Laserfiche WebLink
ONSITE WA EWATER TREATMENT SYS ?M PERMIT( � , <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E WEBER AVE -3"D FL-STOCKTON A20 <br /> NON-REFUNDABLE PERMIT CALL(209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS J~ ` r�r� CITY/ZIP XV—'r LA <br /> �Z � <br /> CROSS STREET A74", % APN PARCELSIZE �3�F <br /> OWNER NAME P'" wAt., I rLti�fr►'I�R Fe L/dS PHONE /� <br /> OWNER ADDRESS ©� /�l 0 l�A�+G it,✓e//2 b r CITY/STATE/ZIP /.'r`O. e-o- <br /> CONTRACTOR c R- rS&4'1x !.a>�5�� �7•0 PHONE <br /> CONTRACTOR ADDRESS CITY/STATE/ZIP <br /> LICENSE ❑C42 ❑C-36 OTHER NUMBER EXPIRATION DATE �- <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y �� <br /> ❑ PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: ❑ NEW INSTALLATION ❑ REPAIR/ADDITIO ❑ ENGINEER DESIGNED/ALTERNATIVE <br /> OL REPLACEMENT DESTRUCTION )=x►S7�N(>— 7N(G_ <br /> INSTALLATION WILL SERVE: RESIDENCE ❑ COMMERCIAL ❑ OTHER (� <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: 3 NUMBER OF EMPLOYEES: !1 11 <br /> All SEPTIC TANK TYPE/MFG `1— CAPACITY o6~ gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS C+ <br /> oes <br /> ❑ PKC TX PLANT DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ( LEACH LINES ❑ LEACHING CHAMBERS AU e4A,,,6 NS #OF LINES LENGTH OF LINES '% <br /> DISTANCE TO NEAREST WELL cSO `�^� ^ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ FILTER BED WIDTH R LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> 6 " <br /> l� SEEPAGE PITS NUMBER � WIDTH e.2S� ft DEPTH ft <br /> DISTANCE TO NEAREST WELL tOO /0A'-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 <br /> ORDINANCES,STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMU �4HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS—PLEASE CALL(209)953-7697 <br /> TITLE 01 <br /> DATE49, <br /> TITLE <br /> IJ <br /> la <br /> RP <br /> VOk <br /> O M N L <br /> T D <br /> DEPARTMENT U.E O Y /q <br /> Application Acce ed By Date Q Area Employee ID# 74 <br /> Final Inspection B Date ❑ SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 t: t/Sump Soil Character: �c-��-�m /'�5 ✓ <br /> COMMENTS L 1.-0F Zf CV 0 • <br /> PE SC Received ec Amount Date Permit/ Invoic Permit ID# <br /> Code INFO B Cash Remitted Service Re nest# <br /> 42-02-001 Fi�i�$TE�A+�cTER PERMIT <br /> 12/22/2003 'l� <br />