Laserfiche WebLink
APPLICATION FOR LIQUID WA819 PERMIT <br /> SAN JOAQUIN COUNTY PUSUC HEALTH SERVICES PAYMENT <br /> ENVIRONMENTAL HEALTH DIVISION AECElVEp <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 OCT(209)"S-3420 4 2000 <br /> 11011-REtWICA9if PERMIT EXPIRET I YEAR fR014 DATE 18s0Ed AN JOACION C011N7Y <br /> ICBmpMts In TrbRof#1 E"PUBLIC HEALTH St r, <br /> APPLICATION It HERESY MADE TO THE SAN JOAOUDI COUNTY FOR A PtRMrf TO CONSTmICt ANOAR INSTALL THE WORK DESCRIaEO.THIS APPLICATION IE a17iDE�wa,M�AWITIJ�AN <br /> JOATRRIL COIMfY OEVELOPMENT TITLE.CNAitjER••7 7 70.'.11 AIRD THE STANOOAARDS OF SAN JOAOIAN COVNTV PLRMJc HEALTH SERVICES.DMAOHMENTAL NEALTN OIVISION. <br /> JOS ADDPEBSATR APNI L 1 /: 'P� (`,•i _J�, - LL].CITY C:`�''!.':.`t: LOT SO:E <br /> OVANEA'SHAMF ("•r•.,° 1!.' AODREat <br /> CONTAMTOR �... I" 'i L 1 <br /> fV6 COHTRACTOA ADORES* LICF RI6NF <br /> TYPE OF SEPTIC WORK: NEW INSTAJATNON Q REPAIVADM THHO❑ OESTRUCnGN❑ <br /> PIO 6Wm SYSTEM PEPMITTEO IF PUaUu EtWER 19 AVAPLAILE YIfHNN SOD REF OF BUILORND.I •I PTRC TSST4.1 I 1 HORN MANY <br /> INSTALLATION WILLSBNE: RESIDENCE ` COMMERCIAL I3 OTHER <br /> NUMBER OF RRNNG UNITS; NUMBER OP SEOROOMS: NUMBER OF IMPLOYEEI: <br /> CHARACTER OF DOLL TO A OEPM OF�•J s•I FEET• RTIPUMP BOIL CHARACTER: WATER TABLE DEP'TF�,-„ ^ <br /> SOMC TmxxxtuEt?RAI ITYTEIAFO CAPACfTY NO.COAIPAATUINT f <br /> PKO TREATMENT PLANT 13 V BTARCE TO NEAREST: WELL FOUNDATION PROPERTY UNE <br /> LNT STATION© ESE TYRE OF FUMP BAND OIL SEPARATOR ENCLOSED SYSTEM <br /> LEACNNO UNE 0 NO.R LENGTH OF Lame OISTANOE TO NEATEST:WELL FOUNDATION "up tm UNE <br /> FRTOt RW O VADfH Lmarn DEPTH DRBTA/CE TO NEAIIE*T:LNEIL FOUN DATIoN PMPENY UNE <br /> MOUNDED I3 WIDTH LENGTH OE►TH DISTANCE TO NEAIIE*T:WELL FOUNDATION PROKATY INE <br /> . SEPAOt Mfg 13 prpTH SRE NUMBER OHITANCE TO NEAREST:WELL FOUNOATpM PFIOPVWY UNE <br /> SALES I7 WMm LENOTN DEPm DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY INE <br /> ONSFOSAL PONDS i7 wwH IEHG7H bfrrH dtTANCE TO NEAREST:WELLFOUNDATION "ope"UNE <br /> - - <br /> 1 NLPESY cuff"7HAT�t HAVE PREPARM TNI*APPUCATION 'THAT THE WONLR wRl tIt•DrPNt IMAC6ONOAJRCE VAT"BAN JOIORIIlE T:OUHTCOI�OWANCES AND STATE LAWS,AND RULES <br /> MND AMULATIONS OF THE*AH JOAOUN COUNTY.Now&WHEN ORLICENSEO ADtMy moNAT1/RE comms TEIEFOIlamm,YcomFfTHAT INTHL PE1i0iR1ANC(OFTIRY+PEI POR WESCH <br /> TTM pEM14T M ISSUED,I SHALL NOT EMPLOY ANY PENTON N SUCH A MANNER AS TO BECOME NBJt=TO WOFKMAN'B COMPENSATION LAWS OF GAUK"AA'COMRACTO"WONT OR <br /> VAI, nLACTINO SIGNATURE CERTFES THE FOLLOvANW I CERRFY MAT N THE PERFORMANCE OF THE WOW FOA WHICH THIS PEIEUT IS ISaUFD,I SHALL EMPLOY FUMNS SU&MCf TO <br /> LADIK MANS COMPENSATION LAWS OF CAUmmaA.• TM APPUCANT MUST CALL?S HOURS M ADVANCE FOR ALL RNLJNC NSPIMMMS,COMPLETE DRAWING SELOW. <br /> 4 ; <br /> BKtNmx IS; +i''ci 't_1C'€A1�- - - TITLE:. :: DATE: <br /> F7aT nm DMW TO SCAALEI BCAIA •R. <br /> 1...HAMEPS OF BTRLLTB TOR ROADS NEAREST TO OR IOLVMM THE MWERTY. S.LOCATION OF HOUfl VCWAGt_tl rCfAL'*YfTTPA OR PIINOSED. <br /> E.wn"6 TNErROPERTY.WITH ONMEHSNONB AND NORTH GDECTION.. UIPIJNWN M SEWAGE QISRAOSAL STRTOIS. ---- . <br /> 7.DigwlSIgHEDA1UTLINES AND LOCATION OF ALL CWSTM AND PROPOBEO SfFLCTUIES.... S.LOCATION W WPlli YYITIRI RADIUS OF OIEHUImREO FIFTY FT:OM <br /> .'.. .. <br /> . :..MCLUD".L'O`VFnEOYIREAf SIICM AS IATROS,pRTVEWAYR AND WALI(S:' THE FIATpERTY.9R ADJOaRNG PfO�tRTY:'- <br /> v <br /> 1 <br /> 1 z` <br /> 1 <br /> I 3 ? <br /> r - <br /> µV,. C� 1 <br /> 014 <br /> `• A 13 <br /> _ IS <br /> t2 <br /> V5 �B 7 8 9 10 <br /> ... cel l♦ <br /> IS • • • • ' <br /> J. <br /> ..... .....:......z.....:. <br /> ;f FOR DEPARTMENT USE ONLY <br /> .. ApFUCATIOMACCE?EDBY ,•: � DATE: <br /> TAK,PITOA SUMP INSPECTION BYE I _FNAL INSPECTION BY _DAT' ^ <br /> AOOTTSINAL COMMENTS: <br /> nz-' <br /> t7- <br /> -12 <br /> FACP <br /> tl? <br /> NIMB•. TNVORCE I <br /> puO.HSLIRSI Serv.•Ernlro.174 oft) - <br />