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APPLICATION FDA LIQUID WASTE PERNItT <br />SAN JOAAUIN COUNTY POILIC HEALTH SEAWCES <br />ENVIRONMENTAL HEALTH OIWSION <br />P.O. %QX Ut, 4" N. SAN JOAOUIN ST., STOCKTOk CA 162414311 <br />(2091463-3420 <br />NOWURIDAILf PIUM fkPIAff i YFAJ FARM DATE )88tfEi) <br />Aria L Twjpseate) <br />Applict-ion is htretry made to the San Joaquin Canty far a permit to constrict wdlor inatall the work described. This appticattan <br />is awde in compliance with San Joaquin County oevetopwnt Title, Chapter 9-1110.3 and the standards of Stn josuquin Caae:ty Pubtit stealth <br />Servic", frwiroroontat wealth Division. <br />Sob AodreeaJar APN1 _ City tat Site <br />r <br />tAmar's Noma teafi 74 <br />Contractor Aaidress tics MW102.1i1 <br />Sub Contractor—retie Phone <br />TYPI Of SEPTic WORK: NEW OiBTAttATtoi i�Oa—__ <br />BEPNW AIMION I I t1t8TiY8GTi0>r I I ISG TD7W ( I Now swA <br />(90 SEPTIC SYSTEM t 1,10 If Pultit SEA* Is AWA)LAW fAITH)H 20 FEET DP simoin.) <br />Lasa ON Anomid as ► <br />installation Witt strv*z saaiderv*— C' 11 rcial— Other <br />iauwnwrr of living unitap number of bachOemar„„„__ Number of aeptayw"s <br />Character of $alt to A depth of 3 f+ata _ _ Ptt/lits p Sot( Characterp Water TeMst 04ift <br />SIPTII TAIdli6ttEA11E TRAP Cl Typ&Afs R 4 I -L CaptcIty 146749 stn. Cn11 P Jt,, 'y <br />HO THATAlfsIT PLANT I ) Distarme to neareat; Shit_ f..atian-.f�t.,y— PrWortY lin Aicma <br />LIfT STATItpai) Sint _ Type of Pimp Sawed Oil S*parator (enctuded syistms) <br />tIACHlita LINE U we. A tensth of liwwta distance to wearsatx Wil ' ftwrdstiatw � prowty Lira1 <br />_ <br />tFILTER 810 II Width tw4th Depth - Vali FwasLtiah Property tii5m <br />MOVED r t) Width tength Depth - " Wet/ foud'atian Property Lira <br />'1 BF Depth s Sita r N Wet founaation Property Litaa <br />ti Width, 2 Ltngth_W D-pth-4-7 * Watt, /& fa+axieiion - Property Liam gj� <br />DIMUL FORDS II Widtb Length O*pih Wil Founmtitn Property ifasa <br />I hereby certify that I have prepared thin <br />application and that the ark wYtl be dans in ww:tordener with Ban Jnsw#ain tou,ty iWffmount:.: <br />and State laws, wd stews and 8emwwiatione at the Son Joaquin Caapty. Nova safer or ticeneed agant's aipnaturt certifies the #allowing <br />. -I Certify that in the partattanct at the wort: for which this permit is 1swed, i &halt not employ any person in such a aaawror as <br />to became subject to workman's c;mpanaation taws of California.- tjntractor's hiring w ash-cantractihii sigrmtUra Certifies the <br />a fot(OWinS4 "S certify that in the performance of the worst for which this permit 1s levied, i %hall employ pararnww sshjsct to tworirmrn*s <br />cowtpanaatirm laws of California.- <br />The apwsmeat N mt ad ll Site"" far e8 revAra/ iamwmtimm. Cowles* draping below. <br />Signed x fm I/ "t_� _ Tititt L%C.�"�i.6„-s_,. Oats( + <br />PLOT PLAN (Draw to Scale) State_, ta____,,,__, <br />I. Games of %treats or roads rwareat to or boarpdirg the pv-aperty. L. Location of house "W*g* diapoesl syat*r ar <br />i. Outtint of the property, with dimermiene and North direction. proposed axpwAion of s+pwa8s disposal ,yatame. <br />3. Dimensioned outlines *rd location at sit etisting and proposed S. Location of wits within radiLl of ISO ft. an <br />atrurturea, irxiudins covered *to" such as patina, driveways, the property or adjoinino Property, <br />and walks. a-, r JL,. e._ _...._.._. ..._.... <br />FOR 011411r'i00SY vu SKY <br />Application AcceptwW by matte Araat <br />Tank, Pit oK ,,trfj—tion by aata'i l 7 f7iisat Inspection by <br />Additional C ameennta: _...... .- —------------ . <br />ACC&ATINA RELY; I ASO/ — I FACT <br />PE coal I FEE we I Andow BEAYTTEo I /Chumi(8ii 1 itE ayEa NY I RATE I s8 I Ptuo woum I wallix x <br />