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SAN JOAHIN COUNTY MLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O.BOX 388,1M EAST WEBER•AVENUE,STOCKTON.CA 95201 <br /> 121M 4.59,341-0 <br /> f PIt1PG9EFllk09.5EE 7Fl31:91T EkPISFS 1 qkR cpCM ppTE ISSUED <br /> - (CamalPtr In Tr1ii=Rta! <br /> APPLICATION IS HEREBY MADE TO THE.SAN JOAOUIN COU}.Ty FOR A PERMIT TC CON-9FPUCT ANS},MR 1NFTAU.THF WORK DEACRISED.THIS APPLICATION IS MADE IN COMPLIANCE WITH BAN <br /> .IOADUrN COUNTY DEVELOPMENT TITLE,CHAPTER L,-1 j 10.3 ANO THE TTANDAPOS RAN."a"IN CCI'NTY PUPIJC HEALTH BETNICE'."ENVIRONMENTAL HEALTH DIVISION. `7 <br /> JOB ADDREBBIOR A-1-1-;L !p7 812E rwC <br /> OWN E <br /> ER'S NAME 1 Ii I•---_-AOORE53_, - <br /> PHONE- <br /> oil *•CONTRACTOR C ADOPF�S_ <br /> / r CT 11CR ��6+7 r�NONE- J -[ rI! <br /> rBUR CONTRACTOR ADDRESA I �T[ <br /> r <br /> TYPE OF 4EPTIC WORT(: NEW INRTALIAT90N r,q— ."TION <br /> IND SEPTIC RYBTEM PERMATED IF FUSHJC SEWER 13 AVAILABLE'NrT,NN 21;V FEE,OP,,I.?INO.I FERC T"TI.I I 1 NOW MANY <br /> XF�1I1I Ae+1lMetlgn f <br /> INBTALLAEION"RLL 11"Im AFSHOENCE YL\ COMMEPI'IAL[,] OTHER <br /> F; NUMBER OF WINO UmTE:_ i NUmnEA OF ErORODMR: �N{A ;OF EMPLOY£.F6: <br /> CHARACTER OF SOIL TO A DEPTH OFF 3 FEEL; S FITIRUMP SOI HARACTER: WATER TABLE DEPTR <br /> SEPTIC TANKIOAEASE TRAY QTYPE/MFO T (I� Y• CPA <br /> J^�¢ <br /> —�f' �,_ NO.COMPARTMEMB <br /> PKO TREATMENT PLANT 0 M$TANCE TO NEAASAT; WELL D e FOUNOATICH I Q _ PPOPERTY UNE AL1 <br /> UFT STATION❑ SIZE TYPE.OF PUMP SANn OIL-SEPARATOR IFNCLUSFO SYSTFW <br /> LEACHING UNE ❑ NO.6 LENGTH OF <br /> LINES )/� <br /> ,_L3 _--p151'ANCE T2I NEAREST:W?:LLJ� FOUNOATIOfi_-_- �PROpERTY UNE r[l: <br /> FILTER BED ❑WIDTH_ LEYCTH —3]EF7H_ DIGTANCL'TO YTARFST:WELL FOUNDATION PROPERTY UNE <br /> MOUNDta SGT WIDTH %� �^ LENGTH DEPTH____DISTANCE TO NF.ARERT:WELL FDUNDgTION PROPERTY LINE 1 <br /> SEEPIgE RTS ❑DEPTH...2. SIZE S NUMSLR �015-I'ANGf.T.a HEAnE3T;yyELL l G' FOUNDATION CTL PROPERTY LINE <G^ /_ <br /> F�! <br /> SWTOTH LE"rH DEPTH EK5TANCE TO NEAREST:WELL FOUNDATION PROPERTY UNE DIBDOSAL xNae W:OTH LENGTH__,_�^--DEH'TH W DISTANCE TO Nr.APERT:WELL FOUNDATION <br /> PROPERTY LINE <br /> — <br /> I HEREBY CERTIFY THAT I HAVE PREPARED TRIG APPLICATION ANO THAT THF WOAC WILE BE DONE IN ACC.OROANLE WITH SAM JDApU1N COUNTY ORpINANCE9 ANO RTATE LAWS,ANp RULES <br /> AND REGULATIONS OF 7NESAN JOAOUINICOUNTY,HOMEOWNER