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LIQUID WASTE PERMIT <br /> SAN JOAOUIN COUNTY"LICHEALTH SERVICESENVMONMENTAL HEALTH OIVIS <br /> JIM a WEOEU AW 3-FL001t.STOCKTO\,CA%D 1MI a 3420 <br /> _ � NON NDARLT.PERMIT EXPIRES I WAR FROM DATE CABLED <br /> JOBADDRcu�9l� LU �/JL'�///�!'jjJJ ��JJ _ APn D,�.s-/yd_�z PAW <br /> RTWJJP _�`,.(f////JJ��R� C'A BCILDINC PP.RMIT/ <br /> OWNLRNAME� /Alr l/ C /���� ADDRESS isryg Al A!�afZ <br /> 1&- <br /> ...2v4 <br /> CONTRALTOX _ _ ADDRESS <br /> CITYOD PHONE nLMRER <br /> GROfiMPN1UL INFORMATION: CWROINAIYA:X Y MIANS IIP RANGE SECTXJN <br /> TYPLOPSEPTICWORK: INSTALLATION WILL SERVE: NUMBEROF LIVING UNITS:_ <br /> ❑ NEW INSTALLATION O RESIDENCE NUMBER OF BEDROOMS: <br /> ❑ KEPAIK'ADUITION ❑ COMMERCILL <br /> pr DESTRURI(NA O OTHER <br /> NUMBEROF EMPLOYEES: <br /> O ENGINEEREDOLLTF.RNATIVF <br /> CHARACTEROPSOTLTODKPTHO Y: PTTISUMP SOIL.CHARACTER: WATER TABLE DEPTH: <br /> ❑ PKRC TESFISI IIOWMANY APPLICATIONM <br /> ❑ W..PTK:TANK TYPETHFO CAPACITY XOFCOMPARTMENTS <br /> ❑ GRKwSETRAP TYPFJMFG CAPACITY NOFCOMPARTMENTS <br /> ❑ PKC PWNT DISTANCETONEARENI: WELL__ MLMDATION PRWERTY LI6E_ <br /> ❑ L6TSTATOpI SIZE 1,01PLM1SAND OIL SEPASATOR(ENCLOSED SYSTEM, N <br /> O LEACH LINE X OF LINES:_LENGTH OF❑NEB:_ PmANaroNLuaRr: wnJ FTwNDATwN PROPERTY UNE v <br /> INFIJTRATORCHAMBERS: �Y <br /> ❑ FILTERRFD WIDTH_ LMWTH DEPTH__ n AHrS TONE.IXLR: WELL_ FOUNDATION_ PRMERi LIKE_ l <br /> ❑ wl,"ED WIDTH LENGTH DEpTN__ WELL PODNDATXIN PRUPEKTYLIME +`q <br /> ❑ sUMP$ WIDTH I.,.— DEP)FI gerAlrtlrvnwrST: WF.II. FOUMIATIDPI— IWOPGryl. ry <br /> ❑ DISPOSwL PONDS W1.11% LENC"i DEPTH_ OBTAnCa TDnwaAi: WELL_ WDNDATIDN pa .TY LINE ��'�\\\♦ <br /> ❑ SEEPAGLPITS tl UTAMEM DEPM_ oeT�n[aio Xcuen. WELLPOUNUATRIN PROPERTY DNE QN <br /> HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE.EN ACCORDANCE WITH SAN JOAQUIN COUNTY OMDRiANCE451'ATR 4W5 <br /> AND RULES A.ND REGULATIONS OT SAN JOAQUIN COUNT'. <br /> MINIMUM N HOUR ADVANCE NOTICE REQUIRED FOR INSPEC nONS-PLEASE CALL(M)46A.SCES <br /> SIGNED 7�. �Lp i _TITLE: DATE <br /> T <br /> t I <br /> I }` - <br /> I ` I L <br /> r-+ <br /> 71 r <br /> .. .r -- <br /> t� 1 ' t 4- <br /> Et4T <br /> t �E4$1 €L <br /> T 4,c 9HSERNUES , <br /> E4Th1ASD1N <br /> DEPARTMENT QAROgIyf.7Y ^J JLry <br /> OAPRXATIOARD <br /> VPEtIEDBY4aO4a L PRR�DT-+FWMEAAL1B YES�DATt.CIiLOti[E! <br /> ffl® mud <br /> - ' lp ��INS/PMVTOINXS. <br /> —L <br /> I-- <br /> R--,'1IkrnU IH'[rsN —"Y.- <br /> DArP nnrt RI[L aIWI,T. I—c- sPTI[Or <br /> PV <br /> z2 ors 8 - � s 3137 <br />