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7� <br /> APFUCA7100 FOR llaulp WASTE PERMIT <br /> SAN JOAOUIN COUNTY PUBLIC HEALTH SERV).,...i <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 <br /> (209)468-3420 <br /> ADRLREFUIIDASLE gNlT %FIRES 1 TEAR FRORp� (Dry <br /> 123MID /�� I.J <br /> k KwImplEte In 71k.5"1tl <br /> APPUCATIOPI If NEIESY TRADE To THE SAN JOAQUIN COUNTY FORA P[IEAIr TO COROTINICT AND"INRTAIL THE WONT DESCRRNiD.THIS APR1CATbN IS MAM#H COWLIAWCI}YOTH SAN <br /> ,FOAOWN COUNTY DEVFLQPOq.Nf TTrLF.CHAPTER 9-1110.8 AND THE STANDAROM OF SAN JUMXM COUNTY PUSUC HEALTH SERVICES,WVMbMAENTAL HEALTH DIVISION. <br /> .Af ADCm6"R APN# 76-1 CITY LCT WYE rv� lO! <br /> 1" �T PHONE '�1T <br /> pSM1,NER'S NAME AbOIESS , 1 I <br /> CONTRACTOR ADDIIESS �'7/A I�_m.i E (_C 192k.__ __my AW A.Vf_RIONT'''f'BFi- i <br /> SITS CONTRACTOR ACUMEN LIC/ TMDI/E <br /> ` TYPO OF AEPHD WORIL• NEW NSTALLAm"U REPAIRIADD/TOW❑ OTSTRUC7FI1L) <br /> INO BF9T/C SYfTEM PEIE4ITTED IF"M SEWER M AVAR,AMA%MTHIN 200 FEET OF MAMMA PITIC TlPTNP 1 I ODW WIRY <br /> INSTALLATION WILL SOWL'. RESIDENCE 13 COMMMAL E3 OTHER 13 <br /> NlMS91 OF ILVOID UNSIS: HUAEm OF SEDROoISS: NUFAER OF EMM OVMN! <br /> CHARACTER OF SOIL TO A DEYTN OPCS NTEET: pFrj9UPw SOIL CNARACTTR• WAY"TABLE DEM_ <br /> &KIM TANIUOREASE TRAP D TYPLOOO CAPACITY No-COMFARTLAENTS <br /> MG TWEATMINT FLANT 0 DISTANCE TO NEMIfAI: WELL FOUWATgN RIOPERTYIJNN <br /> un STATION❑ Er[E TYPE CF PUMP SAND SIL SEPAFIATOR KW-#OETC SYSTEM) <br /> IAACIIND uNE ❑ NO.S LTWOIN OF UNE9_ DMIAHCE TO NEAIlliST:WELL POLWIDATION PRE'" TY UNE <br /> FILTER SED CI WIDTH LENGTH DEPTH DISTANCE TO HEAREer:WELL_rMiOATIDN MWPEKly UWE <br /> NRNsmEo O WIDTH LENDTH OEPTH DISTANCE TO NEAMFr:WELL FOUNDATVN FFOFERTYLSLE <br /> SEVAOE PRS Cl D�rH an _WAAW w CISTANCE TO NEARM:WELL�T TOUNbATAH FNCVER'TY UNE <br /> SIMFS 17 WIDTH LENOTN DFTTN bISTANCE TO NEAREST:WELL_FOUNDATION FTWpmw UNE <br /> DISPOSAL PPWW 13 WIDTH LEH071/ .DTPTN D19TANCE TO NEATEST:WELL--rotmATTON PROPERTY LINE <br /> 1 HENESY CERTIFY THAT 1 HAVE PFEPARED THIS APR)CATNIN AND THAT THE WORK WILL BE DONE IN ACCORDANCE MARL SA/A l JoADUN COUNTY OROMANCES AND frATE LAWS.AND RWTS <br /> ANDRSODUITuMSOFTHESANJOAOUNCOUNrV.NOME4I%4MAORUOLITSFDAOENrSDMATUFWCERTINESTMFMLDC -.'ICMFWVTHATNTHEPEAFOIMAWCEDFTMVVOMIFMYYHICH <br /> TATS PEIMR MHISIU .I SHALL NOT E11FILDY AEN PERSLTN FN SUCH A MANNER AN TO SECOYS SMECT TO WOIRMAWS COATPEHSATRNE LAWS OF CAL"MMA'-W NTMCTOR'S FIIISIPQ OA � <br /> SUS•CONTINCTINO WGWATUPE CERTDIEO THE FCLEDYNIKF:9 CERTIFY THAT N THE PET"MANCE OF THE WOW POR WHICH THIN PEIf,OT IS P181R6,1 SNALi EEIPLAY MtEON6 SUNECT TO <br /> WOANNIALY ATgN 1A. OP CAUFDRNSA: T!� AM7 MUST 9ALL f4 NOUNA IN AOVANCS FOII AL'L IISOUfIED NNLJp MTTOKS.COEAPLM OPIE ANID BROW. <br /> SIONTDX - TITLE: 42 -ref T DATE: <br /> PLOT PLAN(DRAW SCAIYI SCALT __ 'G <br /> 1.wALRS OF I TWn 0 OR ROADS Sl TO OR SOUI4SNO THE T�PERT V. 4,LOCATION OF HOUSE MWAOZ DISPOSAL SYSTEM CA RIOPOSM <br /> 2.OUTLINE OP THE PROPERTY.%WFN OWRRSIONS AND NORTH D RECTgN. EyPAMS10M OF SEWAGE ERPDSAL b"MO. <br /> 7.WWNWONEPI OUTLINES AND LOCATION OF AIL EAIDTiNO AND PROPOSED CTRUCYl11gP. E.LOCATION OF WELLS WR}SN RAOIUROFONE NWAX iO FIFTY FT.ON <br /> ITOMUDNO COVMP AREAS SUCH AS PATIOS,OESVEWAY6,AID WALA9. THE rFMOEffrT OR ADJOMND wnFv1TY. <br /> .. _�. .. ...:.. <br /> _... __.. <br /> - <br /> `.1Jy <br /> ......... ...... .....- .. . . _ <br /> --......� . .. . ..... .... .. .�. _.___...., .. .. . . <br /> - .. ' ....E...., ..... <br /> _ _.,..,.. ... .�... .. IVF �� , <br /> n <br /> ` '- :-Nvl NMENTAL HEAk.TUE Ii DM ION <br /> ._ - .... <br /> EAka fI <br /> .. <br /> x <br /> .. <br /> ,. <br /> -. - - <br /> F//�(P/J� FDR pSFARF1NElIr Usi pNLY <br /> APPLICATION ACCEPTED W • '' GATE: �AAEA:y � <br /> TANK,PIT OR SUMpWaPTCrIGN Byl vv DATE ! ! _r:NAI INSPECTION ST DATE <br /> ADDITIONAL COAEMTWTS: P T SC/ 4 WA, AJD461leA 1!2 1 n T? <br /> ActOIINTRaarAY: AOIDr PAc♦ <br /> nCI FEN Nfe i M..TwSMI1TSD EC A41 RE>:DVm ST OATS SR YPEFw NRSIlEL INVON.f• <br /> Pub.HSMDI Se—-FrMm.174 IM <br />