SU0007631 SSNL - Laserfiche WebLink

Home Browse Search

I � p.1 tpt1 APPLICATION F s ,Uai11Q YVAc, ERNIIT . I �AN JOENVIRONMEN AL HEALTH DIVISION YICfB SCANNED �} 388,445 N.SAN JOAQIJIN ST„STOCKTON,CA 95201.0388 ti p�(,ivwx — {209}4"20 NOR-REFUNDABLE PENT EXPIRES t WAR FROM DATE ISSBEB IGmpku in TNipRnul APPLICATION IS HEREBY MADE TO THE SAN JOAQUIN COUNTY FOR A PERMIT TO CONSTRUCT ANDIOR INSTALL THE WORK DESCRIBED.THIS APPLICATION IS MADE IN COMf11ANCE WITH SAN JOAQUIN COUNTY DEVELOPMENT TITLE,CHAPTER&T f 10.3 AND THE STANDARDS OF BAN JOAO%W COUNTY PUBLIC HEALTH StRVICES.ENVIRONMENTAL HEALTH DIVISION, JOB AOOWSWOR APNJ / jP� � - '�+' `/ C/IiYr s y ,/ J '��. /LOTS?ISL.-i� 0..." WNER'8 NAME ADORE. it /1 ))I.C-iJ�i-JTe. kd 'Z •-•C�' �c� 2'-rf L' PHONE 4:�f"'.�+1 3 T CONTRAC70 ADDRESS C 7 /-- t. x LICA 3LtF Z z PHONE�'L' SUB CONTRACTOR AOLNtESB LICA PFpNE TYPE OF SEPTIC WORK: NEW BRATALLATION❑ OE�rofj❑ B6ITRUOTION 0 NO SEPRC SYSTEM POINOTTED IF PLIBI.IC SEWER IS AVAILABLE WTTRON 200 FEET OF BUILDING.) Mm TF%TNI 1 N HOW MANY APPlloetlan J INSTALLATION WILL S9NC ICSI 04M 0 COMMEImmi-0 OTHER❑ RIINIRM OF UVIIPG UNITS: I NUM M OF SmgOWAS: N1 MSM OF E MPLOYEEP: CHARACTER OF Sol_TO A DEPTH OF 3 FEET: SOIL CHARWCTEI ,�i WATER TABLE DEPTH d�f AfPTIC TANKMAEASE TRAP CI r mmra CAPACITY 1G.COLIPAFITMENT6 PEO TREATMLiPT PLANT Il DISTANCE TO NEARST; WELL POUMOATIOH PYIOP9ITY LINE LFT STATION❑ BLM TYPE OF PUMP - SANO OIL SEPARATOR t LOSER SYSTEM) LEACH NG LOW ND.B LENGTH OF LINES DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE FILTER BED b WLEIITN LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LIN MOUNDED 13 WIDTH LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATIOR PROPERTY LINE SEEPAGE(fFIT�S_ rr ❑DEPTH SIZE NUMBER DISTANCE TO NEAREST:WELL._FOUNOATION PROPERTY EINE SUMPS*`�`1'U WIDTH LENGTN�Owm-"t,DISTANCE TO NEAREST:WELLX FOUNDATION I! PROPERTY LII ^ DISPOSAL PON" ❑vYIDTH LENGTH j DEPrN bISTANCE TO NEAREST:DIAL PDI1NElAT10N PPIOPEITYl1FfE 'l I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WOW WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES AND STATE LAWS,AND RULES AND REGULATIONS OFTHESAN JOAOWKCOUNTY.NOMEOWNERORLICEHSFp AOEIWT'S SIGNATURE CERY94 STHEPoU.0YAN0:'ICERTIFYTHAT LATHE PEAFORMANCEOFTHEWOM FORWHICH THS I RT W ISSUIN).I SHALL NOT EMPLOY ANY PERSON N SUCH A MANNER AS TO BECOME SUBJECT TO WOHCMAN'S COMPENSATION LAWS OF CPiFOFWA.' CONTRACTOR'S HBWIG OR SUBCONIRA MM SIGNATURE CERTIFIES THE FOLLOWING.'I CERTIFY THAT IN THE PERFORFMNCE OP TLE WIOM PDR WlSCN THIS PERMIT IS ISSUED.I SHALL EMFLpY PERSONS SUBJECT TO VVOMMIW'S COMPENSATION LAWS OF CAL"FIMA.'THE APPLICANT MUST CALL 24 HOURS LN ADVANCE FOR ALL ftEOU011181 INSPECTIONS.COMPLETE OKAYING BELOW. _ pp C SIGNED x Z. DATE:.- x•X .•� -- PLOT PUN(DRAW TO SCALE)SCALE 'm 1.NAMES OF STREETS OR ROADS NEAREST TO OR 80UNDING THE PRDPEITY. J.LOCATION OF NOUSE SEWAGE DISPOSAL SYSTEM OR PROPOSE D 2.OUTLINE OF THE PROPERTY.WTTN DIMENSIONS AND NORTH DIRECTION. EXPANSION OF SEWAGE DISPOSAL SYSTEMS_ 3.DIMENSIONED OUTLINES AND LOCATION OF ALL ExFSTNIO AND PROPOSED STRUCTURES, C WCATION OF WELLS NRTIRN RAMUS OF OPIE HINIOIEO AM FT.ON - INCWDINO COVERED AREAS SUCH AS PATIOS,PAIVEWAYS,AND WALKS. THE PROPERTY OR PROPERTY. ..._ ..... ... - - --- _ .....,...v .... . ...-. .: A" ...r. .. :.;..., _.... . ......... ... :............ .... . . ::.. .. .. ..... :......F.. . _ ..... .;.... ... 1 ...... $ ' F .... ,PAY�IEN' , .. �'' r RECEIVED.... ...... . .E ...2 8 1995..... ....... . ......... ... . . . 4.... .. . .. SAM 10AQ4JIN G41fNTYA�,} P..L#BLi�WEAL31i St h�Vlf S . ENVIRON�1aNTAL HEAI.Thi DtVhlDf�....... .. .... . . _ ..... . .;.. .. . �- .... . FOR OPPARTMENT USE ONLY r APPLICATION ACCEPTED BY - DATE. / L/r TANK,HT 4R NI�tNSfE"Im by �' A .T +rr <- -� DATE FBLAt NSPECTION 8Y / JL4 _G TE ADDITIONAL COIAMENTA: )'V\ ` ACCOUNTING ONLY: JADE FACT PE CODE FES FIFO AMOUNT REIAITT£610 CHECKS ASN RECEIVED BY DATE AI I P9Y1QT NUMBNi NVmCE J kz [It la-