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<br /> APPLICATION F-014 PERMIT f'
<br /> SAN JOAOUIN LOCAL_ HEALTH DISTRICT
<br /> 1601 E. PAZE.iON AVF., STOCKTON, CA
<br /> Tci;.(thune 17.f`l} Cr�4;-3i8"1 4
<br /> PERMIT EXP:RFS_1 YEAI' FROM DATE ISSUED
<br /> (Complttt,. !r ";"ril,li,:;ltr'1 "
<br /> Apn4icn:nn r;Ilr�rrby•„ieL• !r,tt,•' ' „ .a,a[I•'ut Lnr,i+l 1�eakf:Datrrrt fol ,�fr^"„I t,re,nTtrr:ct and/or Ine;ralf Lha^JrJrtc herein desuibcd. Tftis eppfiCAtinn is r
<br /> m;tda in fnrYq,lianCn wrth;.,r,,tn,1,p•r!r, 'nr mt,,Onlinancn No i49 for sewamN 1-1 hU ,.'.tnr wrli!lfteml,and the Rules anti Regulati'+r,s of It,e San Joaquin .�.
<br /> Local He11111 Gstnc:.
<br /> ! ✓ l 1 r••• �`Ds_4...— Lot Size 'iO '91C. PM
<br /> _R s
<br /> Jab Address ,_. ��.7_� T f
<br /> ' ` Y A'L Phr•ne C G y Q 3
<br /> Owner'SNamr _..�A.�t }\a 4 ___.. Arlrlrr.5, _.7Z.� ._.� 5. .1=./Il,.C�+r_. ...�C.__.� ---W�--"----f-+----- 1
<br /> Uterse No- 1'tone
<br /> TY-7(;F WELL.F•L'• °: 'EGV WELL. i i 'WELL rr'I_A�F .:rJ'� L i +)ESTRUCTION
<br /> _.__.__. .._.. — - F 11r✓r I`:,TnLI.ATir�N i:, SvC�R.1 CF'a1R C i OTHER [1
<br /> QISTArar.1" 'n NEAT 4 ST_ csr;l�
<br /> TANK ----�__ G�dv',:? INES DISPOSAL f'D._-- PROP. LINE
<br /> k , _ AGflICl1LTl. E LL _ OTHER V'WEL[._ PITS/SCMPS _
<br /> IN7Er!]i[] IlSf' iti 'f rtii V311-.._. PROPLE:n9 ngl:A C :'R13CTI�rI SPf r1fICATION5-
<br /> (.'I IR(1rF5tr"al' OS'.'n {1n'•nm 1 1 Mwill:Ca ! ,A Ertravat pr, _ . ��. Dia.of well Carron �J
<br /> I ; Trary Fv", Specif!catior t
<br /> I l I)nmC l+clFrivalr f I?r.rr l P.xa -_'---__. __--- ----- ---'
<br /> I'r F'nhla
<br /> : n.F,..r f : Rclta � Fl,'F•;',„} r,.;,,,t a1 Type of Gro _
<br /> n1,1,•nx T)Cprh ] E.lSinn, Sur'ir, _ ',.� 1ns,tnl4u NIA
<br /> Y—�__- _--- --- —'
<br /> i 1(nitlWorl - .-._.-_ __..._..�
<br /> RepAi, nr4 [?nr�2 Tvp'` '
<br /> Welt DeStr_,r:tion _ WvIl r'.el" �- _._---_ S^,ling fL11,i” �;r';�!•^} _
<br /> br{+h - .-.• _ ..�._...—� _ � I rr'pl M,,rn't,,! .:'�:,,tia rn i .__.-._._.._-.�...�__ ----.-.., »-.. �• '
<br /> �, .` 1 liE F'rllf;'Df",1Ttf .J�. fel! 11rIIC11,7N I I [Nn�.erztir. sysleln permrth!c! l•ur,lw Sen,nn is
<br /> TYPE 01 $1,1'11(, %,.rnPK "1F'?1 �!J lAl[A'Tlr_"y avail,,51e within 200 frrot.l T {
<br /> ✓ I !T7 ` F1
<br /> Insre[latin',,hilt ecru'? [)r•:i,;^,"" _ _ C•mmnn:a7! . .�Ol.'^r - �-
<br /> flumbne of liv ng ur„• 1 ;,r ,t,.,r of"drnnm”
<br /> Gharactet of soil 16 ',drn! 1•'
<br /> C•C+,' IZ - C?i•,Ik,;J___I�dV__ ,to.
