Laserfiche WebLink
ONSITE WASTEWATE TREATMENT SYSTEM PERMIT <br /> AY✓"/° 304 E WEBER AVE.3�OFL-STOCKTON CA 95i 112")16S-3420 <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEAL"DEPARTMENT `NN•fLU <br /> NON-REFDNDABLE PERMIT CALL 2 SS-7697 FOR INSPECTIONS EXPIRES 1 YEAR FRO ATE ISSUED <br /> N <br /> JOB ADDRESS CITYIZI/PA1� Ee m <br /> j.. �'aj [ T O Lll C VAPIY 7`- o � PARCEL SIZE <br /> CROSS STREET - J�-`t-e ///JJI �/ <br /> (LI ) PHONE R <br /> OWNER NAME <br /> JIL7 Hg //V F . fc� S''/z <br /> GAITER ADDRESS Crl'Y/STATFJZIP ✓� <br /> v — v PHONE xS v I <br /> CONTRACTOR <br /> n . <br /> LICENSE C3 C-42 ❑C-36 OTHER NUMBER EXPIRATION DATE <br /> WATER TABLE DEPFN: ft GEMILPHICALINFORMATION: CDHAYR2HH X Y <br /> ❑ PERC TEST M BUILDINGPERMIT# LAND USE APPLICATION# <br /> TYPEOF WORK: ❑ NEW IrvSTALLATNIN ❑ REPAIR/ADDRIo�n/ ❑O E_NGnIN ER'DESICNED/AyTERNATIVE <br /> y DESTRUCTION y W� (�E <br /> ❑ REPLACEMENT Q <br /> INBTALLATION WILL SERVE: ❑ REMDENCE ❑ COMMERCIAL U Drive <br /> ry L U TS N FB OOM NUMBLR OF EMPLOYEES: <br /> ❑ SEPTICTANK TYPE/MFG CAPACITY gel #OFCOMPARTMENTB <br /> ❑ GREASE TRAP TTPF/MFO CAPACITY $SI #OFCOMPARTMENTS <br /> ❑ PEG TX PLANT DISTANCETONEARFST: WELL R FOUNDATION ft PROPERTY LME R <br /> ❑ LIFF STATION Stil TYPEOFPuMP ❑ SAND OIL SEPARATOR(ENCLOSEOSYSTENO T <br /> ❑ LEACH LINES ❑ LEACHING CHAMBERS #OFLNES LENoTHOFLNEs R T <br /> DISFANCETONGRFSF WELL ft FOUNDATION It PROPERTYLNE R <br /> ❑ FILTER RED WIDTH fl IENOTH It DEPTH A <br /> DISTANCE TO NEAREST WELL R FOUNDATION A PROPERTY LINE It <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCETONEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SUMPS WIDTH fl LENGTH R DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE R <br /> ❑ DISPOSAL PONDS WI1xx ft LENGTH R DEPTH ft <br /> DISTANCETONEARFST WELL R FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDJM ft DEFrH IF <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> 1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINANCES.STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUA1}24H UR ADVA CE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL t209)953-1697 <br /> SIGNED 1 1 = /� TITLE (-: I DATE X12-as- 65 <br /> F � <br /> 1 D <br /> �y9. VE <br /> S <br /> SAHE <br /> =t:—_ <br /> RTMENT EON V <br /> ApPlicatbn AccepteDteAraEmployee ID#Flo.[lnspatbn ByDete ❑ SPECIAL PERMIT-Appmved byCbaracm,OfSoil,. PI '.. herWw': <br /> COM/ME/ TS ��{J BE.•�il./:�. Yriti GJ� _�.�r_!S <br /> PE SC Received cNaHi c Amount MIe PtrmiV Invoke# Permit Im <br /> Code INFO CRFh Remined ServiaR Dent# <br /> lot o C, quos <br /> 6202-001 ONSITE WASTEWATER PERMIT <br /> 1263'2001 <br />