SR0085171_SSNL - Laserfiche WebLink

Home Browse Search

ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONWNTAL HEALTH DEPARTMENT 1858 East Hazatton Avenue - STOCKTON £A 982854232 - (209) 488.3420 JOB AAARM CITYMP CRoss STREET ��.�mkAc APN�„J zl.a "- fit PABzFL smE OWNER NAME ,I � %� PHONE ��>" - ✓� yC✓/� OWNERADORESS CiTYISTATEMP CONTRACTOR _ �.../ �./•t7A'/'.'�.`'�fr•" _ PHONE CONTRACTOR AtSDREBsCITYISTATEIZW ��-'� LtCENffiE ,' C42 C-35 OTHER NUMBER 661WA:.0 E - MRA noN t)ATE WATER TABLE DEPTH: R ! : FERC TEST ie dF WORK: NEW INSTALLATION REPLJN:EAiENT _ INSTALLATION WILL SERVE: a REM NUMBER OF LIVING UNITS: )i SEPTIC TANK * TYPEIMFG 0 GREASETRAP TYPE/MFG GE OaRApHfCALINFoNMATm: Coordinates 7L Y NNG PERMrr # LAND USE APPLICATION # AL REPAYRIADDMON 1.; ENOWEERDESIONEDIALTERNATWE DESTRUCT'�N y"'-" , t-Y'r r 1.. Gtr, jr/'"t DISTANCE TO NEAREST: WELL — Cl LIFT STATION suE TYPE OF PUMP ".J COMMERCIAL E OTHER OF S tl0yg; NUMBER OF EMPLOYEES: CAPACITY ' gal #OF COMPARTMENTS CAPACITY gal # OF COMPARTMENTS ft FOUNDATION ft PROPERTY LINE ft O PKG TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) I HEREBY CERTIFY THAT I HAYS PREPARED THIS APPUCAnON AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JONfr STATE LATHS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIMUM � 4 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7597 SLONED ._. TITLE. /.ACS ____. ______ DATE -1— m w DEPARTM'ENT E LY -r=f-.-- Applkatian Atcepta - Data � Area Employee ID# L Final Inspacdon By Data l C? SPECIAL PERMIT -Approved o1 Charaetar of Soil to Da of 3 Ft. PfVSump Soil Character: COMMENTS d4k-�ra j iI-ST =esc fi?4, &,lnI &-.,o -P-ie" S , 4te, Aar Zi A&%A ; ei k ZR &;&k,97.LG := � f1�i ��%�� ✓fii:+ � , 42-0t 18H1C7 i ONSITE WASTEWATER TRTMNT SYSTEM PERMIT , 1_1b� OF LINES it LEACH LINES 'i t EACHING CHAMBERS # OF LINES LENGTH _ tU DISTANCE TO NEARi=BT WEiL it FOL)NDAIlON it PROPERTY iJNE It ❑ FILTER BED WIDTH ft LENGTH it DEPTH. ft 04TANCE TO NEAREST WELL It FOUNDATION ft PROPERTY UNE R 13 MOUNDED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY UNE It t is SUMPS WIDTH It LENGTH 1.,o —ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE h C1 DISPOSAL PONDS WIDTH ft LENGTH It DEPTH _ � ft DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTYUNE_ �ft Q SEEPAGE PITS NUMBER WIDTH ft DEPTH ft DISTANCE To NEAREST WELL It FOUNDATION tt PROPS ft I HEREBY CERTIFY THAT I HAYS PREPARED THIS APPUCAnON AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JONfr STATE LATHS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIMUM � 4 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7597 SLONED ._. TITLE. /.ACS ____. ______ DATE -1— m w DEPARTM'ENT E LY -r=f-.-- Applkatian Atcepta - Data � Area Employee ID# L Final Inspacdon By Data l C? SPECIAL PERMIT -Approved o1 Charaetar of Soil to Da of 3 Ft. PfVSump Soil Character: COMMENTS d4k-�ra j iI-ST =esc fi?4, &,lnI &-.,o -P-ie" S , 4te, Aar Zi A&%A ; ei k ZR &;&k,97.LG := � f1�i ��%�� ✓fii:+ � , 42-0t 18H1C7 i ONSITE WASTEWATER TRTMNT SYSTEM PERMIT ,