SR0080697 - Laserfiche WebLink

Home Browse Search

ONSITE- WASTEWATER TREATMENT SYSTEMi PERM,F SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTiviENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 NON-REFUNDABLE PERMIT _ CALL(209)953-7697 FOR INSPECTIONS ExPIRES ' YEAR FROM DATE ISSUED JOB ADDRESS -� G fi K+)4-W _►y Ve_T-- CITY/ZIP - G K yS��G✓'� --_- - CROSS STREET !�[�-._�, )��O Y�VLC- _ _ APN n']7-3�0-7-8 --_pPARCEL SIZE = OWNER NAME- fC,�C S 0 Zao(/� y�� -----PHONE 7 U 3 ' / 75 yr u OWNER ADDRESS -CITY/STATE/ZIP CONTRACTOR l l�(/-- /� -- hG ----- PHONE_ <oz, - CONTRACTOR ADDRESS _ p(/JLl�C�+ i/G I7� CITY/STATE/ZIP I LICENSE I.-101-42 L.I C-36 OTHERNUMBER' s y—L_>(PIRATION DATE ----- L'WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X_ Y PERC TEST #— BUI1_DINGPERMIT ` LAND USE APPLICATION --- —1 iYPE OF WORK: (.a NEW INSTALLATION � REPAIR/ADDITION r! ENGINEER DESIGNS JF.RNATIVE REPLACEMENT - L! OUT-OF-SERVICE SEPTIC SYSTEM I I DESTRUCTION IPISTALLATION WILL SERVE RESIDENCE L-1 COMMERCIAL 17 OTHER _- NUMBER OF LIVING UNITS:— --- NUMBER OF BF_DROOMS: _ -- ___ NUMBER OF EMPLOY 12 SEPTIC TANK TYPE/MPG �)<� _ CAPACITY gal #OF C01�YA�J➢l1F-NTS.. 0 GREASE TRAP TYPE/MFG —_ CAPACITY gal {#OFC Q ,,N- DISTANCE TO NEAREST: WELL ft FOUNDATION---- --- ft PROPERTY L¢ IL fly '"d ry]Y ft G d I_.IFT S T ATiON SIZE -- TYPE OF PUMP L PKG TX PLANT I„ SAND OIL SEPARATOR(ENGI._OS Er)% M' K LEACH LINES LEACHING CHAMBERS ##OF LINES� LENG 11-1 OF LINES 410° - ft DISTANCE TO NEAREST WEI_I_ 50 7t' ft FOUNDATION /p ft PROPERTY LINE /n _ ft 1-Z FILTER LIED WID'rl'I ft LENGTH fI DEPTH ft DISTANCE To NEAREST WELL _ ft FOUNDATION _ft PROPERTY LINE _ ft G MOUNDED V11IDI'I-I ft LENGTH ft DEPrH It DISTANCE=TO NEAREST WELL ft FOUNDATION _ fl: PROPERTY LINE ft SUMPS WIDTH _ ft LENGTH I�� fl DEPTH el ft DISTANCE TO NEAREST 1MF:LI_ D��- ft FOUNDATION Jd ft PROPERTY LINE �D ft f�9 DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft SEEPAGE PITS NUMBER WIDTH ft DEP'I'H ft DISTANCE_TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE_ ft 1 HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK.WILL BE DONE IN ACCORDANCE 1NITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIfi11URII 4SHOd�61�AD►1ANCE NOTICE_ _. EQ�ffr�ED FOR fNSPEC IONS//- PLEASE CA 953-7697 SIGNED -- TITLE_ DATE — V L -- --- - — — - -- - ---- — e -- - — — — EPARTRIENT LISE ONLY C � ApplicationAccepted *,o)f' Date � Area Employee ID# - --- Final Inspection By— Date 1 ❑ SPECIAL itF_P,MIT-Approved byCharacter of Sail to De /S rmp Soil Character: r-- PE SC Received Chet Amor.urt —i- -- Permit/ Cot, Date Invoice�# Permit iD## INFO� R Cash I'.en)itfied Seryl e Ret e it _ 42.01 ONSITE WASTEWAiTY-P,TRTMNT SYSTEM PERMIT I/1/i/1P