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Z <br /> T IQUID WASTE PERMIT <br /> SANJOAQUINL ;PUH LIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISKXI / <br /> I— 11M /ERAVE 3-FLOOR,STOCKTON.CA 9520212091 44R-502) �aP <br /> ^3 /e S. n!.'AXION-RL,FyU�rv,POARLEyPERM <br /> IIIT�EXPIRES <br /> �IIYEAR FROM DATE ISSUED <br /> 1 - <br /> JOB wDORe.RS,-4' L��7 /�a,] I..YY/Tf�S//1.CGN JCPJfX,APN LE 2 i STOQ PARCELSIEE:/ 1 <br /> `cm,mr��j If,* q-5-3 BUILDING,-/ '"�BU�IILDIXG PEPM�ITP-X�/� pU��J:�_ <br /> OWNERNAME�'J Q_T�.�f /RI-If'R/I�dJI /%LJ 9'u !l J'�/ J//1TT.tY/Lf� l_IO�Jl� � <br /> s— j a:4ivt/�ccE. 9�frN6 <br /> LcrrvrurN�//./�� C9/(.°�(�� rxone numeeI! _ o�L <br /> CONTRACTOR ADDRESS <br /> L CITYMP PHONE NUMBER <br /> �GEOORAPNIGLINPORMATION: CWROINATE4:X Y TOWNSHIP_RANOE_SECTION_ <br /> TYPEOFSEPTICWORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS:_ <br /> ❑ $TALLATION ❑ RESIOENCE NUMBER OF BEDROOMS: <br /> YFRaI REPAI DITION ❑ COMMERCIAL <br /> ❑ DESTRUCTION ❑ OTHER NUMBER OF EMPLOYEES: <br /> ❑ ENGINEEREDIALTERNATIVE <br /> CHARACTER OF SOIL TO DEPTH OF2': PIT/SUMP SOIL CHARACTER: WATER TABLE DEPTH: <br /> `O PERCTvsr UH HOW MANY APPLICATION# <br /> ❑ SEPTIC TANK TYPEIMFG CAPACITY #OFCOMPARTMENTS <br /> ❑ GREASETRAP TYPE/MFG CAPACITY #OF COMPARTMENTS <br /> PKGTX PLANT DISTANCLTONKARKST: WELL FOUNDATION_ PROPERTY UNE <br /> ❑ LIFTSTATON SIEE 'yNvIN,NIt SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> LEACH LINE 0 OF LINES:_LENGTH OF LINES:_ ouiAYcaroM1wan. WELL_ FOUNDATION_ PROPERTY LINE <br /> INFLITRATORCHAMHERS: <br /> O <br /> FILTER BED WIDTH- LENGTH_ DEPTH_ vu-urv[a To nGRRfT: WELL_ FOUNDATION_ PROPERTY UNEbw _ <br /> MOUNDED WIDTH LENGTH DEPTH_ ouiAlKaiorvuRui: WELL_ FOUNDATION_ PROPERTY LINE <br /> ❑ SUMPS WI.- LENGTH pJFTX- oLiT.WCeTox W[A: WELL FWNOATIOM PRWERTY LINE t <br /> DISPOSAL PONDS WIDTH LENDI'N DEPM- oDTAxC[iOM1GRaif. WELD 10U1 .ATF)N� PROPERTY LINE I\' <br /> SERFAGE PM # pLWETPA� DEPTH_ OUTAnC[T.... WELL MUNDATIOH_ PROPERTY LINE_ <br /> r <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 r <br /> AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> n MINI/MUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)M8-]4]O <br /> RRKIGNED: [ r[/A,/,A( Jl TITLE: DATE: /e7 <br /> F\( <br /> V <br /> ACINTTCHMEM-1 <br /> REPNR OF BROIfflI HEVYER%FE(r ABS-1 <br /> REPAIROR DRONER IE AT`X'OFr BEWEN%PE <br /> FEEDING LEACH FIELD DFAC FROM SEPTIC TANK <br /> FaW A41BlM1J. <br /> I <br /> � �ERIXBTq I <br /> L_r_ISeptlGTuh iFEW1 <br /> FAISSry_ • ps1YUro ry <br /> IE.Im ---FIRM <br /> ^9 <br /> roves% <br /> e:axm oeFW I I <br /> GRi Elena-- <br /> I I I I I <br /> N <br /> DEPART M ENTU-E NLV C� <br /> PPUCATIDACCEFTEDBY: IC OATS L� AREAL�J�/am. 0 PLGY9ElW DISTRKT�LOCATION/^ <br /> IN$PEC(FD BY: DATE PERMIT FINALES DAT PECTOR; /� J <br /> PE[ODE SCMFO AMOUNT CHDL CASH RECEIVED <br /> REMTED BY GATE PERMIiISER VICE REDOESTa INYpE'FA SEPTICIW <br /> aIt 5--o q /,za I S;KVa3 /27 <br />