Laserfiche WebLink
APN CROSS STREET ENI> s-ro Xxia • 3('c-o't PARCEL SIZE 4- fit • <br />OWNER ADDRESS Ar-A-rnP o 2-9-1 '4o Al. So IA3 Le c ez-b • crwsTATElip <br />LICENSE E10-42 C-36 OTHER NUMBER EXPIRATION DATE <br />WATER TABLE DEPTH: <br />PERC TEST # <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />BUILDING PERMIT # LAND USE APPLICATION # <br />9 COMMERCIAL 0 OTHER <br />NUMBER OF EMPLOYEES: <br />INSTALLATION WILL SERVE: 9 RESIDENCE <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />CAPACITY gal # OF COMPARTMENTS <br />ft FOUNDATION ft PROPERTY LINE ft <br />ft DEPTH ft <br />ft FOUNDATION ft PROPERTY LINE ft <br />ft DEPTH ft <br />ft FOUNDATION ft PROPERTY LINE ft <br />ft DEPTH ft <br />ft FOUNDATION ft PROPERTY LINE ft <br /> <br />ft DEPTH ft <br />LEACH LINES 1:1 LEACHING CHAMBERS <br />DISTANCE TO NEAREST WELL <br />FILTER BED WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL <br />MOUNDED WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL <br />SUMPS WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL <br />DISPOSAL PONDS WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL <br />SEEPAGE PITS NUMBER WIDTH <br />DISTANCE TO NEAREST WELL <br />SEPTIC TANK <br />GREASE TRAP <br />LIFT STATION <br />DISTANCE TO NEAREST: WELL <br />SIZE TYPE OF PUMP <br />CAPACITY gal # OF COMPARTMENTS <br />ft FOUNDATION <br />PKG TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND TFIE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />INIM M 2 UR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 <br />SIGNED TITLE La—p-15ki 1.-7.4t &di DATE <br />ft PROPERTY LINE ft <br />NEIN INSTALLATION <br />REPLACEMENT <br />0 ENGINEER DESIGNED /ALTERNATIVE TYPE OF WORK: 0 REPAIR/ADDITION <br />0 DESTRUCTION <br />TYPE/MFG <br />TYPE/MFG <br />LENGTH OF LINES ft <br />ft PROPERTY LINE ft <br /> ft DEPTH ft <br />ft FOUNDATION ft PROPERTY LINE ft <br /># OF LINES <br />FOUNDATION <br />JOB ADDRESS 42-11 e Bi_ves-r-DAJE CITY/ZIP 14cm-114 p 0 <br />OWNER NAME F lac b 514 ITH PHONE 32-9 - 3 -71 g <br />CONTRACTOR C-I tIC OAK- C.,-COENvi ezz Ami EA I L PHONE 36,9-on 5- <br />CONTRACTOR ADDRESS 40 -1 (Ai fiK 57-• cmysTATErzip Lobt cit 9 3-2-4o <br />of 3 <br />Application Accepted B <br />Final Inspection By <br />Character of Soil to <br /> PAYMENT <br />RECEIVED <br /> JUN 18 2019 <br />JuAQUIN COUNTY <br /> ENVIRONMENTAL <br /> TI DEPARTMENT <br />SAN <br />A\ <br />i\J <br />• <br />DEPARTMENT4E oNLy:/ <br />5:10 Pk4-e Date Area Employee ID# <br />Date 0 SPECIAL PERMIT - Approved by <br /> Pit/Sump Soil Character t: <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 E MAIN STREET - STOCKTON CA 95202 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />COMMENTS <br />PE SC <br />Code INFO <br />Received Check* <br />Cash / <br />Amount <br />Remitted Date Permit/ <br />Service Request # Invoice # Permit Ila# <br />Wi2.- -;75 /1.-1// i / 1 <br />( <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT :SSIZIGUy 311S