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- <br /> y.beeJ. r <br /> APV I ICATION 011 LIQUID WASTE PERMIT <br /> SAN JCA':UIN COUNTY PUBLIC HEALTH SERVICE) / 1\�1\ -•- <br /> FNS'IRONMENTAt HEALTH OITISIGN I •ilD "Y# <br /> memP.O.BOX 388, 446 N. SAN JOAOUIN ST,STOCRTON,CA <br /> 12091 4603420 <br /> NOBI It!UIDeEE[PEbMIT ExPu S rt 4 I f A ar 0 E ss II✓ ' . <br /> fOanyi.T.r r.:iW.ui � <br /> r Application is hereby nada to the San Joquln Canty for a permit to construct udfor tmull the vOrk do.crl41 <br /> is made in compllaece with San Iapuln[antY Deuaiepoent If lin, chapter 9.1116.3.rd the Standard.of San Jpapdn Cantr PLCI Ic Mucin <br /> Services, Emlraeentnt Health O-vision. // <br /> Job Addru./or IVYI /��� w- �J�' '< T' TF I i- City .f r—'�-( lot Silo __ <br /> QRMf'a Name fr...[r- T-. �Pr �.Lddr... 15 L..J r' ( C"A-tt� C Phm. ((•/ Jnr <br /> lJ h J Phots <br /> Contractor Ate_ Addreu _— Ll' - <br /> sub eontfKtor Addfeu _ti<#___ phO'r <br /> .� ITIE OF SEPTIC WOW: NEN IR1A114710N 11141� R[IAINADDfT1aN I 1 <br /> DEAIOUC110N 11 It RC THEW III it..roq <br /> (Mo SEPTIC SYSTEM PERMITTED If AMILIC SEWER IS AVAILABLE YITXIM 200 FEET 0: BUILDIMC-` bJ Use APIIWAIa.F <br /> brtsilatlm Milt serve. Camarcial '/Other_ �, <br /> Load" of living enitat_ Mu1wr of badror.u[ Nh.r of m <br /> uryloYe.e: , <br /> a. r Wear ISDIe Depen V1 <br /> Gvracter of moll to • depth of : Mu n x,rplt/sup Scall [Mncnr._ ,�._' <br /> Mo. C <br /> $UqM TANNOBIREARE TRAP 11 Type/1414 c.a.c.tr -��'..--� � ap.n..nt. <br /> ?III TREATN.7T pLANTOIA Diatrs. to nearest: watt Fwd.ticn�F _ Proper[Y tlnx--;71 <br /> ` LIFTSrAT10MI) Sin__Tyr of Peop__ Sand Off Sept-ator (enclosed system) <br /> LEACIONO WE II Ma. A terpth of if..3 ' /OO OnstaKe to Mearaat: Yel l.,00 iFard.[IuyTCtO Property lIM �.i <br /> FILTER!® (1 Yldth_Legth__Dep[h__ Yell_- Foudstim__P:opertY Line 1U <br /> woum (I Vidth_I.anpep <br /> th__Depth_- • " Well_ Feuda[im__Property LIM 1 <br /> L N RE9110 FIT$ 11 Depth_Cf[.__ MuIE r_- Vnll_ Fwxrtim_Property LIM -}J <br /> NOW& IT Yldth�Larsith_Deptn_ " <br /> Wet l_ Faxdatim_Property LIM <br /> R/ <br /> 4 Vail _ Foudotlm__Property'in <br /> DSfp6id l0lDi [] Yldtn_Largth_Depth --- <br /> emeg 1 Mr Wy eartlfY Nat 1 naw prop rad thfa ppifutlm aha thatina wet Mlll M dw in Keerdrm�MitA $m Jopuln CuntY DNfnr.-N <br /> and State Lw, and But" and ReDedstlme of the San Jopuin Canty- Nrr ana,or licensed egAnt*& &:mature certifies the fol ltx li S <br /> p{ [ mi certify that in the peefofeteca of the wrk for Mich this permit is Issued, 1 shs!! not se ItW rry peram In such a maMer as <br /> i to becme rb`m•t to uortarn's cmPs"N""On imus of Catfforniach Contractor's pemits nfrlry it sh.tt apjoy mr. �tb)�t to innortnor"IE: <br /> folloming: "' "'tiff,that In the p.rforsrrce of the wort for ebich cola permit la luuad, ep %'P I { <br /> 3j F California! <br /> Tya inose, !' year)..! Nf.gdrM 1plrtra Caplet.draufn, h.lw. <br /> t florMd% <br /> PLOT PLAN (Dr.. to Scale) Scale_ _' to y`7 <br /> t. L.xatim o/ house oMage diepoas: system or <br /> 1. Mamas of streets or roads, Msroat to or b xx [M property. sed .x lm of ...q.dlapaal ."tome. <br /> 2. OutliM of the property, MItT..dlastsions aha Horth direction. S. Loc.t � <br /> im Ofileito Within radtwa of 150 ft. m <br /> Mm <br /> j 3. D/aml .d outfits, and Loultlm Of alt existing W pruposad tno property or adjoining property. <br /> atrYDTwos, Including co"rej eros ach a pa[loc, drl Vewaya, <br /> and watts. <br /> r <br /> r. <br /> ft <br /> n FAY <br /> 'y P Y E T <br /> - R G IV D <br /> r <br /> 6el N 6r•UN <br /> s <br /> "T — l5• . He 'AL EAL H OV iSiO <br /> j-3 f;f;rt3ptQ- FOS DEPARTMENT USE ONLYame <br /> "I lc.clm Aec.ptad by <br /> l: Date / J Ferol tropectim ty ! <br /> Trli, Pit or $[.4' Inspection b)' � � � :„'� �� may rr✓i.�. <br /> Am!tleroi Comments: <br /> wee TACO <br /> AAAA N..e <br /> ACtVUMTW D%LT: AID# — <br /> PF fADF LEE <br /> INFO AMOUNT A[WTitO [FUSMEIYf0 R DATE =ZUK"A <br /> BeIRY09a E1. '• ,rI <br /> fm <br />