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• d-, " '� s"y'3�� y ;,�: ;z �:�_.'l �a _,3a , r"�',;�,^ 9 '�-k r s <br /> t f, y "" �'' <br /> V. .d� � 'C{ ,a`� tv$;. �F.Ya?�[�!'^" .�t'�' <br /> F F ( LSH DISTRICT�3 '�- i{tt " <br /> rb � 71 - " S# 3, r <br /> E �(,� -rt �yl� AVE <br /> T G�[� ■f �/► L <br /> yRAZt: V3S f'l wA 1q .J�1�•&'�T�.!.o1,1 4A J, <br /> AAA <br /> k a V • <br /> ar rD UGTIONx <br /> N PE OF WEhtJPUMP' q �a�!� �L��•� �. A��� { � a�' J���� <br /> y 'i ((fir -,s„l Pi MriNAR <br /> 1 <br /> � grAU <br /> ^G� ���' -�•. � � 4.I MI��i� t5 -• Cq� �3i` �h'. � ��- � ^ n1�7 ��il�'w. <br /> NEAR ��iF�1 i!.w�.J.�'°'W� �,;'�! r l .��` Cd`�tl '�'• r .3 .,f: ' '•C , �LIAfi�:- � W"t. <br /> U ax�.:syro'+ "' �" r.,;y wY,.; +'•^x Y#:I„"P "•x +3 '�Y 7+�'i �'� <br /> yy rtl <br /> rF4 '�ST�lbl ' s r�r <br /> .F <br /> =� <br /> �' M Vi �•5 � .j,iJ W1 � aY� � I �7tat�YY �Y�t q� { �. �F'. <br /> 9 - olDesow <br /> i J ❑ 17eN��iIQ►P� �t T _JS 4 ' -Gw _ ? i_: 1 .,R. 7'. s \ T y { ,tr..4�. 7.;.' <br /> rrYl{tted(� �eYher}� <br /> TYPE QF SEPTIC:WORK :NEW INSTALLATION}-7,;RF$AIR/ADDtt10N DESTRUCT ION �No raptfc pu p r <br /> g available withk�BUD feaf} + �_" r <br /> Ir�taliatror •Serve Residence_... �Gp�evnerci�tly�i.:. Other ', .. - # �' � "� �,'.`" <br /> t <br /> Number a 17vrrtg unrt� Number of bedrooms pan k. 3 <br /> 1 . y WIltet table [h, <br /> Charatssr'of SOtO a de¢ih of 3 feat. �vOa - ;� ' _ <br /> - A. <br /> udk <br /> NKJ dNpe19 n Y_-1 <br /> SEPTIC, A <br /> PKG. TREATMENT PL k. Method of D I <br /> ' a <br /> Dutanos tonearset »;W�! ourx�etiart , fPr+oPBnY -- `; <br /> Total length/size ` <br /> LEACHING LINE C�' No &-Length of Imes ,: <br /> y 5 9 k +'f g <br /> FILTER SED .,: © Distance to Well "8MFaun7d�ation <br /> 8..i y._ ,g _ -a,€ y A 44 g r <br /> nth <br /> t r `, Number <br /> ' SEWAGEI"fS int: s <br /> s <br /> Distance as rsearaet�,rafl� ndatwn = property <br /> SUMPS, �w-Z T H. -'r! t -:f ,4 .rs -� {.. ,z�": •.; `'•] r i <br /> 'DISPOSAL PONDS'>"3 .p= k � + <br /> be done in ecL�ordance wlth Joaquin ardinanm,'State IerYaR and <br /> 'x hereby celtifY tltet 1 hbve.prapared this eppliCatiorl errd that s wr r �� a c <br /> f` t T xhat the nrunnce of the work - permit ie faerrad"I she`d.nbt <br /> �itoms otianara lioensad s�igrlsttke ae`tiiies'th''t����::o"Mwrrq <br /> ,_ ...R employ any person;in;welt manner t tb berarnea4tiblRct wsxlimatt's:oampet>#st}on laws"of Cafdorrda Contractors hirh►g'or Sub-contr an' g <br /> certifies the fogowing:"t certify that in the perfomlance of the work for which this>rerrrtkt is rasued,1 sltsll employ Pentons subject to woilcman's campenaa• <br /> tion taws of California." <br /> The applicant must tali for dti required inepnctiona Complete drawing on sevsrta axle , S r <br /> ,{x... tet^ .,� r• :�' ..��+� a �' � �t '%�Jf#'� j <br /> DEPl4RT1i11EfYT 6i ONLY t <br /> A ...� :,. p!w.. fir•.-f.'. <br /> Applkaced by Date Area <br /> tlon Acept <br /> i <br /> Pit or Grouism In ata_ Final <br /> inspection <br /> Additional Comments: <br /> _ r <br /> O,Stk„ 4864Mi Q Lodi_369 3621 '. ❑ MentwA .823-7104 '`A ©Tracy 8364= <br /> Pemtit/5trvices 1801 E. Hazelton Ave.. P.O. Bax 2x09. Stk., CA 95201 <br /> Applicant- Return all copisa'to: Environmental HealthICK <br /> FEE AMOUNT DUE AMOUNT REMITTED RECEIVED BY DATE PERMIT N0. <br /> INFO <br /> . EH 13-24lREV.1/051 <br /> E!i W20 <br /> Z <br />