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APPLICATION FOR LIOUID WASTE PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DMSION <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 <br /> (209)468.3420 <br /> P91:1E1DIIOABLE PEIIINIT EXPIRES I YEAR F1011 DAA RlUED <br /> ICEEIPfrr Jw Tr`BsRN <br /> APIATHON OU <br /> 41 HEP"Y MADE TO THE/AN JOAN COUNTY FOR A P10EAA M TO CONSTRUCT ANDA INSTALL THE WORE DEDM EO. T*"MPl1CATlDN q MADE N COAillANC <br /> ICI WITH RAH <br /> JOAMM COUMY DEVELOPMENT TTTEEM.CHAPTER/-T 110.3 AND THE STANDARDS OF/AN JDAQIN COUNTY 7UN1C HEM"/ENVICEC CHR"""E'S"RAL I—""DNMION. <br /> JOE ADOREESIOR A,?N V /O CITY /yam"lfiT d (^ /1-5 <br /> ovrPETU'S NAME cc PHIONEJ�_�;l <br /> CONTRACTOR1�CL�4 ADORE/S P4 <br /> an CONTRACTOR ADDRESS � raow <br /> TYP/OF.WORK: Nl1M SMTALA710N RVAWManaw❑ DESTRUCMW❑ <br /> NO SEPTIC SYSTEM P'ESEfTED E PZMJC SEWER I/AVARMU HTTHIN ZOO FEET Of/UNJOEIO.I FW TwTYH I I MJq MARY <br /> INSTALLATION MALL/NRvi VOON500Cea coMMUEDIM C] oTmr❑ <br /> Nuomm OP LAO""1Yi/:�` OF/EMDOM/: MIME)OF�{AY=E: � ) P <br /> CHARACTER OF W&YO A DEPTH OF 3 MHT: /:atf/ PrrMu P/OIL CHMUER <br /> CT : A 4CI-A '�/y WATER TARE <br /> SWIM TARTRIO LASE TRY Dkl- FO�I.E1 XRjj FAP _ 17,•0 O, dI No.couPAJRTxE+rtE_a'' <br /> PRO 1""TMEIT PLANt 13 NSTANeE TO RS mn; 14-1FOUNDATION P MMM LME <br /> UPT STATwN❑ N2E TYPE CF eLWP , SAND OIL SEPARATOR ENCLOSED SYFLW��_ <br /> ..ACHING UME NO.«LEIOTH OF L e � OIRANCE TO NEAM".WRU�TION��P Draw"I'M <br /> NLTM MED YPDfN LENOTH DEATX DISTANCE TO NEAREST:VFELL___FOIAIDATbN PIIOFERY LINE <br /> NOURRON ❑WROTH_ _ r IENOTH _ OfPTN PSTAU'iR TO NEAPENT:YY[IL FOUHDATIOFIP1D►OITY LINE <br /> -1 TO"EAFEBT <br /> DEPTH SIZE-1-11 --NIANWR�_ __DWTANL <br /> MISERS X3 NWOTH^�LENSTH I S' DEPTH JZI PSFANCE TO NEMEBt:WCIL�PDUMDATWN_MWPERTY INJE— <br /> p/POSMPOIW UWWTH IODT"__RESEREELLOTOA <br /> R OKI.TO HFAET:W _IO — PROPERTY LNL <br /> I HERESY CAWTHAT 1 HAVE HEPARIN THIS APPLICATION AND THAT THE WOM MRL N EON[N ACCORDANCE WITH VAN JOAOUIN COUNTY OIDNANCES AM STATE MWR AND Al"O <br /> AND F&WRATIOHS Of THE SAN JOMDUIH COUNTY.NOW OWHELONUCENSED ASNA'S SIONATUPE CERTIAES THE POTLOI.VNO,1 CWWWY THAT NTIME PERPO MAME OF TII V400M PORYMCH <br /> THIS PE IAV N 1/SUED I SHALL NOT EMPLDY ANY PERSON N SUCH A MA,MER AS TO KcoW SUE.IECT TD WOIKMAN'S COMPENSATION LAWS OF CAWIERA.' CONTRACTORY MUMUE OR <br /> SU/{OMRAC NSMATLNE THE FOLLOWDA:1 CERTIFY TNA:IN THE PETEOIEAAMCE OF THF WORK PWA WHICH THIS PETMTT IS ISSUED.I NULL nOrLOY PERSONS SUBJECT TO <br /> WOP[MAJ11 C T OF PAA.' THE APPIJOANT MINT CALL H HOW N ADVANCE FOR ALL IidEIO NSPEOTIORS.COffilltm ORAWM SELAW. <br /> NPED 2 TTna:1�/��A J 41 <br /> PLOT PLAN DAMN TO SCALn SCALa IF <br /> MTR <br /> 1.HAEE OF STREET!OR ROADS HEJUEDT TO OR SOIRDN40 THE PMDrtRTY. 4.LOCATION OF HL OUEE SEWAGE OW IJ SYSTEM OR PIROHIOSfD <br /> 2.OUTING M THE PR OPVM Y.WABA <br /> N DENNONS AND NORTH ERECTION. EXPANSION OF SEWADE DML SY <br /> POSASTlR,M. <br /> 3.OEAIINOIm OUTLIES ANO tOCATION OF ALL E%IRWO AND PMOPOED.ARU CTUR F", S.LOCATION Of WELLS WITHIN RADIUS OF ONE"U DRED FIFTY FT.N1 <br /> NCLLANO COMM MEAS SUCH AS PATIO#,DIEMWAYS,AND WALE/. THE PROPERTY OR ADJODOM PROPERTY. <br /> Z! -......_4Ge..S•;. �r+5 ply •t Ldv>r/L.�/ <br /> . ................ <br /> °......... .. ......... .... . .....:..... ...... _. <br /> ;... .> <br /> --*. ................ .................................... <br /> ........... <br /> f ................ ..... .............. : - <br /> c .. ..... ..... ...... <br /> ... .......... <br /> .. ............. .................. <br /> .. .� - <br /> ..:.....:......:......:. <br /> ...... <br /> ..:.. : ...:.... <br /> ....... <br /> o .. . . :......:.... :. <br /> <. . _ <br /> ,.r<. <br /> . ... ........ <br /> ............. ...... ......... _ <br /> ... <br /> I�,ti�a <br /> P— ....... ...... <br /> .... .....,..........<.......................>.... ,-r•.... 1.>1 <br /> �. <br /> Y ... <br /> —_ <br /> . .:....... <br /> 0.. <br /> a <br /> � ... <br /> ,... ..... <br /> .:....:.. ...:......:. <br /> .. ... ........ <br /> ........... <br /> :................... . .... .:. ...... <br /> RECEIVE=T .....:.. <br /> °...........:............:... .>... ............. ....... <br /> .:... ...........:......... <br /> .:....... : <br /> . . ....... . <br /> .....: ..: .:............ :. . <br /> ;.....:. . :... . .;...... .....:::. <br /> ' _ <br /> �n . <br /> a <br /> . - l:rl+�lga <br /> . /1L I T <br /> FOR DO+ARTMNNT UM ONLY <br /> TION ACCEPTED BY DAR: AEA:�f„�_ <br /> ( fR _- TON SY L DATE 12,/F f 7 HNA.NEFECTION sY <br /> ADDITIONAL ) <br /> AOOOUNHMO ONLY: A'O' FACE <br /> PE COOS FEE OEO AMOURA""ITm CI MASH A mov"/Y DATE NL I NNW?RTEYENT NwIeS <br /> fUNIl2 O'13 <br /> Pub.H/ITND--WV.-EM".174(3,98) 114 LA 0 <br />