Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQLIN COUVTY ENVIRONMENTAL HEALTH DFPAR TIENT 304 F,WT.DFR AVE-3"FL-STOCKTON CA 95202-(209)468-3420 <br /> NON-REFUNDABLE PERMIT CAI J.(209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> J JOSADDRESS fR.( G2A'L CITYlZIP <br /> CROSS S'REST �Ljg.? s 3 2 7d-o g _ <br /> APN� _._, PARCELSIM C <br /> 4 01ANER NAME j—.� <br /> ,��/JNA A,C, PHONti <br /> OWNERADORLSS � /�4, CITYJSTATE(ZIP <br /> CONrRArroR .,Alto/7t}-V PHONE X7/1 <br /> CONT'RACTORADDRE'.S K7 7�4P io , (� CITY/S''r T�EtZJP._0� 1 <br /> LICENSE LI C-36 OTHER NLMBER ��GJ E%PIRA'ITON DATE C1 Q T <br /> WATER TA .F.DEPTH: _ ft GF.OGRAPHIC..4L INFORMATION: Coordinates X y �� <br /> ❑ PERC TEST(S) NUMBER _ LAND USE APPLICATION# <br /> TYPE OF WORK: Q NEW INSTALLATION RF.PAIRIADDITION ❑ ENGINEER DESICNEDIALTERNATIYF. <br /> RE4LAf:F.M1fENT ❑ DENTRCC.TION <br /> INSTALLATION WILL SERVE: ❑ REs1DENCE 4-`COMMERCIAL ❑ OTHER_ <br /> i NUM1aER0FLIVINGUNI'15: NUPiBP,R pF BEDROOMS: NUM BER OF E6IPLOYEF-S: _ <br /> J SEPTIC TANK TYPF_!MFO ('APACRY geI 40F COMPARTMENTS <br /> _--- - A <br /> ❑ GREASE TRAP TYPEIMFC _ CAPACITY_ gat #0FC0APAR7\1ENTS_! <br /> ❑ PKC TX PLANT DISTANCETONEARFST: WELL _ ft TOINDATION __ R PROPERTY LINE _tt <br /> ❑ LIFT STATION y,E SIT5'PF OF PUMP 13 SAND OIL SEPARATOR(ENCLOSED SYSTEM) - <br /> ❑ LEACH LINES ❑ LEACHING CHAMBERS #OF LINES _ LENGTH OF LINES }, <br /> DISPANCETO NEAREST WELL Ft FTRiNDATrON `_R PROPERTY LINE <br /> FILTER BED WLDTR 10+ ..__ft LENGTH_fe9 0..'... (t DEPiH �C64�Cjs� it <br /> DI.STANCIE TO NEAREST WELL,� d ft FOLNDATInN' O ft PROPERTY LINE <br /> ❑ MOUNDED WIDTH _ ft LE KITH ft DEPrH _ }t <br /> OLSTANCETONEAREST WELL! ft FOUNDATION (t PROPERTY LINE — ft <br /> ❑ SIiMPS WIDTH St LENGTH _ h DEPTH ft <br /> DISTANCE TO NEAREST WELL _ft tOCNDATI0N ft PROPERTY LINE R <br /> J DISPOSAL PONDS WIDTH R LENOIli—^` ri DEPTH_ tY <br /> DwrANCETO NEAREST WELL f. FO(;NDAY.ON ft PROPERTY LINE tt <br /> ❑ SEEPACE PITS WIDTH 6 LENGTH —' 11 DEPTH ._. ft <br /> IBD <br /> DISTANCETONEAItW WELL ft FOLATION .,ft PROPERTY UNE �ft <br /> 1 HEREBY V ITIAT i HAVE PREPARED.THIS APPLiCA'rLON AND THE WORD WILL BE DONE 1N ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STAT WS AND RULES AND RLGUI.ATIONS OF SAN JOAQUIN COUNTY. <br /> NIMUOURADVANCENOTICEREQUIREDFORINSPE NS-PI.ZASECALL 12091953.7697 �y <br /> SIG D <br /> TYTL.R DATE <br /> I <br /> 9 <br /> i <br /> I <br /> � ' U <br /> �riS M <br /> I <br /> DEPARTMENT USE ONLY <br /> Application Accepted eF77�� <br /> �m-1I- <br /> � Daia_ � Arra EmplDyrelD# Qnj.�Final Inspection eyDate SPECIAL PERMIT-Approved by <br /> CharacterofSoil t �P,,,v <br /> /PIT/sump Snit Character: _ <br /> COMMENTS ��r� <br /> s43sr I" <br /> I PE SC Received hec AHnouot Permit/ <br /> Cods INFO B sh Rnnitted Dale serviceR Deet Invoice# Permit 117r1 <br /> liy �Sv3 <br /> 8YK 1 13 to 0 <br /> <ZAI-001 <br /> 122/02 ONSITE WASTEWATER PERMIT <br />