Oil LICENSED AGENT'S SIGNATURE CEPTlTO THE FOLLOWING:PENSTIION LATIN THE PERFORMANCE OFTHE CTOR(FORWHICH <br /> ' E NOT EMPLOY ANY PERSON IN SUCH A MANNER AS TO BECOME SUBJECT TO WO/MMAN'R COMPENSATION LAWS OF CALIFORNIA.' CONTRACT <br /> OR'B HIRING OR <br /> SUBCONTRACTING SIGNATURE CERTIFIES THE F04-LOMNU:'1 CERTIFY THAT IN THE PFr1FCPkAANi:F OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL EMPLOY FEE kd SUBJECT TO <br /> I YYOFKMAN'S Cp NRATIDN LAWS OF CALIFORNIA.- NE AP CANT MUST CALL 24 YOURS IN ADVANCE FOR ALL REOIRRM rySFECTIONB, COMPLETE DRAWING BELOW, <br /> A <br /> SIGNED Ai �/ /[/ <br /> q e O.�I DATE: <br /> PLOT FLVI(DRAW TO SCALEI-All___- <br /> OR <br /> I <br /> T.NANIE90F 6TREETS OR ROADS NEAAf ST TO ON SOUNDING THE FROPER:Y. ..__._ e <br /> 8.LOCATION OF HOUSE SEWAGE,OISFVBAL SYSTEM OR PRDPO$F.D <br /> Z.OIfTLINE OF THE PROPERTY,WITH DIMENSIONS AND NORTH DIR.CT1 N. EXPANSION OF BEWApE p18PDe Al SYSTEMS. <br /> 7. OIMENBIONED OUTLINES AND LOCATION OF ALL EXISTING ANO PROPOSED STRUCTVRES, S.LOCATION OF WELLS WrTNIN RADIUS OF ONE HUNDRED FIFTY FT.ON <br /> INCLUDING COVERED AREAS SUCH AS PATIOS,DRIVEWAYS,AND WALKS. THE PROPERTY OR ADJOINING PROPERTY. <br /> rc� � � <br /> :. -� <br /> i <br /> �� . . <br /> c� ? <br /> Fj <br /> �n� <br /> .......... <br /> ... . ..... ... <br /> . ........ . ............ <br /> I........... <br /> . ........ ..... <br /> .......... <br /> ............ <br /> ................ <br /> . . ........ . ........... ........ ...... ............... <br /> " : : � i :.. ... .....................T <br /> '.. . <br /> h h <br /> ... f .... <br /> _ ...L <br /> .. .... �k � 1- <br /> -7. .... ... <br /> ............. <br /> . .... <br /> .......... <br /> . .. ..... ... ... _ <br /> ..; .......... <br /> ,4t'1 <br /> C 1 ^ <br /> ............ <br /> ..... . ......... ... <br /> .. ........ <br /> .....', <br /> . . ............... <br /> :....... ... <br /> ........... <br /> .. .. _,... - ... _ <br /> ............ <br /> ............. <br /> F, <br /> t�}j1{J) j� FFA DF?49TH NT iIEE pN0.Y <br /> F APRICATIOH ACCEPTED 9Y_W„T vAI _ _` -., ATE:E:_ d ( `-'I A A:^��! <br /> TRAM,PIT OR SUMP INSP+<CFiUtI?y - _ DA:rE FINAL INSPECTtOH BY <br /> ADDIT"NALCOMMMW5: <br /> F� ACCOUNTING ONLY: <br /> PE CODE FEE INF•J AVICUNT AL.f.1 ED N-CK3_FgSei I REr.kT/Ep SY DAT' SR J PERMIT NIAASBI INVOICE$ <br /> kk Pub.Health SSrv.-Envlro.174(3/86) i <br />