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LIQUID WASTE PERMIT : <br /> SAN JOAQUIN COUNTY° T HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION - <br /> i.� 304 E.WERE 1101 FLOOR.STOCKTO`I,CA 952N2 209)AW3420 <br /> �+ L V{I�FA�+/.�I�N-REFliNpABLE PERMIT EXPIRES I YEAR FROM DATE ISSUEDn <br /> JOBADDRESS S3 0tj go. . APN 08r, Ql17' �G .PARCELSIM �Q <br /> &.P C"rLIP_f V. 1 DL��"1'11.1 [?d1• - - BUILI1i�AMl7I - - <br /> OWNERNAME 12(3EF_PY , ,)JES, ...d_, ADD14SS �� ro���- ..--Ol1Cfl1S 1),0. - <br /> I..R CrTYmP 1-162' CA ?5292 �THONE NUMBER(r/c;-,ri� 7VC.� I3 <br /> CONTRACTOR A)IEL ,Q. ,AAJjdAI t ADDRESS `QAJ <br /> CTTY17JP PHONE NUMBER - 60q) 30-3-701 _ 1 <br /> ti. GEOGRAPIRICALINFORMATION: COORDINAZES:x - Y TOWNSHIP RANGE SECTION <br /> TYPE OF SEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: <br /> y <br /> ❑ NEW INSTALLATION O RESIDENCE NUMBER OF BEDROOMS: <br /> ❑ REPAIRIADDITION - '0 COMMERCIAL - - <br /> �... ❑ DESTRUCrION Cl OTHER NUMBER OF EMPLOYEES: <br /> +❑ ENGINEERED/ALTERNATIYE <br /> CHARACTER OF SOIL TO DEPTH OF 31: PTTlSUNIP SOIL CHARACTIEIER: WATER TABLE DEPTH: - - <br /> PERCTM(ST HOW MANY^ 3 APPLICATION fl 09"H - <br /> ❑ 'SErrlCTANK TYPEIMFG CAPACITY NOFCOMPARTMENTS - F <br /> Cl GREASETRAP ' TYPUMFG - CAPACITY - II OF COMPARTMENTS <br /> �, ❑ Pkcm PLANT D1STA,CE TO NEAREST: WELL - FDUNOAYION PROPERTY LINE - - - <br /> ❑ LIFT STATION SIZE ' TYPEOF PUMP SAND OIL SEPARATOR(ENCLOSED SYSTEM) �J,1 <br /> ❑ LEACH LINE #OFLINFS: LENGTH.OFLINES: DLSFANCLTONIARLST: WELL FOUNDATION PROPERTY LINE 4 <br /> INFLITRATORCHAMBERS: <br /> ❑ FILTERBED - WIDTH LENGTH OEM DINTANC,T?O I.RARC4T: WELL FOUNDATION - - PROPERTYGI�_-_� 'T <br /> ❑ MOUNDED WIDTH LENGTH DEPTH - DIRAI'mroNIAgm; WELL FOUNDATION PROPERTY LINE- <br /> . ❑ SUMPS -WIDTH !EN(TI DEPTH I)WrANCITONIARRSTI WELL - FOUNDATION . PROPERTY UNE j <br /> ❑ DISPOSAL PONDS WIDTH LENGTH OEM bMAN TDNIARCST: WELL FOUNDATION PROPERTY LINE � <br /> V\ <br /> ❑ SEEPAGE PrTS M DIAMETER DEPTH DRTtAMCILTDMTANLST: WELL FOUNDATION PROPERTY I,R.F <br /> i.R. I HEREBY CERTIFY THAT I HAVE PREPARED THISAPPLICATION AND THE WORT[WILL BE DONE IN ACCORDANCE WITH SAN JOAQOFN COUNTY ORDINANCES,STATE LAWS '\ <br /> AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. n <br /> ` MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)466-3423 <br /> SIGNED. - —- �rL17' Fl• - TITLE: 7`15CAI IU I(_r A 11 DATE: I <br /> 4 54,11F4.1--li. <br /> ! 1 r <br /> � _ v <br /> T iIAF MN ! i r 1 A '�o ib r <br /> ' yol I <br /> war <br /> - s c� <br /> W P. p -email F ,I <br /> f <br /> 'APPLICATION ACCEPTED 6Y.' DATE:. I! L AREA�EMPLOVEEtDP F DLSTRIC9 COtA710Ni - <br /> Lr INSPECTED BY: - DATE` - PERMIT FINALO (YTS DATE INSPECTOR. <br /> COMMENTS: <br /> PE CODE 6C MFp AMOUNT CNEC ASH RECBy ED DATE MRMTTiSERVICEREQUESTR- M'/OICE>r, SEPTIC IDR <br /> �s REMfT"FEd _ <br /> S2are 9Jp <br /> Pf <br /> RIY¢ID LIST] - - <br />