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LIMID WASTE PERMIT /Xello <br /> SANJOAQUINCO@��LIII��� IC HEALTH SERVICES ENVI0.0NMENTAL HEALTH DIVISION <br /> IM E.W E IV'FLOOR STOCKTON.CA 95303(309)464-]620 %.00/ <br /> / /f iON-REO ABLE PERMIT EXPPFEYrF•l-ES I YEAR FROM DATE I/UE PARCEL\61/]P: RCIjP� <br /> iOB ADDRESS � YOO 1///W��(-'9[— In/7L/.i1 <br /> L,., �1/¢v�////[[���T /(J BUILDINGPERMITY <br /> OWNERNAME L.ifMCiG �G¢� ADDRESS <br /> TV/ME PHONE NUMBER�f <br /> NTRACTOR J_M� /JT �/ ADDRESS <br /> PHONE NUM..6?0gj 667 P7 y l <br /> LEOGRAPHICAL INFORMATION: COOROMATES:X Y TOWNSHIP RANGE_SECOON <br /> TYPEOFSEPTICWORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: <br /> NEW INSTALLATION yr RESIDENCE NUMBER OF BEDROOMS: <br /> REPAIWADDITION ❑ COMMERCIAL <br /> DESTRUCTION ❑ OTHER NUMBER OF EMPLOYEES: <br /> ❑ ENGINEERED/ALTERNATIVE <br /> y HARACPER OF SOIL TO DEPTH OF I': PIT/SUMP SOILCHARACFER: WATER TABLE DEPTH: O <br /> PERCTEST(S) HOW MAW APPLICATIONS <br /> ❑ SEPTICTANK TYPE/MFG f,9efl'v�A CAPACITY NOF COMPARTMENTS <br /> GREASE TRAP TYPE/MFG i CAPACITY SOFCOMPARTMENTS P <br /> PBCrKPLANT DISFANCETONEARKST: WELL FOUNDATION PROPERTY LINE /IV <br /> ❑ LIFTSTATWN SIZE TYPE OF rumppp SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> LEACH LINE NOFLINES: 3 LENGTH OF LINES:SO BlrrAxaTOxuecxr: WELL$O/ FOUNDATION 3Q PROPERTYDNE OF <br /> INFLRATOR CHAMBERS:IT <br /> ❑ FILTERBED WIDTH LENCTH OEPIN o0.4ArvL2iOnuRUT: WELL FOUNDATION_ PROPERTY LINE p <br /> MOUNDED WIDTH LENGTH DEPTH UUTAUCe TONWV WELL FOUNDATION PROPERTY LINE <br /> SUMPS WIDTH LENGTH DEPTH_ .-u.. IAEVEO WELL FOUNDATION PROPERTY LINE - <br /> ❑ DISPOSAL PONDS WIDTH UENOTH DEPTH .1SE .2TOxueett: WELL FOUNUATION PROPERTY LINE <br /> I SEEPAGE PITS M DIAMETER_ DEPTH_ OOTA FTONu0.uT: WELL FOUNDATION PROPERTY LINE_ <br /> HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WON SAN JOAQUIN COUNTY ORDINANCES SPATE LAWS <br /> / AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> /////�Ly[A.j/INIMUM 20 O A CE REQUIRED FOR INSPECTION$-PLEASE CALL(209)463.3421 �B <br /> LICKED: .C.E/31 TITLE: ( ��L�i1_�!�� DATE: -2 `U•� <br /> QA <br /> BLCN PIi Si <br /> NN <br /> ON <br /> It <br /> DEPARTMENT USrNVY - �`]1�J/ 'j//]'/j� <br /> �PPLICATIONACCErtF�BY: DATE'. V- EMPLOYEE IDY_`y__j�[DISOUCT�LOCATIQ9f <br /> INSPECTED BY: - LL DATE L IERMIT FlNAB4 DA TE: `INSPECTOR: <br /> b.MEMS: b� yl Qe'YLf <br /> fE[ODE SC INFO AMOUNT CX N RECEIVED DATE PE0.MIT5E0.VILE 0.EOIIF3TY ..CS, SEPTIC Id <br /> REMITTED BY <br /> 7 <br /> PLATE 11, Page 14 of 16 <br /> REYISEU I-1T91 <br />