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LIQUID WASTE PERMIT SAN R-gUIN COUNTY PUJ3LIC HEALTH SERVICES ENVIRONMENTAL,. -TH DIVISION 304 E.WEBER AVE 3"'FLOOR,STOCKTON,CA 95202(209)469-3420 I (� c NON-RAE/FUNDABLE.PERMIT EXPIRES I YEAR FROM DATE ISSUED A JOB ADDRESS LI,, /7� `U .-�}-t'V�Y�.1� �I� APN aD / -(9\W-O� �I¢ PARCEL SIZE: e Lw CITY/ZIP t/1.91(C.Q C� 1 J `\\) BUILDING PERMIT OWNERNAMF. 1/�\ (go v-1 ADDRESS 1 `J 7 CITY/'LIP of n l Jcl`�,�, _ �0'i/ n [��,��✓ C /, PHONE NUMBER �1N//+��Cv'I�� Co`��// I CONTRACTOR ,N�� I D• �/�r V.iC.y'aJ d 6� 50L- ADDRESS 3� ` oo J' �� Co m— CITY/ZIP Cod� e6) PHONE; NUMBER P02 3 V 7_-z)7D I GEOGRAPHICAL INFORMATION: COORDINATES: X Y TOWNSHIP RANGE SECTION TYPE OF SEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: ❑ NEW INSTALLATION ❑ RESIDENCE NUMBER OF BEDROOMS: ❑ REPAIWADDITION ❑ COMMERCIAL NUMBER OF EMPLOYEES: LI DESTRUCTION ❑ OTHER ❑ ENGINEERED/ALTERNATIVE CHARACTER OF SOIL TO DEPTH OF 3': PIT/SUMP SOIL CHARACTER: WATER TABLE DEPTH:,� FERC TEST(S) HOW MANY APPLICATION# '►`s OD -O � $YS16 PAYMEN ❑ SEPTICTANK TYPE/MFG- CAPACITY #OF COMPARTMENTS r��E, C [:-J�F _t ❑ GREASETRAP TYPE/MFG CAPACITY #OF COMPARTMENTS {{{ p LlPKGTX PLANT DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE .92UOF ❑ LIFT STATION SIZE TYPE OF PUMP SAND OIL SEPARATOR(ENCLOSED SYSTEM) SAN JOAQUiPl I; rravlr;oraMrrira� I.i".SI;.: ❑ LEACH LINE #OF LINES: LENGTH OF LINES: DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE INFLITRATOR CHAMBERS: ❑ FILTER BED WIDTH LENGTH DEPTH DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE ❑ MOUNDED WIDTH LENGTH DEPTH DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE ❑ SUMPS WIDTH LENGTH DEPTH DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE _ ❑ DISPOSAL PONDS WIDTH LENGTH DEPTH DIStANCETONEAREST: WELL FOUNDATION PROPERTY LINE ❑ SEEPAGE PITS # DIAMETER DEPTH DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES,STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. �I NIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)468-3423 (f �J.�1 SIGNED: TITLE: L9�jo J``�— DATE: -1-�` y ). ••• ••• I�YV ML srLwhs rm a.c ly v,t t5(^ I -- - i --;;::f7wa�w---- --- -------- -rxlasa-------i- ` ............. 1 pre I ' 1 � wrpn � r I ............_.._ _....-.---'-�"---- rrwy...R u•Pw ate :............. .........._............ I �} PAf2CLr 1 #can m w pn.w Iea. 1 SCAO 1'• 1w ' i ' I TAL Q.E1 ACR r.u-in s■c.F. ..1.............1.........._0 LOT 4- LOT 3 --II--- .. _ ............�... ....r._.........._............ rl I i _._ ._.._1_........ Ir � `'�•�\ ` I eMH�� Y�'�� .O.OIn CDAf5V1 1 I � .�.__.._.i__......F......-_ -._................... _.._....... 7 j }FARC EL 5 L............1......................... I 0 I 9.01 ACRE I � OAKDALE IRRIGA-ED ACRES _...-.... p Q �n i S �—.�--...... I ...._._:........_........ I ID fMAPS 8t PLATS VOL. .P9GE 28 S.�.C.R. �y i I I _._ ...._..................._.._..._..''- ..... _] I ...... �_........ ------- -. _... Z I � �/ PAIZCEL� W !R 9,01 ACRE9� ® 1 M , _..............................�._.._...__....._I....... j ) I rr ;........f.......... -TI I@ -- .......... f..... I I ?ARCEL 4/ ._.._�..._...._....... __ ___..... LI V.4A ACRES) I i ..._�. _...... A1N00 VO 11.31U - - _-------C.15SEC. 4' Twnn i } I w/I7fY nv --....�.__.._jT.. ._....:........._....._....... , .alaru � —_-- --------------sa'rua�(W_Llw,s en.-------`---• ---------:.— ..—..— - SEC.13 WAAJim � A A NW) A1170r9p�e) 71140(1) r " `C.2? SCC 3 ED'W/aFiDS AVM:2q JE sm Ant0 SEC.23 SCC.2�; it APPLICATION ACCPPTED DATE: AREA EMPLOYEE IDN DI RIC LOCATIONdzl � INSPECTED 1 _ -1- ' DATE: / PER MITF YESDAI�j -"'/� IN �i�/O:/�-..� ;`3r �.r>„x� ��. ter` '�`r l � ��✓ /�:., Y.J`' � �--��` �C� (��<�-1.-� C'OMME'NTS. o� —44 JiCS,}, O H[ cc "( FO ' A UU T CHECKNr ASH RECEIVED DATE PERMIT/SERVICE REQUEST# I Vp };N SEP C IDN �7v / FD RY . 's-a/ - S l U :VISED N-15-01