Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 890 E MAIN STREET-STOCKTON CA 952202-(299)46"20 <br /> PION-REFUNDABLE PERMITCALL 209 953-7697 FOR INSPEC77ONS 11 EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS CRYZF 4 C v <br /> CROSS STREET 1 J rO n I L/ APN I�J 7� Z PARCEL SRE <br /> JY <br /> OWNER NAPE HCP/JCS/ �'r- PHONE <br /> OWNER ADDRESS 15;e� CMISTATEMP <br /> CONTRACTOR /K (�I 4K��"'D//LPHONE <br /> CONTRACTORADDRESS ! CITYISTATEMP da"'4 c-MIF <br /> LICENSE QC42 QC-36 OTHER D4 NUMBER -/yZ'LEXPIRATIONDATE i4 <br /> WATER TABLE DEPTH: R GEOGRAPHICALINFORMATION: COOFdInBtaS X Y <br /> ❑ PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION OL, REPAUVADOrRON D ENGWEERDESI NEDIALTERNA E <br /> IF REPLACEMENT D OUT SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESa2ENCe COMMERCIAL 11 OTHER <br /> UMBER OF WINO UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> SEPTICTANK TYPEIMFG P'Hi CAPACITY I�It'nb Sal #OFCOMPARTMENTS � <br /> ❑ GREASETRAP TYPEIMFG CAPACITY 991 #OFCOMPNRTMENTS <br /> DISTANCE TO NEAREST: WEAL ft FOUNDATION R PROPERTY LINE ft <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP 0 PKG TX PLANT 0 SAND OIL SEPARATOR(ENCLOSED SYSTEMI <br /> ❑ LEACHLINES ❑ LEACHING CHAMBERS #OFUKS LENGTHOFUNES ft <br /> DISTANCE TO^NEAREST WELL fft FOUNDATION R R <br /> PROPERTY LINE <br /> FILTER SED WIDTH Rp l R LENGTH�iG ft DEPTH I RII ft <br /> DISTANCE TO NEAREST WELL_��ft FOUNDATION W ft PROPERTYLINE�2 hM ft <br /> ❑ MOUNDED YAvrx R LENGTH R DEPTH R <br /> DISTANCE TO NEAREST WELL ft FOUNDATION R PROPERTY LINE R <br /> ❑ SUMPS WMTx ft LENGTH R DEPTH ft <br /> DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSALPONDS WoM R LSNGIH ft DEFTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGEPITS NUMBER WOTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY LINE R <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE W ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAWS ANO RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTION�S/.-PLEASE CALL 209 953.7697 <br /> SIGNED •TITLE C- /I PY C6 r DATE ! <br /> . n <br /> awl <br /> DEPAR <br /> 0 <br /> Application Accepted B y ab y' Arca aaE�mLp�bTyee 10# <br /> Final Inspedlon By Uab ❑ SPECIAL PEvAODTayatl by <br /> Cnancdr of S011 to pth f3FU PI Sump So9Charactar: RECE FOV <br /> COMIy}�fJTS <br /> "Glyvn e <br /> EMARONH. <br /> f ESG RacalvBd C ftBBkJI! Amount DataPermitl Involve# Permit ID# <br /> GODe INFO By Cash Rammed SsMcaR uaat#✓ <br /> 4241 ONSRE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 9421110 <br />