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/I <br />LIQUID WASTE PERMIT <br />SAN JOAQUIN COUNTY PUBLIC HE.ALTU SERVICES ENVIRONMENTAL HEALTH DIVISION <br />304 E. WEBER AVE., 3" FLOOR, STOCKTON, CA 95202 (209) 465-3420 <br />NI IN-REFUN DAL_ILE, PERMIFIXPIRES 11'.c:r FROM DATE ISSUED <br /> <br />...--. , ---. <br />JOB ADDRESS / / f' r ie,-Cr 1- i' <br /> <br />.3 -S. <br />CITY/ZIP Z-*OC4•64., PARCEL SI7E/APN <br />OWNER NAME 6%54 )4 4 ADORE SS 414744-1-- 7g24_ <br />crryrzir e-orA_A. El IONE <br />CONTRACTOR ADDRESS - _...4400.---ra..../ A..., i zt E. CAAAACA-al V. <br />CFTY/ZIP 6444-- (-A- 4 ---2.-0 V PHONE 41&-; -S- kt -) <br />GEOGRAPHICAL. INFORMATION: COORDIANTF-S: X Y TOWNSHIP__ R ANGE_SECTION__, <br />PERC TEST(S) ( ) HOW MANY APPLICATION gt. <br />TYPE OF SEPTIC WORK: *>I<NEW INSTALLATION 0 )4E.PMIUADDITION 0 DESTRUCMON <br />INSTALLATION Will. SERVE: 6>filiSIDENCE . . OTHER 4 .0AL <br />NUMBER OF LIVING UNITS: / NUMBER OF EN LOYEES : III.r.AZEDROOMS! <br />CHARACTER OF SOIL TO A DEPTH OF 3 FEETAGtO PEDSUMP SOIL CHARAC ' itiii 44171W WATER TABLE DEPTH kV <br />tilF.PTIC TANK/GREASE TRAP TYPE/NIRO/W., SW 420-A-- CAPACITY I lacD, 0 NUMBER OE COMPARTMENTS 3,.. i o PRO TREATMENT PLANT DISTANCE TO NEAREST WELL.the: -36- FOUNDATION,2A ' PROPERTY LINE 00 '± <br />0 LIFT STATION SIZE TYPE OF PUMP SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />\ ACHING LINE NUMBER & LENGTH OF LINES a 400 )4-rut.- INFILTRATOR CHAMBERS 10 <br />I A / <br />DISTANCE TO NEAREST. WEI 1/050 Ct. FOuNDATIEB30 PROPERTY LINE la' <br />0 FILTER BED WIDTH LENCTH DEPTH <br />DISTANCE TO NEAREST: WELL FOUNDATION: PROPERTY LINE <br />0 MOUNDED WIDTH LENGTH DEPTH <br /> <br />DILSTEANNaCrHE TO NEAREST WELL FOUNDATION PROPERTY LINE <br />I (f) EEPAGE PITS WIDTH \sto <br />qv . <br />DEPTH <br />DISTANCE TO NEAREST: WELL / 9) ir FOUNDATION 745 f PROPERTY LINE Y <br />0 SUMPS WIDTH LENGTH DEPTH <br />DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE <br />0 DISPOSAL PONDS WIDTH LENGTH DEPTH <br />DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE <br />OR!) <br />SIGNED: <br />Y CE ,4 , P EP THIS ICASION . . . - • ItiWILL RE DONE IN ACCORDANCE WITI I SAN JOAQUIN CO . TV <br />CRS, S N JOAQUIN COUNTY. <br />TITLE. DATE -5 6 D <br />i V <br />EMI on4110141 =I <br />i <br />iiiilln11111 <br />NI <br />..III.J <br />Illitill 1111 I'm El t) II Ill I ID) , <br />1 II lkillillill 'Iq mon iIIII INNi._ ill __ . _ ' r... <br />41 I I I <br />1 <br />1 <br />11V)RIN EN k <br />a' ... <br />Uve I 1 I! 11111 III In•IN .. Fi ••••••1W IL, .... .... <br />FOR PAR CMP-NT L E ONUS <br />APPUCATION ACCEPTED BY 1 .e_-6P Arsill...r 1...11 DATE 5-'''' Cl -0 o <br />T R :VW INSPECTED BY -1 Zoill _... DA-I E. 4_---:L.:--&i <br />FINAL INSPEATT1ON BT. <br />COMMENTS- <br />PE CODE <br />_ <br />SC <br />INFO <br />AMOUNT IECK <br />Ft - Mill ED <br />BECLOUD BY r DATE PERNIMSERVICE REQUEST I SEPTIC EDI <br />e., 21/ 1 1 1)'O ?35 ill"- Do