Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JDAWN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 61110 E MAIN STREET-STOCKTON CA 95202-CM)468-UN <br /> NON-REFUNDABLE PERMIT CALL(209)933-7697 FOR INSPECTIONS EXPIRES I YEAR FROM DATE ISSUED <br /> ion AaDREss Crryf <br /> 4P e <br /> CR=STREET )nf APN <br /> PARCEL SIZe <br /> PHONE <br /> OWNER ADDRESS It t:' n, fi C"YM'fATMP <br /> CONTRACTOR % P., <br /> CONTRACTOR ADDRESS <br /> )7 b IeYf CffYISTAWJZJP <br /> L=NSS f]C-62 �CIM OTHER NUNWER_EXPIRATION DATE <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL IRFORKAT10N. Coordinates X Y <br /> PERC TEST 0 -BUILDING PERMIT# LAND USE APPLICATION <br /> iE <br /> - - <br /> TYPE OF WORK 11 NEW INSTALLATLO14 11 f�Am1AooITjaN <br /> El E*MkMADESIGNED 1ALTERNATW <br /> 11 REPLACEMENT 11 OUT-OP-SERVICE SEPTIC SYSTEM 11 DESTRUCTION <br /> INSTALLATION WILL SERVE RESIDENCE 11 COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS- NumarsR OF BEDROOMS: NUMBER OF EMPLOYEES; <br /> SEPTIC TANK TYPFJMFG CAPACITY— gal #OF COMPARTMENTS <br /> GREASE TRAP TvwjMFG CAPACITY_ gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST. WELL_ ft FOUNDATION_ ft PROPERTY LINE ft <br /> 11 LIFT STATION SIZE_TYPE OF PUMP_Q pXg TX PLANT U SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> 13 LEACH LINES D LEACKMG CHAMBERS #40F LINES <br /> — LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> 13 FILTER BED WLDTH ft LENGTH -ft DEPTH ft <br /> DISTANCE To NEAREST WELL—ft FOUNDATION ft- PROPERTY LINE ft <br /> C1 MOUNDED WN)TH ...—ft LENGTH .—ft DEPTH It <br /> DISTANCE To NEAREST WELL—ft FOUNDATION ft PROPERTY LINE It <br /> 13 sumps WtDrrH ft LENGTH ft DEPTH .. It <br /> DISTANCE To NEAREST WELL_ft FOUNDATION ft PROPERTY LINE ft <br /> 13 DISPOSALPONDS om It LENGTH ft DEPTH <br /> DISTANCE TO NEAREST WELL ft FOUNDAT40H <br /> ft PROPERTY LINE ft <br /> 0 SEEPAGE PITS NUMBER Wurm ft DEPTH <br /> DISTANCE To NEA;kiii WELL —ft FOUNDATION_ft PROPERTY LINE —ft <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THtSi APPLICATION AND THE WOW WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAws AND RULES AND REGULATIONS OF SAN joAam COUNTY, <br /> 11 NI IM OUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 <br /> SIGNIED-i 8 #010 TE <br /> .......... <br /> AV- -win <br /> Llk VITJ� <br /> E. <br /> — <br /> Application Accepted By Area Employee 1E)# <br /> Final Inspection By D2% 0 SPECIAL PERMIT-Approved by <br /> Character of Soll to Depth Of 3 Ft: PWSump Soil Character <br /> COMMENTS <br /> PE SC Received Amount Permitt <br /> Code INFO By J cash Date service Remitted Invoice 0 Permit ID# <br /> 42-01 <br /> 81251x8ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />