Laserfiche WebLink
LIQUID WASTE PERM' <br /> J <br /> L pml SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION <br /> 304 E.WEBER AVE.,3RD FLOOR,STOCKTON,CA 95202 (209)468-3420 <br /> NON-REFUNDABLE PERMIT EXPIRES I YEAR FROM DATE ISSUED <br /> 0 <br /> _L2_ E...LWi�jL-f Nlekkt " <br /> JOB ADDRESS F I"', �' <br /> IA. Fu <br /> P p4pD,4, 11 <br /> CITYIZI PARCEL SIZEIAPt; <br /> OWNERNAME —ADDRESS 1110 166, AN04cliv <br /> CITYMP atQ_'*j'('h q5�w PHONE-02Z-0101 <br /> 'WWO -liZ f12�L <br /> CONTRACTOR ADDRESS 4JS. oJ <br /> CITY/Zip PHONE 4a(,2-()D <br /> GEOGRAPHICAL INFORMATION; COORDIANTES: X_ Y TOWNSHIP 1S RANGE-QP—ISECTION <br /> PERC TEST(S) HOW MANY 7- APPLICATION <br /> TYPE OF SEPTIC WORK: ❑ NEW INSTALLATION 11 REPAIR/ADDt'nON 13 DESTRUCTION <br /> INSTALLATION WILL SERVE: 0 RESIDENCE 11 COMMFRICIAL 0 OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES:— <br /> CHARACTER OF SOIL TO A DEPTH OF 3 FEET: PIT/SUMP SOIL CHARACTER: WATER TABLE DEPTH <br /> 13 SEPTIC TANKIGREASE TRAP TYPEIMFG CAPACITY NUMBER OF COMPARTMENTS <br /> 13 PKG TREATMENT PLANT DISTANCE TO NEAREST: WELL— FOUNDATION PROPERTY LINE <br /> El LIFT STATION SIZE TYPE OF PUMP SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> 13 LEACHING LINE NUMBER&LENGTH OF LINES 1 INFILTRATOR CHAMBERS <br /> DISTANCE TO NEAREST: WELL—FOUNDATION PROPERTY LINE <br /> 11 FILTER BED WIDTH— LENGTH DEPTH <br /> DISTANCE TO NEAREST: WELL— FOUNDATION: PROPERTY LINE <br /> 11 MOUNDED WIDTH — LENGTH DEPTH <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE <br /> El SEEPAGE PITS WIDTH LENGTH DEPTH <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE <br /> 13 sumps WIDTH LENGTH DEPTH <br /> DISTANCE TO NEAREST: WELL —FOUNDATION PROPERTY LINE <br /> 0 DISPOSAL PONDS WIDTH - LENGTH— DEPTH <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDIANCESATATE JAWS,AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. Ct4h, <br /> SIGNED: C- TITLE:— DATE: <br /> TENTATIVE MAP <br /> MINOR SUBDIVISION <br /> NO. <br /> I GUISE AVENUE ACCEPTED FOR REVIEW <br /> SEE 7fTA1l[.1 <br /> .1 I CUMITItE ACT104 Xc_ <br /> .7 �j <br /> DAfEO <br /> El <br /> REMAINDER <br /> KIK 1 L![` ,t ir WT­ <br /> 11.OF 1U.E. <br /> 1—T 17SKS iqn Li G�4.iipm[. <br /> alr <br /> .GUISE AVENUE <br /> TENTATIVL MAP <br /> !&MlEl_Lh <br /> P. R Appjication# _OLLOO -0-7 ❑ <br /> Z., <br /> Peceived By<L-n On 0 .— <br /> ENGINEERS, INC <br /> FOR DEP R� RrMENT WE ONLY <br /> APPLICATION ACCEPTED;, 'i': TE <br /> TANK,PIT,OR SUMP INSPECTED BY: o' <br /> FINAL INSPECTION BY: <br /> c C) <br /> uIKyY <br /> Liol s <br /> PECODE Sc AMOUNT IL.LUEQJA�/ PECF]VEDBY DATE PFRMITISERVICE REQLMTW SEPTIC ID# <br /> INFOREM ED CASH <br /> p <br /> S-17 <br />