Laserfiche WebLink
SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.A,EIOX 988.301 EAST WEEISR AVEiNUE,STOCKTON.CA 85201388 � <br /> (2091462-3420 <br /> NOR•REFUNUABLE PERMIT EXPIRES I YEAR FROM DATE ISSUED <br /> 0"Ist.in Trq Iketal <br /> APPTJCATFOh M HEAMY MADE TO THE SAN JOAOUN COUNTY FOR A IERMfT TO CONSTRUCT ANDJOR INSTALL THE VMM OESCIESED. THIS APPLICATION M MADE N COMIt1AHCE V4"IAN <br /> JOAQUIN COUNTY OEVFIAPMENT 1"LE.CHAPTER 9.1110.3 A140 THE STANDARDS OF SAN JOAQUIN CO11N7Y MM.HEALTH SERVICES.EHVYION ANTAL HEALTH or4mON. <br /> JOS ADOFESNOR.VWR �� 5"->0 0-),/y)0's J+O k. f2j. ^� _ __ CRY �12 LOT SIZE <br /> OWNER'S NAME ItiwN ST`.%N 1.NC AD011EM <br /> T <br /> CONTRACTOR_-_LJ�1�� RODLESS LICIr PHONE <br /> slM CONTRACTOR ADDRESS UCP PNONF. <br /> TYPE OF SE1TR:WOW, NEW rNSTALLAHONlpZ REPAMADDITION ❑ DEsTRUCrFON❑ <br /> NO SEPTIC SYSTEM FEWATTED IF PUBLIC SEWER 19 AVAILABLE NST HM 200 FEET Of sU1LONl1.1 FYEC TEA TNI i I HOW MANY <br /> AFPSa�tN,n S <br /> fNS TALUTbM INLL SBIT'E: RE9HIPM:E COMMERCIAL x OTHER CI <br /> MUMSBI OP UNFIG 1N1TA; I N W RIM OF S[DIIOOMS: h MASER OF w"'EES! I D <br /> CHARACTER OF SOIL TO A DEPTH Of 7"IT'- PITTSLMP SOIL CHARACTER: /�--� WATER TABLE DE . <br /> SEPTIC TANKIOREASE TRAP ❑TYPU2Fo !a L_ L CAPACITY �</a IG On NO.COMPARTMENT" <br /> PRO TREATMENT POINT❑ NATANCE TO NEAREST: %'ELL 100,4- FOUNDATION PROPERTY UNE_ <br /> EFT STATION❑ 917E TYPE OF PUMP DD SQ E�1^/SAN� <br /> D OIL SEPARATOR IENCLOSED 9YOTEM1 <br /> LEACHING UNE /11,NO,•LENOTH OF 6;5 UNTO / b 1 DISTANCE TO NEAREST:WELL FOtNDAT." PF4PERTYULVE <br /> FILTER BW ❑WROTH LEN07H DEPTH DISTANCE TO NEAREST:WELLFOMF)ATPJH PROPERTY UNE <br /> MOUNDED ❑WIDTH LENGTH_ BERN DISTANCE TD NEAESTI WELL FOUNDA.FION PROPE/RY UNI 'O^ <br /> ""Ads INTO D DEPTH SIZE NUMBER DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE <br /> ML,LI <br /> SUPS ❑WIDTH LENGTH -_DEPTH DISTANCE TO NEAREST:WELL FOI;MATION PIOPELINE <br /> NE <br /> DISPOSAL PONE <br /> DS Q WTN LENGTH DEPTH OMTANCE TO NEAAF4r;W'RL FOUNDATION PROPERTY LINE <br /> 1 HERESY CERTIFY THAT f HALE F EPAAEO THIS APPLICATION AND THAT THE WORK W PU BE DONE IN ACCORDANCE WITH SAN JOAOUIN COUNTY ORDINANCES AND RATE LAWS,AND RULES <br /> ANO PEOUTATIONS OF THE SAN JOAW14 COUNTY.HOME OVONFRORLICENEED AGENT'S WMATURE CERTFIES THE FOMOWLNO:'I CEMIPYTHAT IN THE PERFORMANCE OF THE WORK FOR WISCH <br /> THIS PERMIT IS ISSUED,1 SHALL NOT EMPLOY ANY PERSON N SUCH A MANNER As TO MCOME 9USJECT TO WORKMAN'S CC.MPENSATION LAWS OF CALIFORNIA.' CONTRACTOR'S HSSNG OR <br /> SAAFCONTRACTINO SIONATURE CERTIFIES THE FOLLOW WO:'ICERTIFY THAT N THE P MFAEANCE OF rK WOW FOA WHICH THIS PERMfr IS MANE,I SHALL EMPLOY PERSONS SUBJECT TO <br /> 1M WMAN'SCOMPEq THIN LAWS NW* TUE APPLICANT MUST CALL fP HOURSIN ADVANCE FOR ALL REdAMD WSPnKTIOFW COMPLETE dUWFW BELOW. <br /> HONED% // <br /> T PLAN UORAW TO SCALL:SCALE _•,P <br /> 1.RAISES.1STREETS OR ROADS NEAREST TO OR SoUNONG THE PROPERTY. S.LOCATION OF HOUSE IEWAOE pSPOBAL SYSTEM OR PROPOSED <br /> 1,OUTLINE OF THE PROPERTY,WITH DIMENMONO AND NORTH"RECTION. EXPANSION OF SEWAGE DISPOSAL MYSTGES- <br /> 3.DIMENSIONED OUTLINES AND LOCATION OF ALL ExiwnNo AND PROPOSED STFR CT S. S.LOCATION OF WELLS%MRM RADRM OF ONE N1INDRED FIFTY FT.ON <br /> NCLUDINO COVEIEO MEAS SUCH AM FATTOI,OAIIAYS,ANO WALKS, THE PAOOV"OR ADJOINING PODPERTY. <br /> r]O G \\ <br /> �ti10`n <br /> xQ <br /> �a <br /> aD RAYMENT <br /> foRECE.I1rFi'' <br /> `fbol4 <br /> ft'dO AAY 15 1997 <br /> SAN JUAtur.�UuNa-� --- <br /> PUBLIC HEALTH SEPVIrFc <br /> .7 <br /> FOR ovARrMar uII ONLY APP1CAi1ON ACCEREO BY � DATE: A9FA:— 2 <br /> TAA(,PIT OR sAMP NN'ECT ION BY ,D,A,TP^'L+' LL FINAL INSPECTION MY DATE_ �pL 61 7 <br /> AOOITIONAL COMMENTS: 4fv <br /> w/.�f� <br /> ACCOULIDNO ONLY! ADI FACS <br /> FE CODE FILE MPO AMOUNT RICANTLO K.P ASN I STECUVED■r I DATE !T'SSWT NLSUSS61 IKVdcE <br /> L I 0 01� <br /> PI:D.HEBIth Sam.-Erwko.174(31N) <br />