Laserfiche WebLink
ONSITE j'6SSTEWATER TREATMENT SYSTEM PP--441T <br /> _- SAN JOAQUIN COUNTY ENVIRONMENTAL I. .I DEPARTMENT 304 E WEBER AVE-3"°Fiu KTON CA 95202-(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL(209)Q953�-76697 FOR INSPECTIONS EXPIRES I YEAR <br /> (J �FROM DATE ISSUED <br /> ` --Pa1Y 1`' S cl wa en J x CITYlZtP r:. 611 _I � <br /> � JpH ADDRE$5 'i <br /> CROSS STREET LCL__ `'_ __ _ _ APN jj!F- 19- an PARCEL SIZE <br /> 1 - OWNERNAME PHONE In <br /> I' OWNERADDRESS T 0"�`;� CITYISTATEfZIP <br /> I �/J Grp [� <br /> CONTRACTOR pl!('L- KEG C&+t— (✓l.Y"V PHONE_ 1X1 <br /> CONTRACTOR ADDRESS O eorp &t7o CITYISTATE/ZIP C <br /> LICENSE ❑C-42 ❑C-36 OTHER VF NUMBER EXPIRATION DATE <br /> �} WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ❑ FERC TEST # BUILDING PERMIT# a Lif J 3 LAND USE APPLICATION# <br /> r� TYPE OF WORK: Iff NEW INSTALLATION ❑ REPAIRIADDITION ❑ ENGINEER DESIGNEDIALTERNATIVE r <br /> O REPLACEMENT ❑ DESTRUCTION <br /> r <br /> INSTALLATION WILL SERVE: 9KRESIDENCE ❑ COMMERCIAL Q OTHER V <br /> 1 NUMBER OF LIVING UNITS: t NUMBER OF BEDROOMS: .7 r� N UMBER OF EMPLOYEES: - <br /> SEPTIC TANK TYPE/MFG PVi- CAPACITY Ir�� gal #OF COMPARTMENTS_9 <br /> ❑ CREASE TRAP TYPEIMFG CAPACITY, gal •#OFCOMPARTMENTS <br /> ❑ PKC TX PLANT DISTANCE TO NEAREST: WELL .I D,aIl' ft FOUNDATION 6l ft PROPERTY LINE 77.0 __fl <br /> 11 LI147STATION SIZE TYPE OP PUMP ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> � <br /> NJ'/ L4 LEACH LINES ❑ LEACHING CHAMBERS y #OF LINES <br /> 1 � LENGTH OF LINES �lp! <br /> ft <br /> ' DISTANCE TO NEAREST' WELL IaO1 R FOUNDATION to ft PROPERTY LINE _ ,.,_ R <br /> h 3 ❑ FILTER BED WIDTH ft LENGTH R DEPTH R <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH R LENGTH ft DEPTH ft - <br /> DISTANCE TONEAREST WELL ft FOUNDATION R PROPERTY LINE ft <br /> ❑ SUMPS WroTH Jt LENGTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION R PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br /> 4fr k SEEPAGE PITS NUMBER 3 WIDTH �]6�. R DEPTH <br /> DISTANCE TO NEAREST WELL 0'1 tl FOUNDATION �t}I ft PROPERTY UNE 0 R <br /> 1 HEREBY CERTI PY THAT I HAVE PREPARED THIS APPLICATION AND THE WORT[WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINANCES.STATE LAWS AND RALES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> ' MINIM UN,24 HOUR ADVANCE NOTICE REQUI RED FOR INSPECTIONS-PLEASE CALL(209)953-7697 <br /> --- SIGNED_ _ TITLE DATE �rl-• <br /> W <br /> ( 2 <br /> e11. 7 <br /> IIX <br /> N O <br /> _ 2 <br /> DEPARTMENT U. ONLY <br /> Application Accepted By d Area /1V / Employee ID# L��� <br /> Final Inspection By Date Itd ElSPECIAL PER—MIT-Approved by / <br /> Character of Soil to Wpth of 3 Ft: PiUSump Soil Character: <br /> ECOMMENTS 2 0 <br /> F; <br /> PE SC Received Amount ate Permit! Invoice# Permit IDN <br /> Code INFO R ash Remitted erviee Re nest# <br /> 3� <br /> F42-02-001 ONSITE WASTEWATER PERMIT <br /> w r 12222903 <br /> �i <br />