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(QUID WASTE PERMIT ,� <br /> SAN IDAW'h RAVE Ix'PLOORCUT SSfOCKTON .CA 95n2 2WHM1W)'T" <br /> DIVISION <br /> PEA <br /> H <br /> ,l NONTRE�F'UNSDARLE�IP�E BEDE EXPIRES I YEAR FROM DATE ISSUED / <br /> K/NLS%; TY¢� APN Ifg3 bLo-D`r PARCELSIZE: ?� <br /> JOR ADDRESS ' <br /> CI,IlTE1P CJ IV BUILDING PERMIT[A y <br /> OWNER • �,T y!F�/(_ ADDRESS <br /> CMIMP TJLN _ PHONE NUMBER <br /> y ,e2 <br /> CONTRACTORiIL/-L��IGS_2,46-rJ! ADORERS Z <br /> FJ •L/� /'� T Gy✓2T-c_�. <br /> CITYILP_J I ILS •v• .o� PHONE NUMBER <br /> GEOGRAPHICAL INFORMATION: COORDINATES:% Y TOWNSHIP_RANOE_SECTION- <br /> TYPEOFSEPITCWORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS:_ <br /> ❑ NEWINSTALLATION ❑ RESIDENCE NUMBER OF BEDROOMS; - <br /> ❑ REPAIRIADDITION ❑ COMMERCIAL NUMBER OF EMPLOYEES: <br /> ❑ DESTRUCTION ❑ OTHFR <br /> ❑ IINGINEEREIVA.l'ERNATIVIi <br /> CHARACTF".ROI+SOI1.'1'ODRPI'HOFJ•; PITISUMPSOILCHARAC4:R: WA"F,RI'ABLEI)F'.P'I'll: <br /> PERITS (S) HOW MANY APPLICATION <br /> ❑ SEPURTANK TYPEAMFG CAPACITY NOFCOMPARTMENTS <br /> ❑ GREASETRAP TYPE/MFG CAPACITY NOFCOMPARTMENTS <br /> ❑ PKLIX PUNT DLSTANCETONEAREST: WELL_ FOUNDATION PROPERTY LINE_ <br /> ❑ LIFTSTATION SIZE TYPEOFFUME SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINE IF,OF LINES:_LENGTH OF LINES:_ OnrAnc[roxlv[cT: WELL FWNDAMN_ PROPERTY ONE <br /> INFIJTRATOR CHAMBERS: <br /> ❑ FILTER BED WIDTH- LENGTH DEPTH_ DUTAMtmNm6r: WELL FOUNDATION PROPERTY LINE <br /> WIDTH LENGTH DEPTH oRl'AM[NnuuiT: WELL FWNDATWN_ PROPERTY LINE y <br /> CI MOUNDED - <br /> ❑ SUMPS WIDTH LENGTH_ OEM WELL FOUNDATION_ PROPERTY LINE_ <br /> ❑ DISPOSAL PONDS WIDTH_ IENGTH_ DEPTH_ ouiAM[TonuRfsr: WELL FOUNDATION PROPERTY LINE_ \ .1 <br /> ❑ SEEPAL-E PHS M DIAMETER_ DEPTH_ OLaTAK[TOX[ARLT;: WELL FOUNDATION_ PROPERTY LINE �V\T <br /> I USSEBY OBJEEDYTHAT I HAVE PREPARED PPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES,STATE LAWS <br /> RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMU 20 R V NCENOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)46X-3021 <br /> SIGNED: <br /> ' TITLE.: LIO�P'//JI�O.I — DATE: <br /> Tn <br /> { k - + <br /> I <br /> DEPARTMENT USE ONLYCl <br /> AP LIGATION A(YE Y: /-�aL _ OATP L_�AREA EMPIll\'F.E IDs 10 l DIST I LOCATION <br /> INSPECTED BY mac-� _OA PERMIT FIN YEE UA i ATO ✓�O}�/� /� - \.- <br /> pTCODE BC IM"O AAbIMT NEC ASN RfaIVLO DALE • PERMRBERVICE 0.E Sid INVONEx SEITK Ip <br /> REMI U BV <br /> �zz2 s�2 �y -bOK <br />