Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPAWMEM 304 WEBRRAVE-3"FL-STOCKTON CA 95202 - C209)IE&34E0 <br /> NON-REFUNDAB E P MIT CALL(2091953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDEFS$ YY CrrY/ZIP_,4446✓.Id /S-t ho— m <br /> CROSSSREET ♦1�yI JO\ /� ,L APN �Qn2!ZJJI <br /> /—,Lk-oj PAICELSIZE <br /> OWNER NAME !Yy{J I- /'O P�v`I\C( [���\ E <br /> � PHONE JY�"TVR/WEaI 'Iy/8 LCS <br /> OWNERADDRESS 133 Ar,i'IAQ IA JJ CRY/STATVUIP 4, olta/ CA <br /> CONTRALTOR CIO "'TTT 'l <br /> /(IIRT` ,P/J/J4eee PHONE u&;6igir 2/-ya—F,77 <br /> COMRACEORADDRESS ///�" CIT•1,IST TF/ZIP <br /> LICENSE (3 C42 OC-36 OTHER NUMBER EXngAnON DAtt <br /> WATER TABLE DEPTH: ft GEOCRAPHICALINFORMATION: Coordioner X y <br /> ❑ PERC TEST p BUILDING PERMIT M - LAND USEAPPLICATIONH <br /> TYPE OF WORK: NEWINSTALLATION ❑ REPAIRJADOMON A ENCINEERDEBICNEDIALTERNATIYE <br /> ❑ REPLACEMEM ❑ DESTRUCTION <br /> INSTALLATIONWILL SERVE: ElM <br /> REsmENCC ;&COMIRCIAL ❑ OTHER <br /> NUMBCR OP LIVING UNITS: NUMBEROFBWROOMS: NUMBEROFEMPLOYEES' <br /> !� SEPTICTANK TYPE/M- }J/\\Ja-j L C"ACHY ?xa000 Sell NOFCOMPARTMENTS <br /> ❑ GREASE TRAP TYPEIMFU CAPACITY Set #OFCOMFARTMENTS <br /> ❑ PKG TX PLANT DISTANEETQ NEAREST: WELL FWNDATKIN ft PROPERTY LINE R _ <br /> 0 LIFTSTATION Sin Ay TYPE OF PUMP 81QOYJ.I OrQn<O ❑ SAND OIL SEPARATOR(ENcWEED SYSTEM) N <br /> ❑ <br /> LEACH LANES ❑ LEACHING CHAMBERS OF LINES LENDTHOFLIMEs ft °fd <br /> DISTANCETONEAREST WELL ft FOUNDATION D PROPERTY LINE ft <br /> A FILTER BED WHIM 2Q'k C9CI ft LENOFH -IK/ ft DEPTH R f IN y <br /> DISTANCE TO NEAR64E WELL ft FOUNDATION R PROPERTYLIN¢ it <br /> O MOUNDED Wtmx ft LENGTH ft DEPDI ft <br /> DISTANCETONEARM WELL ft FOUNDATION ft PROPERTY LINE it <br /> ❑ SUMPS WIDTH ft LENGTH R DEPn1 A <br /> DISTABMTONEAREbT WELL ft FOUNDATION ft PROPERTY LME A <br /> ❑ DISPOSAL PONDS WIDrx ft LEND ft DEPTH ft m <br /> DISTANCETONGRE E WELL R FOUNDATION R PROPERTYLME fl <br /> ❑ SEEPAGE PITS Nun+eee WIDrx ft DEPTH ft l(kl. <br /> DISTANCE TO NEAREST WELL R FWNDATION it PROPERTY LINE ft U <br /> 1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINANCES,STATE LAWS AND RULES AND REGULATIONS OF US JOAQUIN COUNTY. <br /> YMINIMJUUM(JN HOUR ADVANCE Ni REQUIRED FOR INSPECTIONS-PLEASE CALL 12M)233-207.x. <br /> SIGNED A'� fC�k J�`.f� -p4TyR mIB/,i• �� DATE <br /> f7TT--FT—FT—Fl <br /> IQ <br /> D <br /> nl ANN <br /> O M <br /> 0 T <br /> I bEPARTM1IENTL ONLY.__. _ <br /> Appllotlon Accepted ByDBh 14 20 Ub Area Employer IDN '7 9/ <br /> FImJ lmperdoo By Bete ❑ SPECIAL PERMIT-Appmvedby <br /> Chevter orSoli to Depth of3 FC PI ump Soll Chenchr <br /> COMMENTS CYCT-c.H1 Mct,tr RE iKs^Tac..E� AE. 6-F> .eeB P A-aX ('1 1) L `GF <br /> 1,! 4,. <br /> � ouF <br /> 4 <br /> PE SC Rettivod "MY Amount Bete <br /> Code INM B Remhted 9ervke untN IBVOieeN Permit WN <br /> 42.31 5-3/ <br />