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u : <br /> ONSITE WASTEWATER <br /> TAThiENT SYSTEM PERMIT f <br /> jwN JOAUUIN CO11N'TY ENVIRONMENTAL HEALTH DEPARTMENT E WERRR AVE-Y"YL•STOCKTON CA 95202-MP)46&3420 _ <br /> N7 - <br /> t N REFUNDAL <br /> B £PERMIT <br /> CALL 12091953-7697 PCTR INSPECTIONS <br /> EXPIRES 1 YEAR FROM DATE ISSUED <br /> 1110 ADDRM <br /> (:RU9Sr)tEET C l� f n a wPN ` <br /> 101 <br /> PARCRL 5EZE <br /> OWNERNAME E/ <br /> j (1WfICR ADDRE98 � 4e � FC�F-Lr�T f'C1LI,� ��y /1/A, G <br /> Il t!e7� Crn/ST�TFJ7t► f /L.rV `-J <br /> CUNrRAc7aR 1f1coI,7'1�1N-(. � (S]�_ �A�Tt,__-R!a ANG PHVHE �Z�7ca0� ` <br /> CONTRACTGRA DORM l� �PG.L77SAJy�rt� !'cVF, CrFWSrATFJZIF <br /> �j O <br /> IACTNsR ltC-42 CIC-36 OTIAEn VUMRER -1 EXPIRATION PATE <br /> WATER TA13 E Drrr".-___`ter It GEOGRAPHICAL INFORMATION: Ci ordimmin X y <br /> rn <br /> f C7 PERC TEST(5) NT, .ER {.AND USC APPLICATION N <br /> TYPIi OP WORK: NEw IyFTALT.ATION L7 RFPAIR/ADDITION ❑ ENGINEER DUWNWALTESINATIVE <br /> REPL4CE111— E3 urrmUCTION <br /> Ittemn <br /> ATION WELL SERVE: RLSIDSNc= {"� COMMEIICIAL S� OTItERw <br /> V or LIVING UNITS: NummER Op BEDROOM& <br /> �1�7 ���� NUMRCROE EMPLOYEE$; <br /> 5CP AS TANK TYPEIMF:C_ CAPACITY 1•iL7LJ CJ P}1 It OF COMPARtMENTs--Z� <br /> ❑ CR£ASE TRAP TVPEIMFG 7-�"'=-- � <br /> CAPACD'Y C gci #OFCOMrARTMENT4 Tu.•._ <br /> CI PKC TX PLANT DIsTANc;BTONEARR6T: WE C)r+ fl FOUNDATION J I- n PROPERTY LJNE _ <br /> R <br /> O LIFT STATION ' SIXJt TYPEOFPUMP_ CI SAND OIL SEPARATOR(ENCLOSEDSYRTCM) <br /> LEACH LIP49S %I.LLACHINg3CHAMBER31 { f MOF LfN}�_ _� (��I <br /> NOTx OF LINES A <br /> R <br /> D18TANCETONSAES♦' W&.L r FOUNDLl: <br /> FOUNDATION r <br /> _� R ^TI} PROPERTYLOVE � ,� fl <br /> Cl FILTER BED WIDTH __-_R LENGTH R Darr -�—"-- - <br /> DISlANcw rONEAR=r WELL R <br /> j R FOVNDATION _ ti PROPERTY LINE 1} <br /> + ❑ MOUNDED wmrR _.H LENGrk_.. nPFrH <br /> l DISTANCE TO NEAREST WEU_ -- k <br /> 1} FOUNDATION__ D PROPERTY LING It <br /> G SUMPS WIDriI LENUTH n DEPTk <br /> DISTANCE TO NEARWff WELL R <br /> _R FOUNDAl10N R PROPERTY LINT: It <br /> C] bI8P08AL PO[�nu WIRTx _tt LENGTH <br /> R AEPrH DtsrANcET*NrAFffr wfl <br /> ELT Il FOUNDATION fl PROPERTY LINE <br /> 03ELPAG8 PITS Wlpnl - R <br /> R ERI�r—Y -^.'�> D DEPTH r It <br /> DISTANCE TO NEAREST WELL_j_� f It IOUNDATION ' <br /> —....�Q_'�1I PROPERTY LINE <br /> I HCR£HY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND rilE W URIC WILL BE DON[IN ACCPIIDANCC WITH SAN JOAQUIN COUNTY ORDINANCES. <br /> STATE LAWS AND RULES AND 3L6CULATil1NS Of SAN JOAQUIN COUNTY. <br /> SIGNED <br /> MINIMUM 36 HOUR ADVANCE NOTICE REOVIR90 FOR INSPEc-j-wN5-PLEASE CALL(2{91953-7697 <br /> � <br /> 4, TITLE— " BATE— <br /> f; <br /> I <br /> I .I. <br /> I; }7� <br /> r <br /> E � <br /> A OEPARTMCNT USE ONLY <br /> VWkallRn Actcpt(d By <br /> Flnd iArco <br /> c Dote + A "7 {{L <br /> rrpecl Y. ,� F'mpfoyoa IUN <br /> CE+rRCTar ofS 1 o Pit Y Arlrr _�'"'L7 ❑ SPECIALPERMIT- <br /> PltlSump Solt Chsrcctcr ADAwrd 6y <br /> COMMENTS --�'--- .y <br /> tic ReC*chv Cher <br /> �:I+dc INPk Amount �. <br /> ZB e'N Rcmwcr Dale . <br /> 3�3 7 Se�e ueu � IDY T3 PWto <br /> cr <br /> ONBETP WASTEWATER PFR54T <br />