rn._tM~~-Jd.JI!tn1..1'ofn _~ tM ~tr' ",n~l~\ ~4.___
Appliclnt: ... ,nt, .,.cJ&cally ..h.at i. Hilt, ."IW for--wh..tI...,- te COI!lltt'MC ..... 'lJ! ()'~~. g UN _hd.,. worh. at IIMk. .lur:Hi~)llI 01 tdditioal ill ll'Ork. or lNt"Ca and
~___._.h.m1''''Ml~_-"~'~\I~Jt n~. h~ .~__.f!t._~_.pt~~__n________
"....,i..r;;:" i01-,;:;;:; ~"..t:i\.1f'&Kt '=a kM( '1;,u Ob7~(i~ ij*flty lit Do ........
_~~~~_~n~__at.ate .t ~~~~_f__ Mid. ..~~~~ ~__~al__._.______H.__m_____.
Addhioeol ...-. -f .. lilt.......
._~~___~-_~__~:~~---~-.~---~-~~I"i~~~.~~!--~---~+:!!~.~.--~
811 mAClllJ)
that thc_____________.__-*r!I"--.__________d____m____________________ -.. - . .--
(Tide 01 aw _Ii.. .....)
...of..id __OI.._m._.__.____._________.. __d___________ ---_.______.._________._______._
(Qq -.ii, .......d 01 tt__.. ..... .......1......,)
be and is ~ authoriZed and directed to cause the necescuy data to be prepared, and iavecti.sationt to be made, and ill the
rume of uid_.___.__~__~~._~_!!~_____.____
(Ci'f, -. .. -'f. _.)
._to .ign and 61e such application with the said State Board of
Public Health."
PaJSed and adopted at a regular meeting of the
_ em OoalCIL_._
(Goo_.ia. ....,.)
of the .CIT'I_01.It.SIICU._.______..____
on the
U~
day of _ lumJS!
1,J~
(City. tow. or eo..-ty. .tc.)
(
APlI'IX
OFFICIAL SEAl_
HEn
]
Clerk of said.. C1't7 td IQ.-j..-...e.___ --...-..---
Cary. tOwn or coPty. etc,)
(s-lI-SI) FOItN 8E-IClS8
.... I~" .. .lIte
IIIS&DTIOII CITY OF KLSUfoa COlITIJroD
ill operatt.. oo...i tlo. UpOD ,,'deh t.sts ..... bee. .ade wbleh Nt.b1t.h
tk.. .eld .,.ter. ce. be furaisked ead supplied to ~r. of th. City of
l1.t8Ore 18 coapllanC8 .,ith .aid Stat. Board of "e1tb r.,ulr....t.;
the ..fleoridltl08 works IDd pll.8 bl.. bee. d..ilDed IDd bal1t by
cr..1e, . C~aD1 ..1ac e4.i~.t froe Buacerford . Terr, IDO. ead
othera ....1' .D .~Dt witb th. Clty of B1s1.ore . copy of .hl~h
ba. -... previ~lf ftled .,ith the 8tet. Boerd of "alth. "fer..ce
to tll. pr.vlou8 1,.11_t108 tor. t..por.ry .....it aDd the tellPorarJ
perait Ira.ted tbere,'ter are r..peettully ..de aDd are lDcorporated
herela :for .,u:b ..... .. ., be _cea.ar,. That 1. the eve.t the Cl t,
c....t throucb tbe operatloD of ..1d defluorldatloa .l..t faral.h
"fluorldated .atural at.eral w.ter. frea Clt, ..118 1. full GOBplll.CG
wlth .ald 1'...11'....'. tat peral..10D be 11... to tbe Cit, to 1....1.t.l'
add or 81a wlth .ald .It.rll 81aeral ..t.ra~water. ~.1D8d troa
8talDer.Yalle, ...lel,l. Water Dlstrlot or otber ,.blte or ....1-
,.'ltlle 80111"cec 18 ..,llc1..t .....t. ... ....t.. .. .. to coapl,
"ltlt the .t....riII Nt b., t... Itete _I'd .f ",ltll of .. It... fit
Callf.d. uatlt INch t1_ a. t... Clt,. CIID rete_ ,. ... to ...la
t....._ .tlIlOrWat.. ..tv.l .t.....l .t.en .. ........ Wit' ....
...._.__ of .. Stew ",r' of Bealaa ........ at, _, t......ft..
'e.... te perUMt... .... 'I..t reI..... '0 ..".. ,ad __ CSt,
att.,..,. Is ..t..I...... MIPOWa..... to tUDt.. __ ."i ti_1 "*'811.
*io" .,. ... __t" 01" .."...... '*' tM a'ate Boa.. .f llealtb.
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