Laserfiche WebLink
`3�'' LIQUID WASTE PERF ; /`` �­I, <br /> S�IOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONIMENSOOkALTH DIVISION <br /> 304E.WEBER AVE 31"FLOOR,STOCKTON,CA 95202(209)4 3420 <br /> NON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED�.S,/J <br /> JOB ADDRESS r /L AVO V Groorns P,0 APN an-7 1 J./J PARCELSIZE:�� <br /> CITY/ZIP GJ`�L/�n % (^��+/�,, y Q BUILDING PERMIT E/ C5 3-5::� <br /> OWNERNAME �Ds OKI 1 '[ y 15 ADDRESS Pi <br /> CITVIZIP PHONE NUMBER _T,, <br /> CONTRACTOR P/ N31�4�31 �i <1 ADDRESS / o jectk ^�+7+lpl <br /> CITY/ZIP�•'G 4 �/ GV4• `l5•'33 6 PHONE NUMBER �-O 1 PaJ J / � -7-7-Z <br /> GEOGRAPHICAL INFORMATION: COORDINATES: % - Y TOWNSHIP RANGESECTION <br /> TYPEOFSEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: <br /> 11`14W INSTALLATION 0 STRESIDENCE NUMBER OF BEDROOMS: <br /> ❑ REPAIR/ADDITION ❑ COMMERCIAL <br /> NUMBER OF EMPLOYEES: <br /> ❑ DESTRUCTION ❑ OTHER <br /> ❑ ENGINEERED/ALTERNATIVE �� <br /> CHARACTER OF SOIL TO DEPTH OF 3•: Tk-n 1. PIT/SUMP SOIL CHARACTER: WATER TABLE DEPTH: <br /> ❑❑/ HPERCTESTIS) HOW MANY . APPLICATION# <br /> is SEPC TANK TYPFJMFG I1,L CAPACITY IG aO #OF COMPARTMENTS <br /> ❑ GREASETRAP TYPE/MFG CAPACITY #OFCOMPARTMENTS I, <br /> T r 11 <br /> 13PKGTX PLANT DISTANCE TO NEAREST: WELL-15 FOUNDATION'_ PROPERTY LINE-1 <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> V' LEACH LINE #OF LINES:LENGTH OF LINES: INIOUNCE TO NEARER: WELL_jD_a FOUNDATION 10 PROPERTY LINE-/ <br /> INFLITRATOR CHAMBERS: R <br /> ❑ FILTER BED WIDTH LENGTH DEPTH DISTANCETONEAREAT: WELL FOUNDATION PROPERTY LINE <br /> ❑ MOUNDED WIDTH LENGTH DEPTH_ DIRANCE TO NEARER: WELL FOUNDATION PROPERTY LINE <br /> ❑ SUMPS WIDTH LENGTH DEPTH UKTANCETONEARER: WELL FOUNDATION PROPERTY LINE Pj <br /> ❑ DISPOSAL PONDS WIDTH UENG111 DEPTH DDTANCETONEARER: WELL FOUNDATION PROPERTY LINE ' ,JaJI <br /> ❑ SEEPAGE PITS # DIAMETER_ DEPTH DIRANCETONXARECT: WELL_ FOUNDATION PROPERTY LINE <br /> I/HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES,STATE LAWS <br /> AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> URADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)468-342,3 Q <br /> • - SIGNED: b�E./`+- TITLE: GDfI+C40 (6(� DATE: 1 <br /> l l <br /> I <br /> ..-. _ r <br /> I i <br /> 1 - f S t - <br /> 11 G <br /> _- 4 J- i <br /> - - <br /> , <br /> I _ <br /> XDEPARTMENTPT APILICATIDATE: O AREAEMPLOVEE IDN l ICf LOCATION / <br /> i CJT <br /> INSP DBP DATE: a PERMIT FIN* YES DATE/ IN ORrI-d Ate/ <br /> I / G <br /> COMMENTS`:COD �Y!-C� GL�^� -�/X^ C' <br /> PECODE SC INFO O T CH KN SH ECEIVED DATE PERMITMERVICE REOUESTN INVOICEN SEPNCIDN <br /> REMITTED BY <br /> F2 / 17 3 20 '5431(0 I 44 '?/ f <br /> REV6ED N-ISII <br />