SU0006156 - Laserfiche WebLink

Home Browse Search

ONSITE WAST -'WATER TREATMENT SYST- Z PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH D_...,TMENT 304 E WEBER Atm-3"O FL-STOCKTON CA 95202 - (209)465-3420 NON-REFUNDABLE PERMIT CALL(209)953-7697 FOR INSPECIONS EnXPIRE,,S I YEAR FROM DATE ISSUED JOB ADDRESS I S� J`�r Y VY ! .. > CITY/ZIP J/ (-6 " ' C7 Z Lo -� CROSS STREET 1 /a.0 INLVO-(CV X0 APN ( /V�/It7 0 j I PARCEL SIZE Cl rM OWNER NAME c� N✓'I o V ,...J�/ " V r/. �ij L IV,/ PHONE OWNER ADDRESS mm/ 7 W��/I�% �� SL" �yVK`� CITY/STATE/ZIP CONTRACTOR /'1�DO/Irp'LU -f"' S}�zyr2T ( I"`ON� PHONE Zo J CONTRACTOR ADDRESS J�CITY/STATE/ZIP (J 7-b e/, DW Jt- LICENSE ❑C-42 ❑C-36 OTHER NUMBER / ) % S�0 EXPIRATION DATE WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y ❑ PERC TEST(S) NUMBER LAND USE APPLICATION# Af- 0U 7 TYPE OF WORK: NEW INSTALLATION ❑ REPAIR/ADDITION ❑ ENGINEER DESIGNED/ALTERNATIVE ❑ REPLACEMENT ❑ DESTRUCTION INSTALLATION WILL SERVE: ❑ RESIDENCE COMMERCIAL ❑ OTHER J 1 !NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: J..EPTIC TANK TYPE/MFkz I� �S� y yyyyCAPACITY L7L-)OOgal #OF COMPARTMENTS Z IGREASE TRAP TYPE/MFC dQ/1i'� /'d441 Zyalo1e CAPACITY LOUL) gal #OF COMPARTMENTS 2- ❑ PKGTXPLANT DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OF PUMP ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) LEACH LINES ❑ LEACHING CHAMBERS f'�L � #OF LINES J LENGTH OF LINES e?22 ft DISTANCE TO NEAREST WELL ft FOUNDATION 1Z ft PROPERTY LINE .30 ft ❑ FILTER BED WIDTH ft LENGTH R DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE tt gJ ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft tLl _n1 DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft L3 DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH_ ft > L/ DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE +� ft SEEPAGE PITS WIDTH ft LENGTH ft DEPTH J ft C(d DISTANCE TO NEAREST WELLs� ft FOUNDATION �� ft PROPERTY LINE Z ' ft Y n 1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS AWS CATION ANDES REGULATIONS O THE WORK WILL BE DON INA ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, TE AND MINI HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS—PLEASE CALL(209)953-7697 f TITLE QLt//�7� DATE SIGNED I � L � i C • VRO M N� F{ LT DEPARTMENT USE ONLY L Application cep y �i�. _ Date 2 n Area Z Employee ID# S 3 VC(r Final Inspc tion By Date ❑ SPEWJL PERMIT-Appr`o ,ed by pit/Sump Soil Character: Character of o Dept of 3 Ft: COMMENTS - 3e� 3 3 -z " a `c rC Zit ewe. l,� rs c PE SC Received Check# Anion Permit/ Invoice# Permit ID# Date Service Re nest# Code INFO By Cash Remitted 42-01-0 12/2/02