Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOANT,UEN COUHTY EHVIhpHNENTAL HEhLTit ABPARTMTiNT 806.E <br /> MAIN STREET-STt CKM CA 98202-1208)4663420. <br /> NON-REFUNDABLE PERMIT CALL209 953-7697 FOR INSPECTIONS EXPIRES t YEAR FROM?DATE IsSU <br /> JOB ADDRESS S• 5 5 o f f l -D. «nrtlP N c— SSD <br /> CROSSSTREET_ SPI t V"Et!!-4 - APIC. —QLD PAnarsoE 4S-105f%C. <br /> OwNMNNAGr V�-[z►T t-�'o 'M+�;,► 98'S-`F3�Z. - <br /> Owma.AODRESs 1 a� XNEX J1IEw1 pP . CmmTATE P' Rl(>0 W a CA 467310(0 <br /> CONTRACTOR LAVE pmw (p9-D3-#5' --- <br /> CMrRACRm AlrohE$stiFo� W. 1klL $T. COYfSTATEIZiP (rbc t Q S-11 -0 <br /> UotN6E UC-42 QC-se OTHER NUMIRM EXPRATION OATS _ <br /> , ` <br /> WATER TABLE DEPTH: fi GEOGRAPHICAL WFORMATf0N: Cowdinates X19 -_ --_ Y <br /> PERC TEST t j I SUMMING PERARr# ---LAND USEAPPLICAT'fON# • (n <br /> PE OF WORK: II NElOitt'N$TALLATION ❑ RZPAWADDITM D. F]ApNmR DESIGIdEDIALTERNATWE <br /> Q REPLACBAERt ❑ DESTRt MbM <br /> WSTALLATION WN-L SERW. CI RESIDENCE ❑ COMMERCIAL ❑ OTHER y <br /> NUMBER OF LIMO UNIT - NUMBER OF BEOROCM; NUNBER OP eMPUyY9= <br /> 13 SEPTIC TANK TYPEnAm CAPA0IYY gal #OF COWARTMCNTS A�A <br /> U GREA,SETRAP TYPFJMFG _ CAPACttY fly #OF COtrRAT{TItENrg V <br /> DISTANCETO NEAREST'. WELL ft FOUNDATION fl - PROPERTY LTNL ft <br /> 0 LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT I7 SANDOIL SEPARATOR(ENCLOSED SYSTEM) {Ary <br /> 13 LEACH LINES ❑ LEACHING CHAMBERS #OF LINES LENGTH OF Lu+ES— if y <br /> DISTANCE TO NEAREST WELL_ It FOUNDATION— ft PNOPERTYIPE_ _ft <br /> 17 FILTER BED WImH-- —w-ft LEwaTH ----__—_ft <br /> DWAMCETOAISARBST WELL R FOUMDAMN fl PROPFRTYL4NE _It <br /> Cl MOUNDED www" It LeiwK fl DEPTH ft <br /> OWTANCETIONEAREST WELL R FOUNDATIOM It PImPENTY L6NE _ $ <br /> Q SUMPS wmTH----ft LENGTH-- ----�R DEPTH--___. ft <br /> DISTANCE TO NEAREST WELL_ft R)LMATION ft PROPERTYLm_— It <br /> CI DISPOSAL PONDS WMH ft L1 4GTH ft DEPTH <br /> AiSTANCETTfHEAREST WELL ft FW40ATIDN 0 PROPERTYU E_— __R <br /> 13 SEFPAGEPITS WAuum YOpTH--- ------_ n <br /> DISTANCE TO NEAREST. wFu K FOIRiOATKM --R PROPERTY LINE—_,__R,,,,'—ft . <br /> I HEREBY CERTIFY THAT I NAVE PREPARED THIS APPLICATION AN THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JDAOUIN COUNTY ORDINANCE$, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAM JOAJQUIN COUNTY. <br /> .MINIM <br /> HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLIEASE CALL(2� 87 <br /> 883-76 <br /> mmm T1TL S'y}'FNW�k DATE <br /> mama WgUmfin <br /> ;•'' <br /> YID <br /> ENT <br /> CEIVEO <br /> Lahr <br /> 212011 <br /> �. <br /> MAY 9 <br /> *'A a ° N NA'ICNTd�;t <br /> a.,.. <br /> 4 , AEPARTMENT SE LY <br /> Application Aceaptetl Date <br /> A. Employee t0#� <br /> Final lnspeelfon By Date ❑ spECIAL PERmrT-Ap'r ..by <br /> ChwmtW of SDI to DOM of 3 R; pNaump"l Cham <br /> COMMENTS <br /> PE SG Reeeivetl Amoupt A2de AeTTnitf .h►voMx O Permit IAO <br /> Code- INFO Re SeMccR eRt# <br /> 42-01 <br /> . 2 a <br /> 0/4 <br /> 10!4107 ONSITE WASTEWATER TRTMNr SYSTEM PERMrT <br /> 1 <br />