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FEN DEPARTMENT UM ONLY <br />DATE: <br />DATE(-3C? C-(CONMAN <br />1/41 1.4116-41N- <br />AREA -2- f .3- APPUCATION ACCEPTED ST <br />OR SUMP ?NsPECnON sy <br />ADOITIONM. COmmEnTS <br />....... • . <br />.. <br />'-i.:A11.1 2.5 19)8 <br />sAN'JOACILM <br />„ HEALTH S <br />ErPMMIONitn.STITAL MCA . . <br />:MN. • <br />WCES <br />":frolVIEttc.f " <br />490/5-03 <br />RFPUCATION FOR LIQUID %WASTE PERMIT <br />SAN JOACKWACtiliTY PUBUC HEALTH SERVICES <br />...- .7-J.:7.--c-'•'.' Ef0MONMENTAL HEALTH DIVISION <br />SK:1101;X:1-7. <br />. • ••: ' ' 304 EASTWEBER AVENUE, STOCKTON, CA 95202 <br />- -..b..i„ .i. (209) 458-3420 <br />.i-7i,,ri-lil.'-''__..1' <br />goN-REFumpin.f P ERMIT EXPIRES I YEAR FROM PAU ISSUED <br />meatAts in Frisker) <br />calcuizon It HERESY MADE TO IRE SAN JOAOUIN COUNTY FOR A PERMO To cONSTRUcT AND1OR INITTALL THE WOW DESCRUIL13. THIS APPUCATKAN M 6.44.13E IN coMPUANCE NTH SAN <br />COUNTY DEVELDNAENT TITLE. CHANTER Oil 10.3 AND THE STANDAPOS OF SAN JOACKJIN cOUNTY PUILC HEALTN BERMES. ENVIRONMENTAL. HEALTH AMMON. <br />LOT SIZE .4.ir.- <br />ovo4 En' it <br />V JON A <br />NAME -5i7-4-tvo .c.pop ,.. ,..? ADDRESS <br />m2r---Aria., <br />DDRESEVENI ANN 4g7kg Cin .A." r,...001 l g. Lk 1:24/- orTY <br />RHONE <br />coNTRAcTok /.411.4.‘e Ty Ceti )4.1 Y ADDRESS 'II E.. I 41 r. s...____1212,--iJes, 445-'9C q 5- P1-CINE A'E;9-5-4,27 <br />./.. N.I ?TEN I <br />suS CoNTRACToR ADDREss ut A MOTE <br />FTL <br />TYPE OF LISP= Wass: NEW POSTALEATioN ES. REPAINADOITION ID DEAntUcTos <br />RK1 GOMM SYSTEM PENSITTED IF PUDIC EIGNET IS AvAKASLE VOMIT 200 FEET OF sulusly0.1 <br />merTALLATION WILL WNW: RESLOFFNE IR- CONLADACIAL 0 OTHER 0 <br />NUNNIR OF MANG ways 1 NUMKER OF BEDROOM& ...? NUMMI OF EMPLOYEES <br />crimArrrn or son. TO A orrrn OF 3 FEEE 42}14,13.- FISTALuMP SOIL CHARACTER' iI414...L 46.14.1 WATER TABLE DEPTH <br />SONIC TAIIKARLEASI TR.., 61-rePRA4i0 6,E4C.C...i- CAPACITY I ,44")C.•) i NO. COMPARTMENTS <br />P103 TREATTAINT PLANT 0 bitTAACE TO IIIMIZAT: WELL J(Y) rourroArion / („)",. /3 PROPERTY EINE . <br /> <br />JET aTATKIN 0 NOE TOTE of Romp ._. SAND OIL SEPARATOR <br />12 <br />IENC-LOREC:n ITTEI rr r <br />1 NO. A LENGTH op um, -1- 7$.- . rTICIJI #1114_ oNTAME To NEAM <br />7 <br />I‘aE FolINDATION ii ,V..