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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 388, 304 EAST WEBER AVENUE, STOCKTON, CA 95201388 <br /> (2091 469 3420 <br /> NONREFUNDABLE PERMIT EXPIRES I YEAR FROM DATE ISSUED <br /> ICampAt*IP Triplicate) <br /> ANRICATIDN IS HEREBY MADE TO THE BAN JDACdN COUNTY FOP A PfIV.IR TO CONSTRUCT ANOgfl INSTALL THE"W DESCPJRED, TWO MPLICATK>H IS MADE M COMPLIA E WI IH BAN <br /> JOAOUIN COVNfY DEVFLOAMNT TULE,CHAPf ER 8-11110.3 AND THE BTANOARDB/OF BAN JOAOUIN COUNTY PUBUC HEALTH <br /> SERVICES.ENVIRONMENTAL HEALTH 0N8ION. <br /> JOB ADDREB&OR ARAN L <br /> I? 1 <br /> Loi SIIf <br /> owRNElt•*NAMEI�CTiw NJ S/rnNJ elI SIJ( . ADON¢Be _ �7�' �. GtlCt'h' f�lJalEc //7, e EHONE <br /> CONTRACTOR I /\.J V�r_ ADDRESS <br /> )ICI BONE <br /> WS CONTRACTOR ADDRESS <br /> lKI PHONE <br /> 1YPE OF&EVER WD" NEW WBTALLARON'PK PE MWADNIIOH ❑ OEBTRDCTION ❑ <br /> O,u sEPfIC TIBTfM EtNARIEO IF pUBUC SEWER IB AVNLARLE MINIM 200 FEET OF BNLDIN0.1 F91C TESTIU 1 I NOW MANY <br /> Apvfio SFn M ( _ <br /> bJSTALUTIOMYn4 SDEV[: RSIOEMCE�- COMMERCIAL OTHER (3 <br /> N.SD1 OF UNNO UNITS: I NUNIwm OF SIDROOMB' l— Nl.MB91 OF QiPLDYETJ: I(� <br /> CHARACTER OF SOIL TO A DEPTH OF l FEET: I PLTISUMP BOIL CHARACTER --TT WATER TABLE DEPTH <br /> SEPTIC TANOOI lTMP ❑TYFfJMFO .ICL L_ CAPACRY Ol(a. IGC)(-) NO.COMPARTMENTS <br /> PFO TREATMENT RANT❑ DISTANCE TO NEAREIT: WELL 10014- FOUNDATION PROPERTY UNE > <br /> O WE <br /> LEACH,"CAFTUNE�N � Eq.•LENGTH OF LMPL OF yFFUMP�,_^SA/M OIL SEPARATOR)ENCLOSED SYSTEM) <br /> Ea3 i* 6 ADO Y W q LJ 1 dBTANCF TO NEARIf ET:WELL FOUNDATgN PRDPENTY LINE <br /> FILTER BED 13 MOTH LEHOTH DEPTH DISTANCE TO MEANEST:WELLFOUNDATION PIOPHTTY)INF <br /> MOUNDED ❑MUTH LENGTH MPTH DISTANCE TO MEANEST:WELL FOUNDATION PROPEIRY ME <br /> SEEPAGE INTO ❑DEPTH BRE HUMBER DISTANCE TO NEAREST:WELL FOUNDATION PIIOMPFY WIE <br /> .woo ❑WOTN LENOTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY UNE <br /> DISPOSAL MINIS ❑YVIDIH LFNOTN OFPTH DISTANCE TO NEAREST:W£LL FOUNDATION PROPERTY LINE - <br /> I HERESY CERTIFY THAT I HAVE PREPARED THNI APPLICATION MIO THAT THE MW WILL BE DONE IN ACCORDANCE MTN BAN"AWN COUNTY ORDINANCE@ AND STATE LAWS,ANO m.,EB <br /> ANO SIMULATIONS OF TME SAN JOACUIH COUNTY.HDME OWNER OR UCENSED AGENT'S UGNATUAE CERTIFIES THE FOLLOWING:Y CEITTIFY THAT MYHE PEPFOPMANCEOF THE WORL FORYARCH <br /> THIS PERMIT M ISSUED,I SHALL HOT EMPLOY ANY PERSON M SUCH A MANNER AS TO BECOME SUBJECT TO MRKMAN•*COMPENSATION LAWS OF CA FITIIA.' CONTRACTOR'S HNaNO DP <br /> SM CONTRACTING SIGNATURE CERTIFIES THE FOLLOWMU:'1 CERTIFY THAT IN THE PERFORMANCE OF THE MW TOR WHICH THIS PERMIT 18 ISSUED,1 SI EMPLOY PERSONS BUSJECT TO <br /> W wmm'B COM TION LAWS WfORNIA.' TINE APPLICANT MUST CALL E4 MUSS IN ADVANCE FOR ALL P LOWED INSPECTIONS. COMPLETE DRAWING SEIOW. <br /> ..YD xJ TITLE: C�ti--..)feVZ DATE: <br /> T PLAN ORAW TO BCALEI SCALe 'IP <br /> 1. NAMES OF STRIFES OR ROADS NEAREST TO OR BOUNINNO THE PM1JPERTY. 4. LOCATION OF HOUSE SEWAGE DISPOSAL SYSTEM ON fYU198EO <br /> T. OUTLINE OF THE gg14RfY•WITH DMEN&ONS AND NORTH DIRECTION. EXPANSION OF BFWAOE aism I BYSTENB. <br /> T. DIMENSIONED OVTLME*AND LOCATION OF ALL EXIBTINO ANO PROPOSED STRUCTURES, B. LOCATION OF WELL*WRWN RADIUS OF ONE HUNOPED FIFTY FT.ON <br /> INCLUDING COVERED AREAS BUCH AS PATIOS,DRVEWAYS,ANO WALJLS. THE PMPERTY ON ADJOININO PROPERTY. ljFt <br /> i <br /> + 64) \ <br /> �r tj LY <br /> 1 <br /> A0 a o' j3 t1`--=I t <br /> c o nllz G RF-Us-it3 7 <br /> y ro bD1+u <br /> U Q P"MF\Y 15 199 <br />