Laserfiche WebLink
i <br /> LIQUID WASTE PERMIT <br /> SAN JOAOUIN COUNTY PUBEIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION <br /> 304 E.WEBER AVE 3"FLOOR,STOCKTON.CA 95203(309)4hR-3420 <br /> NUN-REFUNDABLE PERMIT EXPIRES 1 VEAR FROM7DATE ISS U�ESRCE <br /> Yrl' Ib JOU ADDRESS •f �p �""/"'1n"'"S •`'vL7. APN ?O - `tl d-J v • Q PARCEL SIZE: L3 CR <br /> CITVILIP BUILDING PERM IT'NJ <br /> OWNERNAME yf <br /> ADDRESS q�"� /�� <br /> CITY fZIPS� PHONE NUMlHER ! G� <br /> CONTRACTOR e- - 14 ADDRESSf_ Z Y 6 �u.1 C.n'�Y S•7� !' /� ��_ <br /> / // / �j�j/ Cf 7• <br /> { CiT1'!71P Ci-�G -72 <br /> �l t`/ PHONE NUMBER F 1 4 4r• - <br /> GEOGRAPHICAL INFORMATION! COORDINATES.X Y_ TOWNSHIP RANGE SECTION <br /> I TYPE OF SEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: <br /> P NEW INSTALLATIONRESIDENCE NUMBER OF BEDROOMS: <br /> ❑ REPAIRIADDITION ❑ COMMERCIAL NUMBER OF EMPLOYEES: <br /> ❑ DESTRUCTION O OTHER <br /> ❑ ENOINEEREDIALTERNATIVE <br /> J 1 <br /> { f CHARACTER OF SAIL TO DEPTH OF 31' PITfSUMP SOIL CHARACTER: WATER TABLE DEPTH: <br /> ❑ PERC TEST ISI HOWMANYp (' APPLICATION <br /> sEPTIc TANK TYPEIMFG_1 - l.c lit^ -_ CAPACITY -f.' .% IY OF COMPARTMENTS <br /> '0 GREASE TRAP TYPElMFG CAPACITY #OF COMPARTMENTS <br /> ❑ PRGEH PLANT DISTANCE TO NEAREST: WELL_ a FOUNDATION PROPERTY LINEZ_� <br /> Q UFT STATION SIZE TYPE OF PUMr SAND OIL SEPARATOR(ENCLOSED SYSTEM <br /> Fit LEACH LINE <br /> OF LINES'. LENGTH OF LIN ES', DIRANCETONEARLST: WELL/� FOUNDATION !v PROPERTY LINE <br /> IN FLITRATOR CHAMBERS: <br /> ❑ FI LTER BED WIDTH LEKGI DEPTH- Dj.—HCETON6lRER: WELL FOUNPnT1oN PROPERTY EINE <br /> Fill <br /> MOUNDED WIDTH LENGTH DEPTH DIRANCFTVNEARE.T: WELL FOUNDATION PROPERTY LINE❑ SUMPS WIDTH LENGTH DEPTH DLRANCETONPaRE.SE: WELL FOUNDATION PROPERTS'LINE <br /> ` ❑ DISPOSAL PONDS WIDTH LENGTH (DEPTH D-ANCETDNEARER: WELL FOUNDATION PROPERTY LINE <br /> ' J�_ If Z_�-( � PROPERTY LINE <br /> '�rSEEPAGE PITS N PUMETER ➢EMH DiRAHCE is NEARER: WELL FOUNphTION <br /> I HEREBY CERTIFY THAT I HAV PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES.STATE LAWS <br /> AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> M1 M4}M 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)468-3423 <br /> SIGNED: - - TITLE 01-) ATE <br /> i I <br /> a <br /> J 1 I IIii �-1 <br /> .............. <br /> � I <br /> I /o'? <br /> L I -T- <br /> 77 <br /> I <br /> AlI <br /> LJ <br /> I <br /> Ll <br /> I <br /> E_4_ dcLl <br /> y rJ7I <br /> F.PAR TM N �UII' }S11f CEN1.Y C "] <br /> 7 APPLICATION ACC TEP BV � �� L' �-DATE t L71 , AREA Z�EMPLOVEE IDA ]I` DISTRI LOCATION_ <br /> a� <br /> M IN5PECTE BY: s DATE' 3 PERMIT FIN YES DATE,�� 3_I ➢ <br /> f r. <br /> , <br /> PE CODE SC INFO ANIOUNTCHEC ICAEH RE[EIVEO DATE PERMITISE-CE nFQut515 +NVOICEx SEI"TIC LOA <br /> REMITTED BY <br />