Laserfiche WebLink
ONSITE:-.._ASTEWATER TREATMENT-9'YS`1'kM},,.,RMIT 0 <br /> AN�IIA4ium COur1Y ENYIRONME.NTAL HEALTH DEPARTMENT 314 E WEBER AVE.Yr FL-STIKIRI'0.1 CA 95202 -(I")468-3420 <br /> f�fpN-REFUNDABLE PERMIT CALL(209)953-7597 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED 1 <br /> dOBAenares Q -`+ CnwY/rP 1S6to-to <br /> CROS ,,((J� <br /> SSIHEET _.._FJ et r!L- APV(513 -I3D i`7 ?ARC VA.ZZ <br /> OWNERNAME PHONE <br /> OWNERADDRESS CITYNrATF:lLIP <br /> E CONTRACTOR PHONE <br /> CONTNACIiOR ADDRESS CIlY7S7ATF/ZIP <br /> li �r <br /> LICENSE 0 C42 Q C-36 UTHP.R NUMBER EXPIRATION DATE -r <br />' WATERTABLEDEPITI: fl GEOGRAPHICALINFORMATION: Coordinates X V <br /> Q PERC TESTS) NUMBER LAND USE APPLICATR)NV <br /> TYPE OF WORK: NEWTNSfALLAION ❑ RFPAIRlADDITION O ENGINEER DESIGNED!ALTERNATIVE <br /> 0 - REPLACEMENT Q Dk_CrRUL-1'ION <br /> INSTALLATION WILL SERVE: RESIDENCE ❑ COMMESWIAL ❑ OrIrER <br /> NCMBEROFLIVING UNUM: q � NUMBEROFSEDROOMS. NUMBRROFEMPLOYEES. -,rJ <br /> SEPTIC TANK TVPTJM}Ti ! 1�_ CAPACITY o <br /> mm_._.,,__ _,« g'aI #UF COMPARTMENT$ c t� <br /> ❑ GR£ASETRAP TNPr1MYC CAPACITY gal #orCUMPARTMENTS <br /> kyr a 1 <br /> ❑ PKG 7'X PLANT--IJIsI'wrR:F ri)NEARTJi T; WELL fl hrn;NUA)Tux ti Pk01'lik1'Y LINE:�p <br /> ❑ LIFT STATION Sim TYPE OP PUMP ❑ SAND OIL SEPARATOR(ENCI JSEn SYSTEM) <br /> I <br /> LEACH LINES ❑ LEACHING CHAMBERS nor LINES rLF.V(Tl'll OF'LINES__-�� <br /> DISTANr:RTo,NEAREST WELL R FOUNDA110N ft PROPER IYLINE _ R <br /> - ❑ FILTER BED WIDTH It. LENGTH <br /> DISTANf:RTONEARM.' WELL ft t1111NDATRiN 11 PROI'I:RTY LINE 11 <br /> 13 MOUNDED W Im R LENGTH a DEPTH Il <br /> DIRFANCETONEEAyRE6T WELL ft FOUNDATION ft PROPERTY LINE it <br /> ICE, <br /> SUMPS WIDTH �-^ fl LEVO�T�H � ft DEPT. fl <br /> / DISTANCE I'l1 NEAREST \VL•LL-e ft FOUNDATION /'� It PROPERTY LINED R <br /> ❑ DISPOSAL PONDS WIDra ft LENGIII R DEPTH ti <br /> DISTANC TO.�'EARCST WELL ft FOUNDATION R PROPERTY LINE fl <br /> SEEPAGE PITS WI fl NGTN ____$ DEPTH H <br /> DISlANL FTONEAAEST WELL r r l MmTIDN fl PROPERTY UNE 17 <br /> 1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONT IN ACCONDANCV WITH SAN JOAQUIN COUNTY ORDINANCES, I <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUINCOUNTY. <br /> T!II.NUM Za HOUR ADYAICF Nf)nCE REQUIRED FOR 1NSPECI110NS-PI.F:A.tih:(:Ai.l,(2I19)953-Th47 <br /> SIGNED Tins DATE L - <br /> T <br /> no 1 sl F <br /> slilsh A p R 3 .,•y rr <br /> t an 0-,0 r er an Ila w <br /> - <br /> s uln to <br /> 1 <br /> 4k I <br /> rN <br /> I DEPARTMENT U7E ON <br /> Appllcatlon Accepted B C Date ^ Arca ,., Employee]DO <br /> Final inspection By Dateakze4l� ❑ SPECIAL PERMIT-Appmted by / <br /> Character of Sall to De of3 FI: Pit/Amp§oil Character: <br /> COMMENTS - 0 001 �Ll F- �,�.J?1:ku _ 4L1 ._ x U :.' , I L 73 LYr� <br /> Y � �c <br /> PE SC Receivedceldt_/ 'Amaunl a Permiu � <br /> Code 1.rro By x Remitted Dao Service R uest R Inwiee A Permit IDN <br /> 42 1-001 <br /> II21D2 i f Aq a69,�/i�u/ a'P-. -If(r/A.0l4 3r`Z$..CAAdw9A?.'kSN' <br /> TFATER PERMIT <br /> .O la/{r/r01�.5tJK AD AZO/v--G-cic.G/Pil�v". 14*9 Ave - 3,601 P6, <br />