Laserfiche WebLink
LIQUID WASTE PERMIT <br /> B� SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION <br /> 501 E.WEBER AVE 3-FLOOR,STOLKTON.CA 95203 GJAH 4M-3420 <br /> _ NON-REFUNDABLE PZR/MIIT EXPIRES/I�YEAR FROM DATE ISSUED <br /> JOB ADDRESS �^!/P=/ /�J �I L-/ j ^/ O/J 1 y( APN Lll py l L/l/yul����/' PARCEL SIZE:��� <br /> him CRY17.Ie F/.t..>"\ E..i�Ti1'\/ /S /)P �L/�."O2KC4 <br /> � BUILDING PeRMIT[ <br /> OWNERNAME �� -9N /J'J3 /TAT �� ADDRESS <br /> bNR CITVMP 1 PHONE NUMBER <br /> [ONTRACI'OR4�///CJGI <br /> /J'T C 9 L j�ADDRESS / SZO P"I /I <br /> CITVIVP �IP�<!JF/t S/,J �aT3J-.� PHONE NUMBER ,'5' /rC_S 3 F <br /> GEOGRAPHICAL INFORMATION:COORDINATES:% - Y TOwNSxIP_RANOE_sELTroN <br /> TYPE OF SEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: <br /> A NEW INSTALLATION irRESIDENCE NUMBER OF BEDROOMS: <br /> 1..R ❑ REPAIRIADDITION ❑ COMMERCIAL NUMBER OF EMPLOYEES: <br /> ❑ DESTRUCTION ❑ OTHER <br /> ❑ ENGINEEREDIALTERNATIVE 1 <br /> CHARACTER OF SOIL W DEPTH OF 3': AJ/J PITISUMP SOIL CHARACTER: WATE R TABLE DEPTH: E <br /> ❑ PERCTEW(S) HOW MANY�/ � APPLICATION <br /> sePlIciwrvK TYPE/MFOL p <br /> 4 CAPACITY � .2[}6 M OF COMPARTMENTS_ <br /> ❑ CREASETR.RP TYPE/MFG CAPACITY NOFCOMPARTMENTS Q <br /> ❑ PKCT%PLANT DISTANCE TO NEAREST: WELL_ FOUNDATION <br /> lZ-2— YROPEATVLINEIT D <br /> \1J <br /> ❑ LIFTSTATION SIZE TYPEoPPDNP SAND OIL SEPARATOR(ENCLOSED SYSTEM) T <br /> T� ® LEACH LINE NOFLINES: S LENGTHOFLINES: .�3� DIRr.xaronuRUT: w[u cDJ FOUNDATION T <br /> INFLITRATOR CHAMBERS: U Z <br /> WELL- PROPERTY LINE C <br /> ❑ FILTER BED WIDTH LENGTH DEPTH_ DIFGrvc[mxWFFT: WELL_ FWNDATION PROPERTY LINE <br /> GTH TH .. <br /> ❑ MOUNDED WIDTH LENDEP . .'..[AR.: WELL FOUI PROPERTY LINE_ ` <br /> ❑ SUMPS WIDTH_ LENGTH DEPTH_ DMAK[NxuRROT WELL_ FOUNDATION_ PROPERTY LINE (C <br /> ❑ DISPOSAL PONDS WIDTH— UINGTH DEPTH_ DMT.WC[TOxW4l: WELL_ FOUNDATION— PROPERTY LINE 1` <br /> ❑ SEEPACEPITS N OMM¢i¢0. MITN PUTRNCETON[AMST: WELL FOUNDATION_ PROPERTY LINE_ <br /> ti <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES,STATE LAWS <br /> AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> /y11 NIM UM 74 HOUR ADVANCE NOTICE REQUI RED FOR I NSPECTIONS-PLEASE CALL j209)168-3123 pppppp <br /> SIGNED: /(// �� TITLE: /D. -JP�Yi DATE: Q7 <br /> L <br /> J <br /> I <br /> V <br /> 6 <br /> li1 <br /> L I I I <br /> 1.. <br /> GP <br /> I <br /> 1 — , <br /> L �w GU <br /> Ek <br /> N ALTwe <br /> N N <br /> DEPARTMENTU EO Y I <br /> ` APPLICATION A DnTE�EA LEMPLOVEE IDE LOCATION I <br /> INSPECTED Y: DATE:� S�� PE0.MITFlYA�YF3 DATE/�9 '�Q <br /> SOIL <br /> ✓`X �'� -`� r Y <br /> CQMMEMS - <br /> bo 1 <br /> PE CODE RCINFO AMOUNT MECXIMRECEIVED GATE PERMIT5ERVMf PEWP3T1 INVOKE[ (EPIICIb <br /> REMITTED BY <br /> 12i li 64-/ ni- -e ^a/r/ <br />