<br /> SEPTIC TANK T•,'p"lh,fa -
<br /> FAothod of DATHMl
<br /> " PKG. TREATMENT f'I.T.I 1
<br /> ,,�•.-. 1n Hr„rPlt; �'Vr11 3 5 lz .,.u,.,.rnnr, � '1•,..F�Prof,Anv Llne
<br /> _.. _. -- --- - 3' ' �•„ ' To11 thla;10 C
<br /> ,•Hto :o ___ .. �._....�_ {
<br /> LEACHIN(l LINE J: :
<br /> 1%
<br /> �. rol>ariv I J
<br /> inn_ IlL`—..�
<br /> ! tl..!%,u.•In nr.�r^g.•
<br /> VP-II �� f�, ,!J a;r.,
<br /> F[t•TEit RED
<br /> SEEPAGE PITS !''•, is ._._..__ _._ .._Sue •- -- �-
<br /> DUMPS r”.1 WOO
<br /> u, nrAlA3t. t r,r,nc at nt, Prr petty One S
<br /> DlSPOSA+. PoNrr, th
<br /> � t }
<br /> I h9rehy rnrtity rt,a1 I !:,” t„''t„'. ,hie rnFr:c^tion nnc5 at the,vnrl ., ',• „,:• ,r arco'dan'a Nth cOmr.'J 0;d:nances, slarA laws. And
<br /> :, rrr,it la isSUAd, 1-hall Hat
<br /> fllte9 Ani!rn[1,Jfltrnna nr ir,., ', .'c,� n r n•:al Hrahh f?ixt•r!.
<br /> };.,rr,e ownar r,r L•^'+-r•I.'r ”"t'•.-';r,:,tilra rrrrtihrs thn k-1141-A—ti: rn•. :I,.,: �•, Ih•C••elramnnrn rf thA work to"W” up the'P`
<br /> �prny any I,,rr%on t•.,;,rr'r•,.r•,nrr nc to hnr-Dmn cuh!^et t"Wwn nwm's r,,'S`nna.,t r•r,!,,Na 01 Cn1i40rni.."Cnntrr•ator"s hisubj c ;,ulwnrk aCt s C rr%-A s
<br /> ee•1rfiA4 the fnttov.;n[t 'I, ••rly rh v.9 0± o !„rrt,r+nr-.n of thr ma lk fill,Nlw t,H,rs t,^•n„t is issureri.t shalt emptor-pertvans subjact b wnrlcman's compena+• s r
<br /> The or.'kIFLA,n�rryl'i•Ik�ISr ",p n„r„rl,u;rd ina�'rc.3nr��/c�J-J[rna,n})ia rlrnw” .7 �
<br /> \�
<br /> Dam:
<br /> sirArid x.__ 1� _....«...� ' moi.- 7'itl.,- _ r•11:.�+..�.�'� ...._ =�J�./-Q�-..._
<br /> I (iron [)EPAn rAC.N! tinE ONLY _
<br /> ApI,E{fetion Arcnr,rn•1 t.v /'1 ll { C"a.�-+-._ .:.::..._._._._... :. —��� ,�
<br /> _ Dein__--,-„•„_- .._. final•nsp8ctinn b yY^-- d�.*
<br /> P4 or Grout jrm-r ,nom t - - - __'..'
<br /> Additlonel Cc,nn,r If;. -.--
<br /> Stk y[r,x;71 !r^,li a?f2 t•J M.olrcn e23 71(11 f'i T' my A35•FiVS
<br /> nrm,n+anlal HeAhh F'wn,irl$ml ',,'ht F.. tip rn:'•bn Ave., P.O. AOX 2"- SN . GA 65201 r
<br /> ApprcFini
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<br /> _ r •_;F- -- Af:CEIVfO61DATE PflWAII,N
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<br /> FI :,L!l`l'•t'-I I'lE ^r.a:=v.NT f M,T'11T)
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