Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL IIEALTH DEPARTMENT 600 E MAIN STREET - STDCKTON CA 95202 - (209) 4683420 <br />INUn-A"FUINVANLE rEKM[I t 6+'701 UALL JZUVI 95J-7697 FOR INSPECTIONS EXPIRES I YEAR FROM DATE ISSUM <br />JOB ADDRESS <br />CROSS STREET APN(/. (� V /O OP\ /PARCEL SIZE <br />� <br />OWNER NAME �61r/�I Aneew^'l! n <br />OWNERADDRESS /d .3.x%3 4—• ��L�r741),,!Al IG.H• CITY/STATE/Z/ZP+�.�+ Y%!•(.$'/// L..�'r 7���� <br />CONTRACTOR%�� <br />CONTRACTOR ADDRESS t?O. C7 t�X �y Cl'fY/S7'ATE/ZIP !�f/// <br />LICENSE ❑ C-42 0 C-36 OTHER NUMBER EXPIP-A'ITOY DATE <br />WATERTABLE DEPTH: ft GEOGRAPIIICALINFORMATION: Coordinates X y <br />Gr FERC TEST M BUILDING PERMIT # LAND USE APPLICATION # j90 <br />(7 REPLACEMENT O DESTRUCTION <br />INSTALLATION WILL SERVEI ❑ RESIDENCE 0 COMMERCIAL O OTHER <br />NUMBER OF LIVING UNITSt NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES: <br />O SEPTICTANK <br />TYPEIMFG__ <br />CAPACm <br />gal #OPCOMPARTMENTS <br />I <br />❑ GREASE TRAP <br />TYPEIMFG <br />CAPACITY <br />gal 1i OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL <br />ft FOINDATION <br />it PROPERTY LNC <br />ft <br />O LIFT STATION <br />SIZE TYPEOFPUMP <br />Q PKGTXPLAN'I' <br />O SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />O LEACH LINES <br />0 LF.ACOING CHAMBERS <br /># OF LINES <br />LENGTH or. Leves <br />R <br />W <br />DISTANCE TO NEAREST WELL <br />R FOUNDATION <br />R PROPERTY LINE <br />ft <br />O FILTERBED <br />WIDTR ft LENGTH <br />ft <br />DEPTH <br />R <br />DISTANCE TO NEAREST WELL <br />ft F"WATION <br />R PROPERTY LINE <br />ft <br />O MOUNDED <br />WmlTt Jft LENGTH <br />R <br />DEPTH <br />R <br />I <br />DISTANCE TO NEAREST WELL, <br />R FOLNDAT[ON <br />R PROPERTY LINE <br />ft <br />SS <br />Vo <br />1] SUMPS <br />WWTK ft LENGTH <br />R <br />DEPTH <br />ft <br />DISTANCE TO NEAREST WELL <br />R FOUNDATION <br />ft PROPERTY LNE <br />R <br />1 <br />❑ DISPOSALPONDS WmTR ft LENGTH <br />R <br />DEPTH <br />ft <br />DISTANCE TO NEAREST WTi1J, <br />R POUNDATION <br />R PROPERTY LINE <br />R <br />I <br />❑ SEEPAGEPITS <br />Numm WmTR <br />R <br />DEPTH <br />ft <br />DISTANCE NEAREST <br />TO WELL <br />ft FOUNDATION <br />It PROPERTY LINE <br />ft <br />LN <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WLTH SAN JOAQUIN COUJITY <br />ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />DEPARTMENT <br />Application Accepted By Date t <br />Final Inspection By Date �,��•' <br />Character of Soil to Depth of 3 Ft: Y <br />COMMENTS ,7 ,, s //a''_ 1jwP-Al1-/ ot-- <br />Area Employee ID# <br />❑ SPECIAL PERMIT-Approvedby <br />Sell Character: <br />PE SC Received Amount Date PermlV Invoice # Permit IDN <br />Code INFO H Cash Remitted {� /Service R uest # <br />f 2:LZ 5'L f l7 � �t �� • �� 8 /'_-L.Iv G . <br />42-01 i <br />05/30/2007 O:`ISITE WASTEWATER W ATER PERMIT <br />