Laserfiche WebLink
ONSITE WASTEWATER TREATME'N'T SYSTEM PERMIT <br /> SAN JOAQUIN C- ENVIRONMENTAL HEALTH DEPARTMENT EWEBERAVE-J"'FL- <br /> ��J+� STOCKTON CA 96292 -(709)468-3420 <br /> NON-REPUNORRLE(„PEL2R PERMIT 'yam r�-�C�ALL/(�209)953-7697 FOR INSPECTIONS EXPIRES I YEAR/F'RROM DATE ISSUED <br /> JOB ADDRESS /I��J HKvei!!H r.y ArLIE. CRY/ZIP ;VP ' N q p N' <br /> CROSSSTREET CI-Y�EQl1►GF rte] pp ^ <br /> APN DSRO�o I U- /PARCEL SIZE ZACZE',J <br /> OWNER NAME 66FOFFK I.-ar,L PHONE <br /> OWNERADDRESS 0AAAC &13 A'poEjF <br /> 00 <br /> �L o-� :Sr CEN/STATE/LP <br /> CONTRACTOR �JToGGYr ��jr yT^�� p ��'j�sll'= .L Ln�' PHONE <br /> CONTRACTOR ADDRESS IV. E34� a�KJ/'N`� IRJy. �1�C/I�T/y[/STA/T�E/ZIP IST( T�I�,PV q5 P <br /> LICENSE TIIC42 ❑L--j6 OTHER NUMBER a,J-a-J�pJ ERPIRATION DATE <br /> WATERTABLEDEPTH; fl CEOGPAPHIGLINFORMATION: CRordtortes X y <br /> ❑ PERCTEST(S) NUMBER LAND USE APPLICATIONM <br /> TYPE OF WORK: ❑ NEWINSTALWTION IL REPAIWADDITION ❑ ENGINEER RESIGNED/ALTERNATWE <br /> ❑ REPLACEMENT ❑ DESTRUCTION <br /> INSTALLATION WILL SERVE: ® RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: I NUMBER OF BEDROOMS: NUMBER OPEMPLOVEES: -&- <br /> ❑ SEPTIC TANK TYPEIMFG E'B'-4ftt -NGT CAPACITY IJ-?,OU BM #OFCOMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY Bel If OF COMPARTMENTS <br /> ❑ PRIG TX PLANT DISTANCE TO NEAREST: WELLR FOUNDATION R PROPERTY LINE IT <br /> ❑ LIPTSTATION SHE TYPE OF\\PUMP (3SANDOIL SEPARATOR(ENCLOSEDSYMM) <br /> ❑ LEACH LINES QLEACHING CHAMBERs6 &Q 'Z,F MOF LINES I LENGTH OF LINES 40, fl <br /> D4STANCETQNGREST WELL ICES'+ ft FOUNDATION IOJ fl PROPERTY LINE 143, ft <br /> 13 FILTER BED WIDTH ft LENGTH It DEPTH k <br /> DUITANCETONEAREST WELL ft FOUNDATRTI ft PROPERTY LINE R <br /> ❑ MOUNDED WIDTH IT LENGTH R DEPTH (f <br /> DIBTANCETONEAREST WELL fl FOUNDATION <br /> ❑ SUMPS ft PROPERTY UNE ft <br /> WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY LINE (1 <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL It FOUNDATION R PROPERTY LINE ft <br /> It SEEPAGE PITS WIDTH 5(,,S .T y—L�. 2 <br /> y DEPTH 2.�1 ft <br /> DISTANCETONEARFST WELL I&0+ ft FOUNDATION L40f R PROPERTY Lin IT <br /> 1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM PI HOUR ADVANCE NOTICE REQUIRED FOR INSPEE�CT�IONSS--PLEASE CALL(209)953-7M7 <br /> SIGNED �� TITLE I s o <br /> T. <br /> I <br /> a <br /> v <br /> > <br /> J <br /> 1 <br /> M NT L <br /> D PA <br /> DEPARTMENZ-T SE O 'LV ��-/a-�� � <br /> Appl4Mfan Ampted I, �"Date ' - rta"--A. Employee IDR <br /> Findlnsp"tlo y P I D. /' ❑ SPECIA E MIT-Appmyodjby "r <br /> Charaeler of eptho 3FU DSnmp Soll Ch.Cimr: <br /> COMMENTS - d� <br /> _ , X <br /> c+a_ <br /> PE j SC Reedeetl CkI,W Perntlt/ °'-- <br /> Code INro By Dao SU'l.Re Deet R Involm R Permit 1 <br /> l 38-! 1 sco ) a3 3G <br /> 141-091 <br /> -^AD ONSITE WASTEWATER PERMIT <br />