Laserfiche WebLink
% , G-0-t6 o�,Y-\ <br /> ONSITE WASTEWATER TnEATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1888 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL 209)95p3-7697 FOR INSPECTIONS�y�,'EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS _ F��— .__� (�Vrla�p P-1 or__.CyAR�YILP__y(,13299 t ZI '� <br /> CROSS STREET V G>l� _ ill _ / APN/Qr/7 BOG" ' PARCEL SIZE 9 __ j <br /> OWNER NAME. __. _..�-Y-F-fl-►+��/ 1.� 1—�/1IIVJ�� 1� I �3 9'$ f <br /> J <br /> OWNER ADDRESS I,wfi _ #64CITY/STATE2,IIP <br /> CONTRACTORsM, rCGS /L17� �('J Ate+ �' PHONE ._ t c <br /> CONTRACTOR ADDRESS _ Q__T7.(7.�... 7� <br /> 0.__..._ "_ ." .a" "CITY/STATEIZIP CA 4w /��r�✓t- 1.��� <br /> LICENSE i 1 C-42 .. C-36 OTHER NUMBER_�(�}� � EXPIRATION DATE "7n A., _11-31 <br /> 1 r - <br /> WATER TABLE DEPTH: 10 it GEOGRAPHICAL INFORMATION: Coordinates X!_ Y__-_ <br /> PERC TEST •_ BUILDING PERMIT#_ _ LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION REPAm/ADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> X REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: t/ntsDENCE COMMERCIAL i OTHER__ <br /> l NUMBER OF LIVING UNITS:�_ NUMBER OF BEDROOMS:__�{ NUMBER OF EMPLOYEES:_ <br /> P-1-SEPTICTANKTYPE/MFG .. L� CAPACITY jkg250 _ gal NOFCOMPARTMENTS <br /> ❑ GREASETRAP TYPEIMFG _ _ CAPACITY __ gal 4 OF COMPARI MENTS <br /> DISTANCE TO NEAREST: WELL _. 1_ 8 FOUNDATION "a tt PROPEnTYLINE _.�-_l" II <br /> 0 LIFTSTATION SIZE TYPE OF PUMP_ --__ 0 PKG TX PLANT i7 SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> 0--'LEACH LINES LEACHING CHAMBERS _ #OF LINES LENGTH LENGTH OF LINES I it <br /> DISTANCE TO NEAREST WELL 56, it FOUNDATION—.__it PROPERTY LINE_ 4,Ai it <br /> Cl FILTER BED WIDTH It LENGTH ___ it DEPTH___ it <br /> DISTANCE To NEAREST WELL . it FOUNDATION_ it PROPERTY LINE it <br /> ❑ MOUNDED WIDTH N LENGTH _ ft DEPTHit <br /> DISTANCE TO NEAREST WELL it FOUNDATION it PROPERTY LINE it <br /> ❑ SUMPS WIDTH _it LENGTH __ _ _ _. ft DEPTH it <br /> DISTANCE TO NEAREST WELLft F(XINOATION it PROPERTY LINE it <br /> ❑ DISPOSAL PONDS WIDTH." it LENGTH--.----,-- N DEPTH it <br /> DISTANCE To NEAREST WELL it FOUNDATION it PROPERTY LINE it <br /> 0,-'-SEEPAGE PITS NUMBER u___ WDTHI;4__ __ft DEPTH It <br /> DISTANCE TO NEAREST WELL._,__r aA0 t- ERTft <br /> it FOUNDATION_ $i___._It PROPERTY LINE 4�T <br /> 1 HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND TTHE�WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAOUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 209 953-7697 <br /> SIGNED-___— }_ - _-- _-. .. TITLE._<!O roII "--— DATE 4r___/�__r_(,v_— <br /> r. <br /> 2 <br /> JW <br /> 'D 2 <br /> s UWC <br /> ZW4 <br /> - - Qa`� <br /> _ 445= <br /> 1 zW� <br /> — N = <br /> EPART EN US Y �` <br /> Application Accepted By\--C� ' ^ J�— Date r] /Area �'�aq Employee 10# 'fS7 <br /> Final Inspection By ____ .raw) Date `L��' _7"�'�b': SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 Ft: Pit/8ump Soil Character: <br /> COMMENTS QI r Ids(IF R_ELo_Pn <br /> PE SC Received Check#/ AmountPermit/ <br /> T Invoice# Permit IDB <br /> Coda INFO B Gate Cash Remitted ` Service Request B <br /> C) it (O 24Z• � m�? <br /> 4T.J1 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4124,12 <br />