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/` ryON#ENNOA/BLE PERMIT EXPIRF31TfAOR�F}ROM,`DATE DIED D <br /> JOB AD' a205�y L`C�/%�///�/J Q6/ Y 0 Lam. -✓-� PARCELSIZE: �r <br /> P� CO,.,�/�I 11��v IUIL..NL,.AMIT <br /> OMNERNAME IPiT.t rdOzd-- ADDRESS"A.A <br /> COWED P PHONE NUMBER A-34 �//—Al'J✓�� <br /> l] <br /> FREE <br /> CONTRACFDR116L , Sp/,/�l�N.}�/ �1 <br /> CITYMP S` GIa�X/l/'V /> ✓- PHONE NUMBLP�.J <br /> IRS, - GEOGRAPHICALINFORMATION:CODRDINATES:% Y RIWNVIP RANGE— --*I_ <br /> TYPEOFSKMCWORK: INSTALLATION WILL SERVE: NUMYEROF LIVING UNITS:_ <br /> 0,,>EWINSTALLATION O RESIDENCE NUMBEROFBEDROOMS: <br /> REPAIWADDITION O COMMERCIAL <br /> O DESTRUCTION ❑ OTHE0. NUMBER OF EMPLOYEES: <br /> ❑ ENGINEEREEMALTERNATIVE <br /> CHARACTEROFSOILTODEPTHOFJ': PITISUMP SOIL CHARACTER: WATER TABLE DEPTH: <br /> BEER, ❑ PEEN TEST ISI HOW MANY APPLICATION# <br /> O SEPfICTANK TYPF/MFO CAPACTTY X OF COMPARTMENTS <br /> ❑ GRF.A.AE TRAP TYPFJMFG CAPACITY NOFCOMPARTMENTS <br /> ❑ PKLTX PLANT DISIANCETONEARESE; WELL. fODNDAT10p FPOPFATY K. <br /> ARa <br /> ❑ LIFT STATION SIZE / TYPEOTNIMP ll SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> LFACN LINE #OFLNES:_'Z- LENGTHOFLINES: Ve) PpT,vKTTDNaPagT; WELL/M'"' FOUNDATION_ PROPEMY LINE_ <br /> INFUTRATORCHAMBERS. <br /> r O FILTER BED WIOTM LENMH_ DERV_ CaeTax[L in xIAC[aT. WELL FOUNDATION PROPERTY LINE_ <br /> ❑ MOUNDED WIDTH— L£NOU DRRN_ FVTaxE't iOxuaeSf: WELL N)UNOATON_ PROPERTY LINE_ f'( <br /> ❑ SUMPS METH LFNOTN GERM_ oPTUK6TOxWYT. WELL WVNDATION FPOPERTY LTM_ a1 <br /> w <br /> Ll DISPOSAL E <br /> DISPOSAL FONDS WIEM L£NOIN RM UN <br /> DEAIHi Tlxa4uti. WELL— FODATION_ PRMERTV UNE_ \ <br /> ,C SEEPAGE PRS N� dANDR.,��p DEPTXI /y ,; ` <br /> OniAncaianauLNi. WELL L FOUNDATION_ PROPERTY LINE_ <br /> I HEREBY CERTIFY THAT I NAVE PREPARED"IS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WRH SAN JOAQUIN COUMY ORDINANCES,STATE LAWS <br /> AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> ` <br /> (MUM <br /> 24 NOV ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(M)683121 <br /> SIGNED: TITLE:_rM�/j DATE: <br /> ` R <br /> G O <br /> A� n <br /> M <br /> C <br /> O <br /> •# tR M-0 07 <br /> M <br /> a <br /> r <br /> `IF <br /> ' osPARTMEPIr nl.v <br /> _ APPLICATION Y� OA,f' AREA EMPLOYEE IMS5-t�wMSIR I.00ARON�� <br /> A� <br />