Laserfiche WebLink
~ ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> CAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E WEBER AVE-3PO FL-STOCKTON CA 95202-(209)468-3420 <br /> NON-REFUNDABLE <br /> fPERMIT CALL(209)953-7697 FOR INSPECTIONS EXPIRES I YEAR FROM <br /> DATE ISSUED <br /> JOBADDRESS /{ Lam,R{R5 S-V i h(� C4IT(WZIP �] :�/ sI 57-t 37'7 <br /> CROSS STREET M - �+V v AIN �V 1 I IV— �+ PARCEL SI'LE TO <br /> O <br /> OWNER NAMEPHO\E e S t� L"--"L <br /> C(�' � ~ A <br /> OWNERADDRESS /1 qCITY/STATEIZAP <br /> CONTRACI.OR /P�//�iR fG . ice({ w Ire PHONE /� <br /> CONTRACTOR ADDRE.4S/y0 C'I f�l��I�t/`l A.J / i. CITY/[ST�ATTEJZIP Aclw���..3'4V /�1''7• r s <br /> LICENSE ❑C-42 LJ C-36 OTHER /t NUMBER 7 e J g11— EXPIRATION DATE <br /> WATER TABLE DEPTH:_ It GEOGRAPHICAL INF•OR.MATION: Coordinates X V <br /> ❑ PERC TEST(S) NUMBER LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION ❑ REPAIPJADDrr1oN &- ENCINEERDESICNEDIALTERNA! <br /> ❑ REPLACF.MF-NT ❑ DESTRUCTION C <br /> INSTALLATION WILL SERVE: El RESIDENCE 12 CDMMERCIAL ElOTHER_ \. <br /> NUMBEROF LIVING UNITS: NNUMBEROFBEDROOMS: r NUMBER OF EMPLOYEES:\ <br /> J* SEPTIC TANK TYPE/MI.,(:,,, ��C �e,le CAPACITY�1 �p0 V gal k OF COMPARTMENTS <br /> ❑ CREASE TRAP TYPF/MFG CAPACITY gal #OF COMPARTMENTS C <br /> ❑ PKC TX PLANT DISTANCETONEARF_ST: WFIA. ft FOUNDATION Il PROPER"rY LINE fl <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) 1� <br /> LEACH LINES ❑ LEACHING.CHAMBERS #OF LINES /(C=,_ LENGTH OF LINES ft ' <br /> DISTANCE TO NEAREST WELL fl FOUNDATION Il PROPERTY LINE ft O <br /> ❑ FILTER RED WIDTH _ft LENGTH I ft� DEPTH fl ou <br /> DISTANCE TO NEAREST WELL_ D FOUNDATION ft PROPERTY LINE <br /> O MOUNDED WIDTH it LENGTH _11 DEPTH fl <br /> DISTANCE.To NEAREST WELL. ft FOUNDATION--ft PROPERTY LINE ft <br /> ❑ SUMPS WIDTH ft LENGTH R DEPTH fl 1 <br /> DISTANCE TO NFAREST WELL _0 FOUNDATION_ ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH_ fl DEPTH ft <br /> DISTANCE TO NEAREST WELL '—.0 FOUNDATION tZ PROPERTY LINE ft <br /> 8 SEE PACE PITS WIDTH _J-�7' ft LENGTH -7 it DEPTH -:XS + R <br /> DISTANCETONEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL.(309)953-7697 <br /> SIGNED TITLE DATE SI o/UAP <br /> 'NEIU W'LEACH LM6- <br /> /SEEPAGE PITO <br /> 3XIBTtNG a&, <br /> WEEPAGE PITS - <br /> w <br /> Si t <br /> o <br /> D-WAY AUTOHATIG 1 CIPO <br /> DISTRIpUTIC!'f VALVE ' <br /> 1 o <br /> EXIST!NG... 1�U(6)200 ) <br /> (2)2900 4 C,.AL.TANKS <br /> DEPARTMENT USE ONLY <br /> -F t fl �} <br /> Application Accepted B* V _ _ Date -a� ✓__- Area 7�0 Employee IDN_ iJ�'7' <br /> Final Inspection _ _ Date_ P1 __ E3 SPECIAL PERMIT-Approved by <br /> Character of Soil to De of 3 Ft: Pit/Sump Soil Character: <br /> COM�M�ENNTS ��(._03'! 'lam tC ). fJ -,e e_ _ <br /> 161L.496-- <br /> PE SC Received Check#/ Amount Date Invoice N Permit IDN <br /> Code I'm B Cash Remitted Service Re neat# <br /> 5Z2 �� 122 g y`-10-03A0033926 I <br /> 42.01-001 <br /> 12/= ONSITE WASTEWATER PERMIT <br />