Laserfiche WebLink
r - APPLICATION FOR LIQUID WASTE PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH OMSION <br /> P.O,BOX 385,446 N.SAN JOAQUIN IT,STOCKTDN,CA SSZDI-0388 <br /> (ZOSI 488-3420 <br /> 0QIF•REFIIRDASLE PEIt11R EXPIREi 1 YEAR FROM DATE ISSUED <br /> If yfM/k Tdp§WW <br /> APNJCATOW O spllY MADE TO THE SAN JOAOLIN COUNTY PDII A PQMfT TO CONVTA/CT ANO,OR INSTALL THE VAOM OESC1SBE0.THIS AMXATION N MAOf N CO►iVMICE!%STH SAN <br /> JOAOUIN COUNTY DENMLOPIENTTTTITLE..CHAPTER II 1110.3 MO THE STNIDAMB OF SNI JOAOWN COUNTY PUNK HEALTH 419WICEL EN�NOANUDIITK HLAALLTI . <br /> DIN OOmillo <br /> JOB ADEBf,OR kPK0 5�_Z <br /> IS cm L��iJ�J1/ L_.II-IFLOTT sum <br /> OWNERENA/AEADDIEfB �IC P1f011Ejjj./3b�Z <br /> CONFMCTDI�� ADORES-T7��/��/IL SF)N WY HCP` - ��a R701PJ <br /> SUB CONTRACTOR Yf�'--?"L _ ^AODIfDS _uC* FYAHE— <br /> W I TYPE OF"IFTIO wow: NEW INSTALLATION❑ RVNNIWRT1oN PIOTPLUCTON 13 <br /> (PUO @TIC SYSTEM PEIVATTED N PUBIC SEWER IS AVNIANE WTHIN 200 FLET OF BUILDIN0.1 B w MANY <br /> K A,,P AN�SNI I, <br /> NpALLATION WNL wive IedDEACE coFAM sx.❑ oTHER❑ <br /> _ NullIIIIIw OF LMM ufTS: I NIA`JIS�1 NUNrl DIP IMPUYN& <br /> A�f�i <br /> pFA1VLCTETI OF SOU TO A DEPTH OF i RET: , /BUMP SOIL CNARACT9E ���IWATER TABLE OEll �( <br /> S/IIG'7ANRNr/LN TRA. ,�TY14AlIF0-�� 1 L CAPACITY/� (SIL NO.COHAPARTNEMS - <br /> PILS TWATTBNIT <br /> RANTJ "ICE TO ONtl`iT: LhmI � I OUNDATIDN/O,-}- PMDPERTY_INE� <br /> LiFTSTATION[yTTOF rUNw SAND OIL SEPARATOR[INLOSD 11YSEUI <br /> SUN` LSACRIN IM J <br /> T� <br /> LMH_ ' �C L� T DISTANCE TO N[wilfT:WBL EOLAOA:TM]N PR019RY tld 1,.,0_ <br /> PETOH NTJ 13 WVTN LENOTH vDLRH DISTANCE TO NLWfT:WHl FOIMJATION PMPF]TY LINE_ CA <br /> NOLSSOb (3 WOTN LENGTH— ---Dl1TN DISTANCE TO NEI WELLFOI:MPE <br /> ATION r IJFTY LIE <br /> SmAOf RTS ODEPTH BGE NU%WN DIfTANCE O <br /> TO WMENT:WELL FJLNDATN PIOPERTY LINE <br /> SIPS Q WIDTH LHPOTH DEPTH DISTANCE TO NEAPEST:WELL FOUNDATION W"E TY L/! <br /> DWPOSAL PONOS O w1DTN LENOTN -•DEPTH DITI MICE TO NEAFIEFT:WRL__FOUNDATION FFONATY LING <br /> r, <br /> I HUEBY CEPDIFv THAT I HAVE PTEPAPED THIS APPLICATION AND TI VUT THE WOW WILL K DONE N ACCOPOANCE WITH SAN JOAOUIN COUNTY ORDINANCES AND IFTATT LAWS.AM RUES <br /> AND WGULATIONS OF THE SNI JOAOUINCOUNTY.NODE O%T#"OR LK EN9ED AGENT'S SIGNATURE CORTWES THEPOLLOWNIO:T CERTIFY TWAT N THE Pe"Fl LANCE OF THE WOPPC FOR WESCH <br /> TILS PEF&Ay IS IBSUED,I SHALL NOT EMPLOY ANY MASON IN SUCH A UMWn M SI SSUBJECT TO WONUAVIN'S COMPD/SATON NAW$OF CAI/ R' <br /> DISAOL' CONTRACTOS HSMO OR <br /> SVB-CONI SONAT WE CERTIFIES THE POLWMNO:T CERTIFY THAT IN THE NFIFONWANCE OF THE WOPK FOR WHICH THIS NP"T IS ISSUED,L SHALL MPLOY PERSONS SLJBECT TO <br /> WOPKWUFS COMPENSATION LAWS OFC 7 APRJCAIR MLMT CALL b HOW N ADVANCE FOR ALL REGV111m RNPIWTONS,CON IPLETt OPLAWLNO SIDON. <br /> °aNm <br /> ROT PUN IMAW TO SCALD SCALL b <br /> 1.NINES OF SREETS OR MADS NEARfT TO OR NOUNDNG THE PROPERTY, 4.LOCATION OF HOUSE SEWAGE dSPOSAL SYST&A CA POPOSED <br /> 2.OUTLINE OF TWE PIOPERTY.WA'TH DEAEIWIONS AND HIOPRW OYECTON. G{PANDJN OF SWAGE DINOSN.SYSTUAS. <br /> 1 DRAINSW ED OUTL.SEN AMD LDCATON OF ALL E)IBI110 AND NIOPOSED STWJCTUNEE, S.LOCATION OF WELLS WSTNN RADIUS OF 014 HNDFC0 NIFTY FT.ON <br /> NCLUOND COVE/lm MEM SUCH AS PATIOS,dSVEWAYS,AND 111.. TIE PPOPYITY OR AOJOININB""Iffy, <br /> s <br /> ,N i <br /> i <br /> � 1 <br /> — <br /> .....,.. .I:. I .: e _ <br /> ... . .i: ::. - ►moo <br /> ....a........ . µ- ... . <br /> _. . _ <br /> t <br /> . ....... ... <br /> 3 77 <br /> APPLICATION ACCEPTED BYI^isDAn:- - - - -- ATEA <br /> TAW,PTT OR SUIS N1BPEICTION BY DATE _( I FINK INSPECTION BY DAT <br /> I <br /> ADOITONA_CDMUEPTl �r L !LY+NT.•� <br /> L - l L <br /> At coLJNTB'.o oNlr: AIOF TACE ,est / <br /> N COTS PEE IPlO AMOUNT RPN',I ASN wwmIvE6 BY PATE M I PYEtT NUTAEM IIIVOT•f S <br /> 7 <br /> a <br />