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APPLICATION FOR LIQUID WASTE PERMIT <br /> SAN JOARUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH OTVISION <br /> P.O.BOX 388,446 N.SAN JOACLUiN STY STOCKTON,CA 96201-0388 <br /> 12081 4881470 <br /> NOR-REFUNDABLE P[HMIT£KPINES 1 YEAR FNG!j DATE U�RUEG <br /> (rAmptatA in Triplmral <br /> AIPLWAIWN IS NE)ERY MADE TO THE&Ah JOAOIIIN COUNTY FOR A PEPAFrT 70 WNSTRL/CT ANOPA Arlo AU TME WOR[DfaCf4FAED. THIS APPOCAVON 16 MADE'N CdJPk}AW:E',NTM FAVI <br /> jDAGUIN COUNTY IRVLLOF'MEkT TITL> I`llMfA 9 1110.3 AND THE>,AND,,,9 OF SAN JOAOUIN COUNfY FUNAO REPLTII 6WICE3.ENVIMfAAFNTAI H,YTN N! ON- <br /> I0a ADUIIESW! APNJ -_���� E?tf-,7 11Ea all t><-►TIC DITY �-D 17"� — lay SUT ! <br /> 0_.,.$IIutF_7��} --�Fie.�.n ` ADPREas 3 <br /> r� II <br /> �DATwACTr;R_, }� C-v E�E331•_ - ADDRiss <br /> SUB CDn'1 A/•C rcP AWIAE$$ L1CJ M,ONE <br /> rTPE OF SFtTC WDR II NEW INBTAILAT!ON 13 REPAwAOOITLON II o"TNNCTFON D <br /> iNO$fPTIC SY$TFM HW-11FTL01r F%,WC SPNER W AVAILABLE WITHIFI 700 FEET OF BUILDING) P�Y9Eipr I 1 KO`Y MAIFY <br /> AFPBPFtl—J_ <br /> IASTALLATION WILL SEFIVE- RE61DEIICE❑ COMMS Jff OTHER❑ <br /> ALWBLi1 OF LAMM UMTS: NLOMOt OF�■EDPDOMS: NUMstTI OF.J .YFU:�� / <br /> CHAAAGWR Of 904-EO A OEFTH OFP�D]FEE', c� WTIBUMP W0.CHAiNC M I Ca _WATER T Wi OEPTTL r•' <br /> (.`,jay1OMFAaE TMP QTYFSIUFa c—" RO-COUPYrVlWTk—_ - <br /> wAaYwATARMrt FEAkT 0 OLSTANO[TO NIrARFAT', WELL FOWDATION FIIIK) Y IL ME <br /> LAT STATION 13f yWEE_TWE V <br /> OF FMF SAND OIL SEPARATOR IEFICLOSEO SYSTEM] _ <br /> LEA N"LOA LJA NO,A LENGTH OF LLNE6� g -;C Z4_1 , DIST FNCE TO NEAREiT:YAELL�_TOAPrpATgN= ROPFP1Y �• <br /> N11610O 13 MLDTH LENGTH. O"vm: DISTANCE TO NENLCBT:WLL FOVNUATAON Pft E UN <br /> MOUNOm ❑3 W[DFN lk"TH oEPT1r DIST ANCE TO N[MEB-.VOLL �{�! FOt'NDATIQN M FAOPERT'A MEAT <br /> i1MAAN MR i7r-F:All _S:TE NUWER _DISTANCE TO NEARF4T:WFLLyyy�_FOUMATIONJ.I'•+` PROPERTY LOIS—�J <br /> •LAMPS U LM.1-_—UNGTN__OEFTN URLTAHCE TO KEAPEST:WELL -fOUNDATBIN RgPfg; LANE V ` <br /> pmm0 JGNGA C3 WIOTN LENOTR DEPTH DIOTAACE TO NEAREST:WrLk.FOVODATLON IYLOPtATY UN[ <br /> .HERESY CERT!rY TIIAt i HAVE PPEPARM THIS APKICATION AND TIiAT THE WOW]WIU Of DONE Nr ACCORDANCE WIfN BAN JOAOIRH CaNNrY ORDINANCES AMI STATE LAW$,AM MVI ES <br /> ANODE.OLFLAT-Uti W-NESINJOADIINCDUKTY.NOME OWNER ORLICJ ED ADWr'S SNINATUF9 CIATIFIE6 THE FOUDNTN0:-I CKPMFYTHAT IN THE P"VENILANCE OF TNEWOM WRMMMFI <br /> THIS VEFMtT IS mQ V$l 191F._L HOT FNIMOY ANY NERSON LN SUCH A Y.AEENEA A8 YO BECOME V%MWECT TOYIOtY.NAN'S COMPENB►T.LIM OP CA—' CtlNTAACTDR'B WNKG OH <br /> SLL&1:DIr%PINI:I'NC&INA RT1AIE9 THE FOL WINO'-I CERTWY THAT IN TIE i'[RFORMFNCE OF THE WOFK FOP—H THIS YETIMfT IS ISOUED,I SRIAU EMPLOY PAPaONO BLSACT TO <br /> !'Y:IIIL M1I-•1'IAiEAUTIM1 A r1F CALIFO TME ANT-OAT tALL M HOW IN ADVANCE Fart ALL AEOMIIED I"PIC TAONIS. C'Q-111I DRAAnAFID BELOW, <br /> SaNED R _ TTTIE:_ GY_.JV7 -L DATE:3 <br /> ROT FLAN IORAW TO BC ALEi SCALE [A <br /> 1.NAMFF W FYW t 'i ORlYYAUB hEAAEBi Tp OM ROUNdMO THE FAORPRY. 4,LOCA710N OF HOUSE SEWAGE DISPOSAL XYW M DM PRCPDBED <br /> !. DUTUM LAI IIR Kigvl!RTY,WITH DIM�rSWMB AND NORTH DIRECTION, EXPANSION OF SEWAGE DISPOSAL We-rFIA9. <br /> 1.M%V,:.e. I-ti!T.AHTS LOCATION DF ALL FSU&TING FND PIgP08ED aTRVGTIJNFS, 6,LOPATION OF WEUS WRH]N RAp U6 OF ONE NUNOPEO FIFTY iT.GN <br /> i w1'LLt.IPx FI, •r,i AAA$SUCH A9 PATIOS-Ory VEWAY6,ANO—KR <br /> THE PROPERTY OR ADJOINFiG PADfERSY- <br /> -- - - -- <br /> I <br /> x � Z <br /> \a ... Cl <br /> � <br /> 1 ey ! � <br /> L <br /> Ji <br /> 1 <br /> O <br /> PAYMENT �° i <br /> RECEIVED <br /> MAR 3 I 1995 <br /> --,ANJoA�'.%q4"L i r.r}CJr1�Y <br /> i tC SERV <br /> .rtL ,icTl <br /> DM DEPARTMENT ir6E ON <br /> l.PRICAtIaN ACLJ PrFO RY��r lyj _ 4�ic. pATE: <br /> T AHN,�RFIVMPINS! CIIPNs A'+ DATE t-li.���PI#iJL PFSE'ECTLON FT[� 7 <br /> 1� ��~ <br /> ADOt TIOIi AL LOUMf:irB_ <br /> AGCGUNTYIp PNiY. AaDF FACJ <br /> rt CONE EEE IAFp AMOUNT REMITTED !CASH RECNVEO aY DATE =.I T MIMBEP LNA/gOF J <br /> 1L a <br />