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APPLICATION FOR LIQUID WASTE PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES C <br /> ENVIRONMENTAL HEALTH DIV98109 <br /> ` P.O.BOX 885,446 N.SAN JOAQUIN ST,STOCKTON.CA 96201=8 <br /> (2091 468.3420 <br /> VON-gV;UV8Alt1 PEW r tfit <br /> RAmpW»in Tr*buW <br /> APPLICATION IN HEFAMY MADE TO THE SAN JOAAUIN COUNTY FOR A PEWST TO CONSTRUCT AND,OR INSTILL TW WOW OE-sNM-THIN APPLICATION K MADE 401 COWUAMLE VMW MN <br /> JOAQUIN COUNTY OEVkld'MENT TTTL.E•CHAPTER¢1110.1 AND THE STANDATOS OF SAN JOAQUIN ODUN'ry PUBLIC HEALTH SUNICK ENVTMT MENTAL•HEALTH Y <br /> DNON- <br /> / <br /> VIA c' �L� LTTY C_ L'Ly�o1nG _LOT KM <br /> Ju ADOIESLMQA_PNA_ A�� -_y_Zc> <br /> ovia R3 NAW&yA 4^LA".E,Y'WHG SIFYc 4fiaYMDDEICS V . <br /> � 11- 3cx�S1 l PNDNE�-9�a 7 <br /> CONTRACTOR. LtV -+UV I STyUI\ ADOLEsa (SaN 4 Lc. <br /> ,,LF WAY! <br /> SUB CONTRACTOR ' <br /> TTPE OF G ITIC WORK; NEW WSTALLATION NOASUADOITION❑ 09TRYCL1oN❑ <br /> alo EEPnc IMTHL TEFOJ:iTm A FUSTIC eEWT3l LS AVAILA8IE wTrHw 200 INET OF euLLOs+a: <br /> FMIG 7RTLN I I MYJT MANY <br /> ANAiPESPn• <br /> IYTALLATION WLL ARRvt W20D.CE❑ COMMOKIAL q OTHER❑ <br /> WFi81 OF LHIYIO IBFTS: 1RAAS/1 OF� *LU <br /> MM OF MPLX) <br /> CTE <br /> CHARAR OF SOIL TOA DWrN OF 3 FEE: !;&E <br /> P[TISUMP SOL CHARACTER WATER TABU XMt_ <br /> LAPALITY .COMPAFTYENTS I C_l? <br /> SaT1C TAMK1iWS TIIAF �TVPEAl116 V - f <br /> PSD TR"TTAMT FL.AANT Q DATAO"TO NMUST: WELL CO L FOUNDATIO fl1OFERTY I:FE <br /> LET STATION❑ SM Tvm OF W(J�EiV &ANDONC <br /> OIL SEPARATOR ELOSED BYYTEW <br /> LT,ACNHo Lar NO.a Laxrm OF LIWO_ 10.5(w(DwT^Nce TO NEATEST:WWRL /ao FOUNDATWN- FROmry UNE <br /> FILTER No ❑wvM LENOTN owrH DISTANCE TO NEALEST:WLLL Fo%WA&TION PMPERTY'LME <br /> ❑yWTH LENGTH DEPTH DISTANCE TO IEATEST: FOVAIDATWN NLO"m'y LIME <br /> • MOIMOm -!— ✓1 <br /> SLm__sukIN R OMTANCETO NEJiIE-ST:wiL FJAMOATION mwee"LAVE <br /> ❑yy,D•TIL LEHSTH DEFTH DMTANCETO NEMIEST:WELL FOUNDATION F"OFV`TY UNE <br /> Alva •� <br /> OISFOSAL FGRASS ❑WIDTH LEFIOTN DEPTH pLRANCE TO NTUULETiT:wEl1l�-_ <br /> FOUNDATION PTIOPERTY LME <br /> I)ERE"CERTIFY THAT I HAVE FTEPATED TINS APPLIC/ITION APD THAT THE WORK WLL BE DONE M ACCOIDMICE WITH SAN JDAOLM COUNTY ORONLANLlS AMD STATE LAWS.AID-;'Z.';-- <br /> is OF <br /> OF TFESAN JOAWNCOUNTY.IA4E MVr1ut OR L0.•FHKDAABlTT!SIDNATUIE CNrTWpTIIE FOLLOWIND:T CERTIFYTHATINTIE VUVOFNJANCEOFTTEEWISLFDRwFM:H <br /> gM LAWS OF CAUFOIWU.'CONTRACTOR'S NIIYtr OR <br /> THIS IT ISISSUED.16NALL NOT EMPLOY ANY PE1N0DN M INCH A MANNER AS ma <br /> We.l[C-T TO WOIKMA,M ppFAPEPrGT <br /> NPERM , <br /> SUBCOFRT4ATw0 ULE CorrpMn THE FOILOJMNG:,CERTIFY THAT M THE PDWOWAANCE OF THE V4OW FOR-LICH TM3 FEMAIT IS ISSUED.I WALL BAFLOY FUN ONS lKB7�T TO <br /> WOPAMAN'S COM WAT N LAWS OF CALIFOof <br /> yf" '� <br /> APFUCANT UNFIT CALL lA HOURS M ADVANCE FOR ALL[/T'LWM INMBOTIONS.COLIPIliE OILAINMO OBAW1 <br /> -cTITLE:-. <br /> S <br /> PLOT PINI(DRAW TO SCAUSCALE <br /> 1.NALES OF STWXr3 OR MADS NEAREST TO BOUNDING THE PPWVffy. �4.IDCATgN Of HODS!C WADE AL reaOHMSAL CYlTEA/OH PIO1'OEN <br /> 2.OUTLINE DF TIE PPOPEJOY.WITH WMENMDN4 AND NORTH WRECTOH- owANSION OF SEVMSA PTSPOSAL SY6T8N. <br /> 1 J. WITISII MdL1S OF ONS ID/0Rm Wry FT.ou <br /> DRAEmKm=OUrto"AND LOCATION OF Ail.MISTING AND pMPOSED SFNICTLMG, S.LOCATION OF WENAt <br /> NcLUGNn COVERED AAL M"K AS PATIDSiONVEWAYS.AND WAILS. TlE PROFEIRY OR AO.IOWNO pMFeST`/. <br /> 'I 1 <br /> �I ! <br /> I <br /> —— <br /> I I I ' <br /> I f <br /> �...{..4.,. I. <br /> . :1 <br /> ........... <br /> • it •�{a - - <br /> T� -- <br /> E <br /> . I <br /> �.. . .. . 1. .. . <br /> I <br /> l : • <br /> ..... ...:...:...LCI;.. . y -•;�_ � <br /> S�,p.• 4. <br /> _ - <br /> _. I 7 ``..i.. <br /> F.} MAS- 8 1997 <br /> , <br /> 7-1 <br /> (\�] FOR OWARTMDrT u"ONLY VIIMEp TJHEALT�Ai1;•1/fg11 <br /> L <br /> APCATM ACCEPTm eY /iDATE: <br /> O ( <br /> P 7 <br /> TAN.FR DR INSETION Y <br /> keg-l- A. 0 <br /> GLo3: <br /> ADDRINAL <br /> w .. <br /> - <br /> a, axcZ Qacw L mac. 11�^t w G L yu L+•.G Fa�cJ <br /> 02 KA -5- <br /> AC FACE <br /> K COCA FLA mm .AMMOCT RENNITTSD CHWK#)C MH RLCINV®ST DATE OR 1 F/WST WOKE F <br /> 4 ( So aoo 787 9� <br />