Laserfiche WebLink
APPLICATION FOR LIQUID WASTE PERMIT <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />P.O. BOX 388, 446 N. SAN JOAQUIN ST., STOCKTON, CA 36201-0388 <br />(208) 488.3430 <br />V ROIFNEFUNOABLE PERMIT EXPIRES 1 YEAR FROM DATE M$Uel <br />(CBS*I u is TA aorto) <br />APPOCA'iTO1119 HERIW MADE TO THE SAN JOAQUIN COUNTY FOR A IERMIT TO CONSTRUCT ANOJOR INBTALL THE WORK DEWROED. THM APPOCATWN 18 MADE N COMRLANCE'1WTH SAN <br />JOAOUIN COUNTY DEVELOPMENT TITLE, CHAPTER W1 I TO.;i AND THE STANDARDS OF SAW JOAOUN COMFrY PUSLIC HEALTH SERVICES, ENVSIONMENTAL HEALTH DrAsKft <br />JOB ADDRES&IO 1 <br />LOT wmz±�- <br />OWNEi'8 NAME_ <br />k-49-lZ-r-- <br />ADORE"C <br />R10NE�'� f D 2 <br />CONTMCTOR <br />ADDRESS <br />IJ(y. <br />,�/ <br />SUBCONTRACTOR <br />xlPHONE <br />T <br />TYPE OF B®IM WORN: <br />MEW INBTALLATNIN <br />RPASOADMIDOR ❑ <br />DMTRTION ❑ <br />UC <br />910 BEPTIC SYSTEM PEA KUTTEO 1F PLISM BEV&R I4 AVAIABLE NRTHN 200 FEET OF BUUQINGJ <br />Egll, 7f3TW 1 1 NOW MAMY <br />APPEOWM �� <br />NBTALLAUGN WILL SWNE <br />RESIDENCE 9 COMMERCIAL. ❑ <br />OTHER ❑ <br />Nwlavl w Lrv1No MITTS: / AVAMwI DF.m1100M.: 3 W."m w IHPLOYm <br />C'� <br />Cv <br />A r I A 1 FOR DVAIRLmT USE ONLY j <br />APPLICATION ACCEPTED BY ATE: <br />TANK, PIT 011 SUMP 1 ,=ION BY GATE J / iON1L INNP'ELTgN <br />ADDITIONAL COMMW(S: <br />ACCOUNRN9 ONLY: mw FACE <br />FE GOOF FQ IMO AMOUIR RBNTTBD CTEC�JGIMX RICC1•VVED 8Y OATF $R I P~T NIM86I eP/OICS F <br />