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y - LIQUID WASTE PERM' l7 � N OAQUIN COUNTY PUJ3LIC HEALTH SERVICES ENVIRONME EALTH DIVISION 0 304 E.WEBER AVE 3"'FLOOR.STOCKTON.CA 95202(2 A-3420 108 ADDRESS ts' ®� �� _ el l�(-e� FUN I, RMIT EXPIRES 1 O FROM DATE PARCEL SIZE:�� S CITV/ZIP [[ BUILDING PERMIT p P-AFNI 0103 111 OWNER NAMF, 'Altoce I L( 11L L/ C- '� YLyLC.tiL S ADDRESS-�' If CITY/ZIP Loc, rd CA, -1�1_ ✓ PHONE NUMBER 7 CONTRACTOR ../ EADDRESS_;? CITY/ZIP PHONE NUMBER / / 7'7.�;75 GEOGRAPHICAL INFORMATION: COORDINATES: X Y TOWNSHIP RANGE SECTION - TYKE OF SEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: NEW INSTALLATION L3RESIDENCE NUMBER OF BEDROOMS: ❑ REPAIR/ADDITION ❑ COMMERCIAL (.�, NUMBER OF EMPLOYEES: LI DESTRUCTION yR OTHERA)!:� O LC— ❑ ENGINEERED/ALTERNATIVE a CHARACTER OF SOIL TO DEPTH OFr /3': C—PIT/SUMP SOIL CHARACTER. ¢170/4;? _ WATERT'ABLEDEVIll:�/ ❑,/ � PF,RC TEST(S) I IOW MANY APPLICATION# J SEPTIC TANK TYPEIMFG�sn-.[', CAPACITY I #OF COMPARTMENTS C /❑ GREASETRAP TYPE/MFG //�� CAPACITY #OF COMPARTMENTS . ❑ PKGTX PLANT DISTANCE TO NEAREST: WELL./00' FOUNDATION.'SG PROPERTY LINE lCk� ♦ 7- ❑ LIFT STATION SIZE_ TYPE OF PUMP SAND OIL SEPARATOR(ENCLOSED SYSTEM) 1, / I6♦AI : `/C� / / LEACH LINT #OF LINES: LENGTH )F- ES` DIiTANC.ETONEAREST: WELL FOUNDATION� PROPERTY LINE �L��l INF OR IAMBERS: j[ ❑ FILTER BED WIDTH LENGTH DEPTH DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE ❑ MOUNDED WIDTH LENGTH DEPTH DI.STANCETONEAREST: WELL FOUNDATION PROPERTY LINE ❑ SUMPS WIDTII LENGTH DEPTH DISTANCE TONEARE.Sf: WELL FOUNDATION PROPERTY LINE ❑ DISPOSAL PONDS WIDTH LENGTH DEPTH DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE. 1. .SEF,PAGE PITS # DIAMETER DEPTH S DISTANCE TO NEARF-W: WELL'`'0' FOUNDATION/06 PROPERTY LINE 1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES.STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. INIMU HOU ANCE NOTICE REQUIRED FOR INSPECTIONS-P ASE CALL(209)469-3423 SIGNED: TITLE DATE: ..: I i I « _. . ... _. r i ;............ _;__.._(.._...._..._._. _.._..__;.._....__ ..__...................-.................- ........ �.__. r.....-. .... f.... . F1 �. _..,....._........ _ _._ + ..._ ........_......._ .. _. �.-._._._. ` {----t---f-�, I I I ! I {.._.._._L.._.............._.+_...__j___.... ...1...._....J. - ! _ � _..,......._ � ........ _ r ..._t..� Vit. _.........._ _' ...�....--- - �.._.._ J _ _. t.... ��... ... 3 -t • : ....r......_.._ 40 1.. +-+._.._.�......._ i- ........ 1 -_ +.... a._......... I I I f. .....�.... Ill1b C,Ill Al I U _... I - 1...._.....:..._..... ..._._.;......... - -._.....�.........._.. 1....._...., _.. ......_..1..._.._....__......1......................_.__.._...........' 1 ................_.1 _.. ................. -- .. ........ I --..._....._...__;__..� ..>.._...$..._._ ....._....._... ....._._..................._. ...._............................._. >............;_.........-_....._........................_. , -.�......_....,............ ...__I I . —...... . ._._. _..._ .... 1...... 1..._ I _ - , , Io _. _....__..,........ {._.._ ..._.. � ,_...._ .. .. ,._.... I I I i _.._�_._.._....._..._., -1-..............__.�.._....__._.._ �._.... .......... ........._i-._... r._...._�......._. +......_ �. - ... _.. - 1 .. i I v �. Imo.. �_....__._____- ._. �..__ __............:__ _. _; __.! _.. I fi ........ 1 �.._ f......... _:t _.� .............. ........... ............ ........... I i t_------ .. -r .. .. ! jIcI DEPARTMENT USE ON LV DATE:APPLICATION ACCEEDPTED Bt O'O' REA 2{ 2' EMPLOYEE IDpry �' 5 DISTRIITA—LOCATION 1 INSPECTED BY: O DATE: A PERMIT FIA DATE:I� -/OLINSPECTOR:� iG J• COMMENTS: � I'1/ A/Q� j! Cp Q r �/ 7 r e PE CODE SC INFO AMOUNT CHECK .ASH RECEIVED DATE (((PERMIT/SERVICE REQUEST# INVOKE# SEPTIC ID# REMITTED BY 2 I g -)-So -3 5G 0031 q-14- REYISEDR45-01 - -- --