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LIQUID WASTE PERMIT , <br /> SAN MAOCIN COUNTY POBLK HEALTH SERV WES ENVDONMIiNTAL HEALTH DIVISION <br /> 3a.E WEBER AVE iw FI OOP,STOCKTON.CA 93303 RMA MM-34a <br /> JOBADDRFS9 19�a► GlP7t.n pDN.REFL'NDABI.E PERMIT F.RFlNRREAIYf.L�FROM D ISSUED� PAACLL MZEj�_ - <br /> L'ITY21Py 1 CJS �1 jIRDILDINGI(E/RMTE11E553/���► -�ay�1{1o�U <br /> OWNER NCA,M11 Ef t I I r/' ( C-ad BUILDING <br /> !]31��f/`(�//I�I II �( KG <br /> cayra I'LI�JASYI�C 9�IDf 9 IND.\E NUMBER l7��1 - �� t 61 <br /> CONTRAClY1R ADDRESS _- <br /> CITY/L! PHONE NUMBER <br /> GEOGRAPHICAL INFORMATION:COORDLNATFi:R Y R)"SHIP SANDE SECTION <br /> TNPEOPSEPTIC RESIDENCE,04OK: IN WILLSERVE: NUMBER OF LIVING UNITS: <br /> NEW NUMBER OF BEDROOMS: <br /> ❑ REPAIR'ADmrION ❑ COMMERCIAL <br /> NUMBER OF EMPLOYEES: <br /> ❑ DESTRUCTION ❑ OTHER __ <br /> O ENOINEEREG'ALTERNATIVE <br /> CTIARACTER OF SOIL TO DEPTR OF T: PEVSUMP 8011.CHARACTER: WATER TABLE DE►TH: <br /> ���❑/// PERCTESTISI HOW MANY APPLICATION!_- <br /> J{ SEPTIC TANK TYPEMFOLT1T t CAPACM LOO MOFCVMPARTMFMTS <br /> ❑` GRTASETRAP TYPE'MFG - -- CAPACITYROFCOMPARTMFMA <br /> Ll PXCTK PLANT DISTANCETONEAREST: WELLIO <br /> _ AXNDATN= PROPERTY LPIE <br /> ❑ LIFESTATION SIZE TYPEOi N31P_ SAND OIL SEPARAFON(ENCLOSED SYSTEM)_ <br /> LEACH UNE POFLINES: LENGTH OF LINES: TO Mm Err[m wAVExr: WFit Mo PX%lSATKLN Z0 PROFERTYONE__[QO <br /> INFLITRATOR CHAMBERS: <br /> ❑ FILTERBLD WIDTH_ LENGTH DEPT._ suTMfRTn NLAR[sT. WEU_ FOUNDATION_ PApERTY LINE <br /> ❑ MOUNDED WNTX LENGTH_ DEPDIDLL_ F DATION PROPERTY LINE_ <br /> ❑ .iUMPS WIDTH_ LENGTH_ OLMH_ n AMC[TOn[AROT: *RA._ FOUNDATION_ MOPERTY UNE__ <br /> ❑ DDPOESI.PONDS WII>IX_ LENGTH DEPTH �J�`r M'C(lON[.U(LT: WELL--y_�y� F'(IUHDATIBIE_ PRLVERFY LINE /!L\ <br /> SEEPAGE MTS R pAMttEA JWN DEPTIIJ/ rou uxi TOMWL WELL" 1'OVNOAUENa6 MMEPIY LIN E_m <br /> 1XEREDY CERPFY HAVEMPAREDTHISAPPLICATION IAND RUAI90NDRIGU AXION OtDOMESAN lAQUIN ACCORDANCE WPTH SAN JDADVW COUNTY OppINANCTy STATE LAWS <br /> Y. <br /> MIM UM R ADVAyNCE NOTCE REQUIRED FOR INSPECTIONS-PLEASE CALL(11H1M8-3427 <br /> 81CNEDFi� IA TITLE: C$L?L1lD�i' DME: OL�! <br /> . V - <br /> t I Ji <br /> me <br /> 1 i' 111j <br /> l J. <br /> I { <br /> 1 i ; <br /> - - <br /> I ( { <br /> 'r m 7- <br /> - - <br /> 1 <br /> \JJJ��N1 11JL,1 CC Di,PARTMCNT EO LY /�( �A <br /> APPLKATIOXA PE1fED ,/!i 4 .OATE'.�T' iyRFAEMPLOY iF 11M_�u�(E61$D{ICT�LOfAT1ONVI <br /> INEPEL BY: TTT� M�r� �^ ��F DATE/�/�f�. PERMIT EIAAI.D YAY DATE' __INSPECTOR' __ <br /> COMMENTS' _ .. <br /> 1'F. RANO LNPt'Y ONI'k PERML15ErtVIfERE(N. • 1!IVURYR ([FIIf IW <br /> !'17-II 1 8320 /Q3 �` 0 2C�C72kC U <br />