Laserfiche WebLink
LIQUID WASTE PERMIT <br /> (� SAN JOAQI HN COUNTY PUBLIC IIEALTH SFRVICES ENVIRONMENTAL HEALTH DIVISION <br /> 3N E.WEBER AVE JM'FLOOR,STOCKTOKCA 932020NE)JNI 11ID <br /> NON' <br /> 5 nN�/R��lq kk 1'.%HRFSIYE^RFROM I'o195U A� PARCELS.U: <br /> JOB ADDRESS YEAR <br /> RFRO l; nT <br /> BUILDING PERMIT F op- M{/�IJO� <br /> OWNER NAME T�/7..- ADDRESS 93,60/ <br /> CDYILP_-_�, /}� .1- PHONE NUMBER <br /> CONTRACE^_R ,/Qgr�l"� �1 C ADDRESS_ <br /> CITY2IP i�i/��T(SG/Z -_-„ 11105E NLMBER <br /> GEOGRAPHICAL INFORMATION: COORDINATES: K Y _ _ _ TOWNSHIP, RANGF._9ECrtpN_ <br /> TYPE OFSEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING.UNITS: <br /> NEW INSTALLATION /-'yRESIDENCE NUMBER OF BEDROOMS; <br /> ❑ REPAIWADDITION ❑ COMMERCIAL <br /> NUMBEROF EMPLOYEES: <br /> Cl DESTRUCTION ❑ OTHER <br /> Cl ENGINEERED-ALTERNATIVE <br /> CHARACTEROF"LTODEnI OF)':___ PITSUMPSOILCHARALTER: WATER TABLE DEPTH; <br /> ❑ PERC TEST LA IIOWMANY APPLICATION# I. <br /> pf SRPTICTANK TYPEMFG_ � CAPACITY HJO #OFCOMPARTMF.NTS o` <br /> ❑ GREASETRAP TYPE'MFO CAPACITY _ #OF COMPARTMENTS <br /> ❑ PKCT%PLAM DISI'ANCETONEARM, , WELL__ TOF NDATNM PROPERTY LINE <br /> ❑ LU`TSTATON SIZE. ., TYN.DFNMP _ SAND OIL SEPA.RATOR(EWLO'SED SYSTEM) <br /> LEACH LINE MOF LINES: LENGTH OF LINES!530 .AMTroNeuRW� WELLZOV MUNDATMN�J ERDreRry DAEX&F <br /> INMITRAI'OR CHAMBERS: <br /> ❑ FILTER BED WIDTH FIRM_ DEPTHBIRdNCt TO VPAYv4 WELL__ 1`0UNDATION PROPERTYDNE_ <br /> ❑ MOUNDED WIDTH_ LENGTH_ DEPT - NRANRTOWOUNS; W91 IULEOA'IION� PROPERTY LINE <br /> ❑ $DMPB WIDTH_ LENUDI DEPTH_ NSTANfLTONEARII W),t L FOUN"TION PROPERTY ONE <br /> ❑ DISPOSAL PONDS WIDTH LENGIX UEPI'M elsTwa mneweLYi. WELL__ FOUNDATION_ MOPFATY LING <br /> ❑ SEEPAGE flTS # DIAMETER_ OLPIN DNTnvfRO...T: WELL MNDATION MR ERTY UNE_ _- <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK V ILL BE MORE IN ACCORDANCE WRIT SAN JOAQUIN COUNTY ORDINANCES,STATE IAW$ <br /> AND RULES AND RECULA TIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM IA HOUR <br /> ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE <br /> �CALL <br /> ,j�i09)468-3173 <br /> _TITLE:. DATE: <br /> q 1 <br /> I 1 <br /> J. i <br /> .-- A <br /> - <br /> . ..L. <br /> I t <br /> 1 <br /> L ... <br /> i - ..,-_y. _- •__ 1. i I. _... _ s^'1:1) Nth !Pf" M.- - <br /> 1 <br /> DEPARTMENTUSF.ONLV �1 Q 4 <br /> APPLICATION ACCEPTiD ��'D/IIAIi S'10�7- AREA�'I�_EMPLL/OYYEEE IW 3-1+wTRIR �IJICATION • <br /> INEPEITLT NV:` DATE yI1 b(/PFRMIT FINAL FS DATF:�I/ INSPECTOR`(L'�1�+'iF, <br /> COMMENT$' <br /> PE(ODL ECIHTO AMOUNT MEC /SN RFCLVED GATE PLRMITSERVICERFWE3TA MYq SEP11<IM1 <br /> BV <br /> 4-211 H-1 1310 67831 I"1 45 <br />