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PINC MTN: 1 1 NOW MANY APPIINTSTA SAN 40AQUIN COUNTY pueue sakt_D-1 SERVICES ENVTRONMENUAL HEAL.Thl DIVISOA, PAliftlE41- :RFCEJIT 11110 5 1999 E ...... . . ... TANK. OP SUMP INSPECTION BY 7- DATES--/ fe7qHPIAL INNECTION BY( AnorrroNAL COMMENTS, CAAN UL9--5G* w1/4-1, DATE: ,F07147INIT USE ONLY AppocADON ACCEPTED By APPLICATION FOR LIQUID WASTE PERMIT SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION P.O. BOX 388,304 EAST WEBER AVENUE, STOCKTON, CA 95201-388 12031 46B.3420 acoy 11011.11EPUIDA5E PERMIT EXPIRES I YEAR FROM DATE ISSUED Matiplats is Triplicate) APPLOADON it HEREBY MADE TO THE SAN JoALANN COUNTY Foil A PERMIT TO CONSTRUCT ANOXIA INSTALL THE WORK DESCANTED. ENS APPLICATION IS MADE IN COMPLIANCE WITH SAN JOAQUIN COUNTY DEVELOPMENT TITLE, CHAPTER 5.1110.3 AND THE STANDARDS Of SAN JOACKAN COUNTY PUBLIC HEALTH SERVICES, ENVIRONMENTAL HEALTH DIVISION, JOB ADDRESS/OR AMA' 6 crry ArdiLAA.,.4pZ) PHONE 1.77LOT oWNETTS 'I-le ADDRESS contraAcTon e-14-7 '2"‘ tics RIB -7-11996PHeNtpt402 31 111:4 B CONTRACTOR ADDRESS TYPE Of ILDTIO wow: wew imaretunata D REPARVADDITIONA., neareucroa a NO SEPTIC SYSTEM PERMITTED 9 PUBLIC St-wEA IS AVAILABLE WITHIN 200 FEET OF BUILDING.1 INSTALLATION WILL NERVE REBIDENCEX..... COSAIJEFICIAL 0 OTHER 0 NUMBER OF MIND UNITS; ji NOMMEN OF SENTO PANNIER OF EMPLOYEES: WATER TAKE CRATE ./04."7 1-71' CHARACTER OF SOIL TO A DEPTH OF 3 PIT/SUMP SOIL CHARACTER: same TANK/GREASE TRAP 0 TYPE/MFG CAPACITY NO. GOINPARTINErs Piro TREATMENT PLANT 0 DISTANCE TO NEAREST: WEIL FOLERIATION PROPEATY US UFT STATION 0 SIZE TYPE Of POMP SAND OIL SEPARATOR ENCLOSED SYSTEMI r-C- ...1 LEACHING UNE RI NO. IA LENGTH OF UNE/N 4,6 i DISTANCE TO NEAREST: Imeu._ef rouNto.-nori 2" PROPERTY re twurFE die, 2 •cz-A FILTER ISO a WIDTH __...--. LENGTH DEPTH DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY UNE MOUNDED 0 WIDTH LENGTH DErTH DISTANCE TO NEAREST: WELL FOUNDATION________ c— SEEI.A011 PITS A DEPTH ,V„5" i SIZE T Ir i .... 7 UMBER i DISTANCE TO NEATEST ww#2),-)___ FOUNDATIONTO PROPERTY UNE ,S.--- SUMPS 0 wanu WIDTH DEPTH DISTANCE TO NEAREST. WELL FOUNDATION PRDPUTTY USE PROPERTY UNE 1-71 DISPOSAL PONDS 0 WIDTH LENGTH DEPTH DISTANCE TO NEAREST: WELL FOUNDATION I HEREBY CURRY THAT I HAVE PREPAND THIS APPLICATION AND THAT THT WORK WILL SE DONE IN ACCORDANCE WITH SAN JOACANN COUNTY °MELANGES AIR) STATE LAWS, AND Atlas AND REGULATIONS of TEE SAN JOAOUIN COUNTY, HOME OWNER OR LICENSE: AGENT'S SIGNATURE CERTKIES TEE FOLLOWING: 10ERTIFY THAT NEN PERFORMANCE OPENWORK FOR %HENCE THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN SUCH A MANNER AS TO BECOME SUBJECT TO WORKMAN'S COMPENSATION LAWS OF CAUFORNIA." CONTRACTOR'S HIRANO OA SIES-CONTAACTING TIA3 ATuAE cEREFES THE FOLLOWING 1 CERTIFY THAT IN :NE pERFORMANCE OF THE WORT FOR WHICH THIS pERMIT IS ISSUE-D, I RIAU. EMPLOY PERSONS SUBJECT TO WORDAAN'S COI.5iATION LAWS OF CALIFORNIA," THE APPLICANT MUST CALI. 24 1401.411 IN ADVANCE SON ALL REERAND INSPECTIONA. COMPLETE DRAWING BELOW. SALTED X TITLE; DATE; PLOT PLAN ;DRAW TO SCALE SCA: E I. NAMES Of STREETS OA ROADS NEAREST TO OR BOUNDING THE PROPERTy, 1. OUTLINE OF THE PROFEPTy, ‘ARTH DIMENSIONS AND NORTH DIRECTION. 3. OIMENSIONED OUTLINES AND LOCATION OF ALL EXISTING AND PRopOSE0 STALECTIJILES, INCLUDING COVERED AREAS NIGH AS PATIOS. DRVENAYS, AND ;HAULS. 4. LOCATION OF AMIN SEWAGE DISPOSAL SYSTEM OA PROPOSED EXPANSION OF SEWAGE DISPOSAL SYSTEMS, IL LOCATION OF Ways INDIRA FULDRES OF ONE HUNDRED EIFTY FT. ON THE PROPERTY OR ADJOINING FTIOPERTY. ACCOUNTING ONLY AIDE SAC/ PE CODE FEE INFO AMOUNT MEMITTED (....,cHEC5,TercAsH 0t, noilvED ST DAT SRI 1 Mawr RUMEN INVOICE 1 Lp-10 ta-5 I -0 -- ,11.7g v/yetz.a.... -5- 7 .,i'ootq IL/