Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL IIF:AI.TH DEPARTMENT ` — 304 E WEBER AVE-3"FL-SFOCKTON CA 95202-(209)468-3420 <br /> NON-REFUND IT CA1.1.12 9 953-7697 FOR INSPEc-rims EXPIRES I YFA&FR?A DI§Jg4k <br /> JON ADUR1;Ss / <br /> L—A <br /> p^ 1 <br /> CROSS STHF:F:T y-+ on APNCJI�J'4—IV a V PARCELSIZE a �' o <br /> ()\%N F:R NAMl: PHONE <br /> O%%'NF.RAIH1RE.. C� - / i CITY/Sti'ATFlLIP �V <br /> 41— <br /> <—' � 111. �. // <br /> CONI RACIl)R -• Z .f F ✓L I`�� I��V PHONE466"flfc-lk-17 <br /> _ ' 1 <br /> CONI'RA['TUH AI)DRHSS NJ CITV/STA ( <br /> I.It'F:NSF: 1'-•12 LI['-ln l/I III.H _� � NIUIBEH EXPIRATION DATE <br /> WATER TABLE.DErru: / R GF:[H:NAPHIC'ALINFORMATION: Coordinates X <br /> ❑ PERC TESL'(S) NUMIIF.R _ LAND USE APPLICATION# , <br /> TYPE OF WORK: ❑ NEW INSFAI.I.AIION ❑ RerAIR/ADDITION .16 ENGINEER -N � EjhATIVE <br /> ❑ RF:PI.ACEAIENT ❑ DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE COMMERCIAL ❑ OTHER <br /> i <br /> Nut no H OF LiviN(:UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTICTANK TVPI/MPU CAPACITY gal #OF COMPARTMENTS <br /> ❑ GREASETRAP 'I'Y197MFG CAPACITY gal #OFCOMPARTMENTS <br /> ❑ PKC TX PLANT DwrANCETONF:ARF.ST; WITI. it FOUNDATION R PROPERTY LINE fl <br /> 1 <br /> ❑ LIFT STATION Sm. TYPE OF PUMP ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> LEACH LINES ❑ LEACHING CHAMBERS #OF LINES LENGTH OF LINES it <br /> DISI'AwE TO NEAREST WELL R FOUNDATION R PROPERTY LINE 11 <br /> ❑ FILTER ICED Winn 1 R LdNGTI1 R DEPTH It. <br /> DISTANCETO NEAREYI' WELL Il FOUNDATION R PROPERTY LINE R <br /> ❑ MOUNDED WIDTH It LEN(III1 R DEPTH 11 <br /> DISTANCE'To NEAREST WFLL R FOUNDATION R PROPERTY LINE R <br /> ❑ SUMPS WIDTH R LENGTII R DEPTH R <br /> DISTAN('KTO NEAREST WITI. it FOUNDATION R PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH_ It LENGTII R DEPT R <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY LINE R <br /> ❑ SEEPAGE PITS WIIITII 11 LENGTH R DEPT ft <br /> DISTANCF.TO NEAREST WEI.1- R FOUNDATION R PROPERTY LINE fl <br /> 1 ITFREUY CERI'Ip%'THAT I IIA VF:PHKPAR FU THIS A PPLICA'TION AND THE%YORK WILL DE DONE.IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> SI'A'i'E I.A WS AND RUI.E.4 AND RF.Gui xnom5 OP SAN JOAQUIN COUNT'. <br /> SIGNEp /1�,,_t�INl yvC'�.l• V,NOTICE REQUIREDFO C�'. ONS-PL CALL(209)953-7697 TITIL ATE V ! <br /> =F kFTh El IT <br /> P Ul P <br /> N <br /> DEPARTMENT IUSE07LY / <br /> Application AcccplcJ fly O'- Date_ Ara Employee IDN <br /> Final Inspection By Da(ea/y� fj ❑ SPECIALPERMIT-Approvedby <br /> Character of Soil to Depth of 3 f•'t Pit/Sump Soil Character: <br /> COMMENTS�Fcn_.�.�', �e i1 5-P- 003 <br /> PE SC Received heckX/ Amouat Dale er it/ Invoice# Permit i <br /> Code I. R ash Rendlicd vice Request# <br /> 000 <br /> 42.01-001 <br /> 1 <br /> '2102 ONSITE WASTEWATER PERMIT <br />