Laserfiche WebLink
- - PERMIT 10. QEf_ 3 <br /> DATE ISSUED <br /> : 1 <br /> Appi lotion is hercor na Ge to the San t,cal f. r 1 "rmrt to i]5L r.: an:•or install the work herein <br /> described. This application is mope in rice r. rir•1•hant Vii. 'An for sewage or :b. 1662 for well fpmrp <br /> r I <br /> ant the F Wle, <br /> yyy)))ppp777niiid Rl;gulatlons of th`eJSd2 <br /> Jrp nddressl 6,y ��?_-,"1,: E Loh _w�_ .r�, ..ro-. Naurt_ --_ --_ <br /> O7hone <br /> Owner's Name Lal /z1 Address _ _ may) <br /> Contractor'.. Name _C�y' C-_�)`yr�(✓�- _. LICe05e Y.n. -_ ••i-. _ Vh.]pC <br /> TYPE OF WELL/PUMP KORA: Eu! rvEELLL �w WELL RFn:6CE'�LYI -' i GTc'1CrI0N j <br /> PUMPRC Ai fON if_ll SYSTEM REPAIV OT++LR i <br /> DISTANCE TO NEAREST: SEPTIC TAN)'. SEIJEP LI%i.S _a U:S'rVL FLO. PROP. LINE .+ <br /> FOUNDATI0M1 -----it PICULT;;PE 'WC[. DIPEP ..dtL PITS/SUMPS <br /> AW- <br /> INTENDED USE TCE OF iiLI PROBLEM ;, Ep- nNFRU(il)N SDEc If!CATIONS (� <br /> -�1��Industrial (J Open Bottom Manteca Dia. of Well F.cm,bon <br /> ilkL Domesti cJPr+va to �S'�j Gravel Paco racy Dm. of Well Casino _ C— <br /> J <br /> • <br /> ]Public �Ej Other LJ Del Q+ Igor of Casino �C— <br /> J irrigation Approx. ]Eastern Specifications -F <br /> ❑Cathodic Protection Dept). se'-1 N <br /> OepUr Of GrOut Sea/�---2.y�_ <br /> E_I Geophysical -y;:c of Grout 1J� .GnJ_�'c _ N <br /> 0 Other Surface Seal Installed by <br /> Repair Work Done ❑ Type of Pump H.P. __ state Work Done -_ <br /> Well Destruction L_J Well Diameter _ Sealing sbterial (top SO'1 <br /> Dept), Filler Material (Ga L,w 50•) <br /> 7 <br /> TYPE OF SEPTIC WORK: NEW iNSTALLATION L.i REPAIR/ADDITION J ('la septic to^k o, seotage pit permftted If public sewer is <br /> available within 200 feet.) <br /> 1` Installatim-. will serve: Residence _ C]nauercial Other - <br /> Nw.,ber of living units: _ Number of bedrooms _ lot size <br /> Character of soil to a depth of 3 feet: Water table depth <br /> SEPTIC TANK ❑ Type/Mfg _ _Capacity No. Compartments <br /> PKG. TREATMENT PLT. ❑ Type/Mf3 Capacity Method Of Disposal n <br /> SEWAGE SYSTEM ❑ Distance b nearest Well Foundation Property Line- <br /> DESTRUCTION <br /> LEACHING DINE Jho, h c? tth lines _--- TO[nl_I engr.h/six ___----- <br /> FILTER BED _I Distano: to ^eaearesr Well tour dot int ____ Prrnrerty Line _ <br /> SEEPAGE PITS r Depth Size N,r,her <br /> SUMPS L. -.ami n.crest: d 1 - Fn:m".at§m ____ Property Line _ <br /> DISPOSAL PONDS [ ( <br /> I <br /> I hereby cerr-if• --_ wort roll be done 'n ,cc.rdo'ce with San Joaquin county ff4 <br /> rd bra otos, i•at - ecal Pealth Dlstnct. <br /> m <br /> Meme Amer or 1 ' - e ti ry that in th• narfornance of the work for which this <br /> permit is iisuep �a ^�' subirct :a •ortlan:compensation laws of California." X2 <br /> Cpntrector'S hit rl ar sdD-a 'I certify that in the perfm+nance Of the work for which tt4f <br /> this e,it is i"sue], 1 5r.a. .. In laws of 'aliform ia. ' fy� Orf <br /> t n <br /> The appl roan• for 1 side. Date: <br /> Sinned _ [-t.--Ktt `p/�.. . L`� .-_--__'— <br /> ADP7+cation : Va,:ra ?r � .( '�_ n`•'" _S!____ ❑ St.;. 4E6-6781 <br /> dCi i .a C•x'r'enL. _ ra - _____ / __-_ _ _ (- Lodi 369-7621 <br /> n ✓ovt :rSpeoilOn by 'F�\ �•� -_ i =_g�. ^anteca 823-7104 <br /> t�hJ I-tI i 'racy R3i-6385 <br /> r 1 s <br /> ct1r, Bm 2009, 'k., CA 95201 <br />