Laserfiche WebLink
LIQUID WASTE PERMIT, ) <br /> SAN JOAQCIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL hEALTH DIVISION <br /> 304 E.WEBER AVE.,3RD FLOOR,STOCKTON,CA 95202 (209)468-3420 2-4- VAR <br /> NON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE—ISSUED '�� <br /> 21 <br /> i <br /> JOB ADDRESS <br /> CITY/ZIP a PARCEL SIZE/AP <br /> OWNER NAME ADDRESS <br /> PHONE <br /> CITY/ZIP <br /> CONTRACTOR 4 ADDRESS <br /> CITY/ZIP PHONE <br /> GEOGRAPHICAL INFORMATION: COORDIANTES: X Y TOWNSHIP_RANGE—SECTION <br /> PERC TEST(S) ( ) HOW MANY APPLICATION#: ' <br /> TYPE OF SEPTIC WORK: 13NEW INSTALLATION REPAIRlADDITION ❑ DESTRUCTION <br /> i <br /> INSTALLATION WILL SERVE: IkRESIDENCE ❑COMMERICIAL ❑OTHER <br /> NUMBER OF LIVING UNITS:_ NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> CHARACTER OF SOIL TO A DEPTH OF 3 FEET: PIT/SUMP SOIL CHARACTER: WATER TABLE DEPTH <br /> ❑SEPTIC TANK/GREASE TRAP TYPE/MFG fJ>' <br />