Laserfiche WebLink
APPLICATION FOR LIQUID WASTE PERMIT <br /> �JOAQUIN COUNTY PUBLIC HEALTH SERVICES �...Y <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 388, 446 N.SAN JOAQUIN ST, STOCKTON, CA 962010388 <br /> (2091 468-3420 <br /> NON-REFUNUABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED <br /> ICBmpha u TryDTax) <br /> APPLICATION IS HEREBY MADE TO THE SAN JOAOUIH COUNTY FOR A PERMIT TO CON8TM ANGIOS INSTALL THE NOIR pF.RHIND. THIS A ATW N IS MADE IN COMMANCE WRN SAN <br /> MAWIN COUNTY DWEt.DflMENT RALE.CHAPTER S- 110.3 AND THE STANDARDSS OF SAN JOAOUM COUNTY WBUC HEµTH SERVICE$ENVIRONMENTµHEALTH ESMROON. <br /> Joe ADORESBRn R1J777E .Cti��c, �A, ,� T <br /> //-_ yi �( Cm•- wr azE�Calt <br /> OWHEXB NM1F t/ .II Ui / 'rLL{ T41 AGGRESS_) (n) <br /> /31�/� J s.'lt P FT PHONE-71 �-lc•z i <br /> cpxrwuTpY_,/l+ T -Ul✓:i�-K(,Y ASE.Ecc <br /> rrr{{\ LIOs�L5�7 <br /> m1B LOMRIGTOR App11E8g ILLI gpNE <br /> { TYPE aF imIO wORc NEW w-rAluTMx❑ ADmnpx�, DnYRunlDx❑ <br /> INS SEPTIC SYSTEM PERMITTED IF RIBUC BEVJER IS AVRIABLE WITHW]00 FEET OF BV .a.I P91C TESTIN I I HOW MR1Y <br /> ARAM.P _ <br /> INSTAl3AilON WILL i61Vf: MSIDFMCE� COMMEIY:Iµ❑ OTHER❑ <br /> A..OF...UST.; ROME. OF SIMPLOT.: / <br /> CHARACTER OF SOIL TO A MFTH OF]FEET-/ WAWMP SOIL CHARACTER: WATER TABLE pFRH I:A�G t <br /> SERIC <br /> 1ANN/tl1FAi5 TR.V ❑TYPFMfO CApACffY NO.COMPARTMEMB <br /> MO TREATMENT RANT O De".E TO FEUDIST' WEIy FOUNDATION PR]PFAry LINE <br /> UFT STATION O ]QE TYPE OF MMP SAN.On...R IENCLOSEp WY EMI / <br /> LEACNNO UNE �ryO.E LFNpTM OF UNEB pSTµ1CF TO NEARBY:WELL �O FpUNOATpN�PPgPEnry UNE 'S <br /> .11.\FO /❑W1DTH LENGTH DENTN DISTANCE TO NEAREST:Wpl FOUNDATION RgRRTY UNE L <br /> MOUNDED ❑WIpTX UFN`TH pEpTN DISTANCE TO MEANEST:WELL FOUND.. RgPFRTY'HE <br /> {EAAOf RTS OEPTM - 56E HUMBE DISTANCE TO NEARER:WFIL %/✓J FOVMOATM]NPROPERTY UR S <br /> .•.� iIMFS 11..T.— Y.r_>t� <br /> IFNOTN DEPTH pHYAFCE TO NEAREST:WEly FDUNDAl10N FTOPDDY UNE ' <br /> miPoSµMNM ❑WWTM IFNOTII M,N DISTANCE TO NEAREST;WELL FOUNDATION�PRORRry UNE <br /> A-PREPARED THIS MITIGATION AND THAT THE NVR.WILL BE DONE IN ACCOWANLE WITH RAN JOAOVIN COUNTY O11pINANCEB AND STATE UWB,.WO Mae <br /> Se ANO RGVUTION9 OFTHESANJOAOWNCOUNTY.MN ONMFH..ULEN5DAGEM'SMONATUMCF FIEBTNEPoLlA1 .:'ICFROMTHATINTRPEFFORMANCEOPTMENOIR WHKH <br /> THIS PERMR IS ISSUED.I MIALL NOT EMRDY ANY PERSON IN SUCH A MANNER AS TO BECOME SUBJECT TO V NKIAAN'S COMMNSATpN•AWB OF CµIFONIM,' COMMCTOTB Neew OR <br /> WU OMMCTING SIGMATUR CERTIFIES THE FOLLOWING:'1 LERTNR THAT IN THE FERFORMANCE OF THE w RK FOR WRC.TMS PEWIT IS ISSIIED,I SHALL EMRDY FFABONR SUBJECT TO <br /> IWMMAN'S COMRNBATpN UWB OF CALIFOIWIA' THE ATIIC ANT MUST Cµ1 M NOW IN ADVANCE FOR ALL RE..IXSPECTpNS. LOMRFTF OR WIN�� L.GBELow. <br /> w <br /> SIGNA - TTHE () <br /> : �/ DATE:`� V . �// <br /> r <br /> PLOT RAN IDMw TO X.MALE_-,. <br /> 1.NAMES OF STMETS OR ROADS NEAREST TO 00 BOUNDIND THE pREK ry. 4. LOCATIONH OF HOUSE SEWAGE DISFOBµSYSTEM ON IMPoREO 2. OUTUNE OF THE PROPERTY,W DIMENSIONS AND NORTH DIRECTION. f1PANS10N OF REWAGE m8108µSYsTEMB. <br /> ]. DIMENSIONED OURMEB AND LOCATION OF ALL E-ISTIRG.0 RIOMI ED RROCTUMS. S.LOCATION OF WELL-WTMW MmUc OF ONE HUNDRED FIFTY FT,OH <br /> / INCLUOINO COV b AREAS RUCH AS PATMR,DRVEWAVB.AND WAUIB. THE PRJPERTY OR AOJpRRNR PRO, <br /> IE <br /> PAYMENT <br /> RECEIVED <br /> DEC 8 1994 <br /> f SAN-JOAQUIN COUNT <br /> L PUBLIC HEALTH SERVICES <br /> ENVfR-0MENTA_Y.ALI ii w/.dCN o / <br /> I �t <br /> 5 I \ <br /> - ✓ � <br /> U _. <br /> IE <br /> ,1 y <br /> IL <br /> ` FOR DEPARTMENT UIE ONLY / 'I <br /> (` APRICATION ACCEPTED BY DATE:�-� ✓ �_ / J ARFA�( G— <br /> //////yyyy���� / [ /1 <br /> flSVMFINRPECiIO.BM ^.GATE lL fr9[FIHµ1N8PELTMNBY 1 /J/ /L02f X DATE L1 F L� <br /> rT <br /> POOppHµCOMMENTS: <br /> SNF <br /> ACCOUNTING ONLY: AIDE PACS <br /> PE CODE FFE INFO WOUNT BEMIRED C FCx PABX RECpVFD SY GATE FRIFERMITHUMIUM INVOICE• <br /> Q` <br />