‹ pRoMITY UP4E,2414:0 <br />RETEST CERTIFY THAT I HAVE 'IMPAIRED THIS APPUCATION AND THAT THE WON( Will. BE Dom IT AccoRDANcE WITH LAN JOAQUIN CERRO', ORDINANCES AND STATE LAWS. AND RUES <br />THIS PENULT KS AMMO. I SHUT PICT EMPLOY ANY PERSON 04 SUCH A AFAHTF31 As To aEco/AE Ivan= TO WoRKMAP/SCOMPEMATION LAWS OF CAAJIRIFNLA.. <br /> RACTOTS HIRING DR AND NLOULATIONs OF THE SAN I0A0U1/4 COUNTY HOME oWNER OR OcEMED AGENT'S MOHAWK CERTIFEs THE POELDWIN31 'CERTIFY THAT NTT, <br /> F THE WOM FOTwHICH <br />SDB-CONTRACTISIO SIONIATUFF CERT1TET THE FOLLOwINET I CERTIFY THAT IN THE PERFONAANCE OF FM WON( FCKI TISCH THAI PENNI PS ISSUED 1 STALE SS4IY PEIVIoN0 su/LJETT To <br />WORKMAN'S CoMPIPTIATION LAWN Of CALIFORNIA. THI NNUCANT MINT CALL. AN Noufle IN ADVANCE FOP ALA. p51015Th IMMECTIONS, COMPUTE DRAWING MOW <br />own. 1040,- <br />PLOT KAN 117115W TO SCALE) SCALE <br />4. LOCATION oF HOUSE SEWAOS EINFOSAL STtM OR PROPOSED <br />EXPANSION OF SEWAGE DISPOSAL . <br />S. LOCATION OF WELLS WmON RAMIS CEO 4151950940 FIFTY FT. cal <br />TM PROPERTY DR ADJOINING PROPERTY. <br />... <br />gt" <br />ACCOLACIVa ONLY ....131 <br />1 , ../ <br />r .....- 1 <br />SRI POSIT NEWT I <br />11==trEnli <br />I <br />PE COSA Ha IWO 85101.541ANAIITED W II(Cija SECUREDSECUREDsr DATE ,...... <br />.-I t <br />......t <br /> .L l ( 1 0 <br />IT= <br />ti fc). CIF.'("4-- W.11570/ Sir60/60 V,' <br />Pub. Heetth Serv. - Envino. 174 (306) <br />NBC TILSTIN 1 1141W LIMIT <br />RNEINAlon <br />LEACHNO UN! <br />METER BED <br />MOUNDED <br />SWAM PITS <br />WIMP, <br />9411,02AL Midas <br />0 WIDTH LENGTH DEPTH INSTANCE TO WARM: WELL FOUNDATION PROPERFY EINE <br />0 warm UNGTH EIENTH DISTAIKE TO NEATEST. WELL FOUNDATION PROPENTY UNE <br />la oerrm ,AS" ' °cm '36 " HUMMER 4 *STANCE TO NEAREST: WELL /5-4 WOUSIDATION MO ' rnortirrr UN! 444127 ' <br />0 wpm LENGTH DEPTH DISTANCE TO NEAREsT: WELL FOUNDATION PPOPENPY UM <br />a WIDTH LENGTH DEPTH DISTANCE T0 NEAREsT: W411. FOUNDATION prOPEINY UM <br />NAMED OF STREETS DO RoADS NEATEST TO OR SERRADTKI TM PROPERTY. <br />OUTuNE OF TM PROPEITY. WITH oimENHONS ANN TOOTH DirEcTIoN. <br />DIMENSIONED DUTUNEs AND LOCATION OF ALL EXPATIN2 AND MDFOSED SITFWICTUREA <br />INCLUOINCI COVERED AREAS SUCH AS PATIOS. °Nye-WAYS AND WAU(S,