Laserfiche WebLink
LIQUID WASTE PERMIT..� <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION <br /> 304 E.WEBER AVE.,3"D FLOOR.STOCKTON,CA 95202 (209)468-3420 <br /> NON-REFUNDABLE.PERMIT EXPIRES I YEAR FROM DATE ISSUED <br /> l <br /> . .091 <br /> F <br /> DRESS <br /> CI'1'Y/ZIP LIQT 1^ ��Z 0 PARClE�LLSIZZE/APN <br /> OWNER NAME _QJU- ij) � PHONE <br /> r-M0-p%--ADDRESS li�7 7 E TDLA y��j (_'_OLDA1 S� <br /> CITYMP_�Q CA 15;Z40 �l+2��I s e 93 <br /> CONTRACTOR QE'L! �A A]pG DG01) ADDRESS 2A N0 0- <br /> PHONE <br /> CITY/ZIP LBOT <br /> GEOGRAPHICAL INFORMATION: COORDIA7NTES: X Y TOWNSHI---r— GE SECTION � <br /> PERC TEST(S) (✓) HOW MANY 1 APPLICATION#: NN*-97-;0 <br /> TYPE OF SEPTIC WORK: ❑ NEW INSTALLATION ❑ REPAIR/ADDITION ❑ DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑RESIDENCE ❑COMMERICIAL ❑OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES <br /> CHARACTER OF SOIL TO A DEPTH OF 3 FEET: <br /> PIT/SUMP SOIL CHARACTER: WATER TABLE DEPTH <br /> ❑SEPTIC TANK/GREASE TRAP TYPE/MFG CAPACITY NUMBER OF COMPARTMENTS <br /> ❑PKG TREATMENT PLANT DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE-- <br /> • <br /> INE _❑LIFT STATION SIZE TYPE OF PUMP SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑LEACHING LINE NUMBER&LENGTH OF LINES / INFILTRATOR CHAMBERS <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE <br /> ❑FILTER BED WIDTH{ LENGTH DEPTH <br /> DISTANCE TO NEAREST: WELL FOUNDATION: PROPERTY LINER N <br /> ❑MOUNDED WIDTH LENGTH DEPTH RECEIVED <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LII I _ 2001 <br /> 13 SEEPAGE PITS WIDTH LENGTH DEPTH ���u <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LVM6 LIf)AJaUHEALTH ERVI T <br /> ❑SUMPS WIDTH LENGTH DEPTH NVIRONMENTAL HEALTH DIVISION <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE- <br /> 0 <br /> INE❑DISPOSAL PONDS WIDTH LENGTH DEPTH <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE <br /> - <br /> I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDIANC \TF. WS,ANDA RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. t J <br /> SIGNED: ` � TITLE: `�1, DATE: ` <br /> -SNITH- <br /> ��TIoJ v? P�cO(.ATrCw1 <br /> TEST <br /> N 66.4744 E 709.6]' N 66.4744'E 72967• <br /> 20' 20' 46 <br /> mC moaf- <br /> I <br /> � e? <br /> I <br /> N[TEIIWV ROAD — <br /> N•, ., IIAFIIEY UIE <br /> PROPOSED PARCEL 1 PROPOSED PARCEL 2 >! oNAr <br /> 5.00 ACRES GROSS : 4.99 ACRES GROSS <br /> 4.55 ACRES NET 3 4.84 ACRES NET jl -GEORGr- <br /> 10,ILI REMF <br /> VICINITY MAP <br /> $ 1050 loo NOT 10 SCALE <br /> 8 { <br /> \.. 5T- _.0.�_A�r.�-72' I -WA DFLL- <br /> T :u sar <br /> o '.�:9T11�••, 'sro9r 1 INCH� 100 IN /T. <br /> �/W56 <br /> '9'm6940 j Ex <br /> I • �9 �� �^� <br /> m <br /> /OAM1CMAT <br /> 274 16.4f00'E 60160' Y .,IN <br /> 66 <br /> .._._.i <br /> -- '--------- � - -- -- <br /> _ 2a Z. 20 <br /> �_ FOR SPAR 'N USE ONLY <br /> APPLICATION ACCEPTED BY: DATE: <br /> TANK,PIT,OR SUMP INSPECTED BY: DATE:_. <br /> FINAL INSPECTION BY: <br /> COMMENTS: <br /> d <br /> IV rz <br /> I'L CODE SC AMOUNT CtIECK#/ REC 11VFD BY DATE PERMIT/SERVICE REQUEST# SE C IDM <br /> INFO REMITTED C A S I I <br /> zi $I v <br />