Laserfiche WebLink
42-01-001 <br />12/2;02 ONSITE WASTEWATER PERMIT <br />; CX <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 F, WESER AVE - 5 ° STocaToN CA 95202 - (209) 468-3420 <br />exS 16' cirwz., C.-sot:L/0r, 9 Y3j-C), <br />WATER TABLE DEPTH: It GEOGRAPHICAL INFORMATION: Coordinates X <br />TYPE OF WORK: D New INSTALLATION REPAIR/ADDITION 0 ENGINEER DESIGNED /ALTERNATIVE <br />0 REPLACEMENT 3 DESTRUCTION <br />INSTALLATION WILL SERVE: <br />NUMBER OF LIVING UNITS: NLMBER OF EMPLOYEES: <br />U OTHER 14 RESIDENCE 0 COMMERCIAL <br />NUMBER OF BEDROOMS: <br />ft PEG TX PLANT DisrANcE TO NEAREST: WELL fl FOUNDATION ft PROPERTY LINE <br />1.1 PT STATION SIZE TYPE OF Pim. 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />Or- 1 Ater <br />e r <br />11—WW. <br />i; <br />,Ao14 ,tpsr.) <br />cse <br />IA) -e <br />‘A14 oattV\-cl. " <br />1 <br />CAI I 12.1141 041-76,07 mu I -T A <br />JOB ADDRESS I LP <br />CROSS STREET S . V rc lz) rci <br />OWNER NAME <br />OWNER ADDRESS <br />CONTRACTOR 746E9 teACit Ser (49 <br />NON Hurt tarn E Duo • • <br />P*2(4 efi vki, PHONE -- C9 'At '1 <br />PHONE s-aci acy <br />CONTRACTOR ADDRESS CO& /3 LJ OCCI leck-k-1 411 e 0,-IsTATErzip ad edj-6_64- <br />LICENSE LI C-42 0 C-36 OTHER NUMBER -71 "c) 41. EXPIRATION DATE <br />r.,./Ar I rsr.a I T EAR FROM VATE ISSUED <br />CITY/STATE/ZIP <br />APN 229 -ZOO --Z3 PARCEL SIZE 6/ 9 <br />PERC TEST (S) NUMBER LAND USE APPLICATIONS <br />SEPTIC TANK TYPE/MFG CAPACITY gal #OFCOMPARTMENTS <br />GREASE TRAP TYRE/MFG CAPACITY gal IF OF COMPARTMENTS <br />1;( LEACH LINES 0 LEACHING CHAMBERS i 9 OF LINES LENGTH OP LINES 4/0 1 II <br />DISTANCE TO NEAREST WELL i CC,'ft FOUNDATION ID ft PROPERTY LINE 5-6' ft <br />D FILTER BED WIDTH ft 1 DEPIH .ENGTH ft ft <br />DISTANCE TO NEAREST WELL _ ft FOUNDATION ft PROPERTY LINE ft <br />0 MOUNDED WIDTH tt LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL It FOUNDATION IT PROPERTY LINE ft <br />gi SUMPS Winn ___),, ft LENGTH I 0 11 i Z ft DEPTH <br />DISTANCE TO NEAREST WELL 1 OLS . fl FOUNDATION I 0 ft PROPERTY LINE 45Z) ' n <br />DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL II FOUNDATION ft PROPERTY LINE ft <br />SEEPAGE PITS WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />SIGNED <br />R ADVANCE ygrice mur RED FOR INSPECTIONS - MINI PLEAS CALL (209) 953-7697 <br />-) e,f TITLE DATE 7- I -03 <br />Final Inspection By_ 6 ,44,14( Date "7-1.- CT-27 0 SPECIAL PERMIT - Approved by <br />Character of Soil to Depth o13 Vt: Character: <br />COMMENTS _Ctri.g.t9u r‘i stem hkr s-uny 3 sto,-04.4 —a- ch,r e, g <br /> <br />ir /s z <br />PE <br />Code <br />SC <br />INFO By <br />ReceivedCILL.Ve <br />ash <br />Amount <br />Remitted Date Permit/ Invoice # Permil !DOI <br />210 itc" 141.-- 75/3 ig/)..' <br />„..........- <br />Vi i C .•L_g5 gO0 3 91 iia3 <br />DEPARTMENT USE ONLY <br />Application Accepted Date -7 I 03 Area iy Employee If.)4 eca `1/99 <br />()I