Laserfiche WebLink
pq - 02 000SS (m5) LIQUID WASTE PEW IIT <br /> �QLIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH OIVISIC`J <br /> L mE WEBER AVE lL"FLOOR STOCKTON.CA 95202 OQH.3.20 <br /> �) NON-REFUNDABLE PERMIT EXPIRES1YEAgq0. TDAIR^IJSSU-EyD, <br /> JOB ADDRESS I,�'33d LIIiAAT�V n AIR `Vy CI (�/�- 'l PAREEL BITE: ("Y�K�'% <br /> Cmall, AOC%. 1 801 EIY* <br /> LE <br /> BUILDING PERMIT <br /> ` ,y1 _ <br /> OWNERNAME Ly1 SFF M U/L�I.O'L LLL '�J/ /I ADDRESS 8} 00y (' Q q N T N -LD,' <br /> CITYMP F$�X t(.Ix (' koye r4 ?NJ Jl PHONE NUMBER <br /> JOBS CONTRACTOR A)I[.(, n, gn/DHE12601.I ADORE65 <br /> CITY/LP LOOT G9 IF51 A2. PHONE NUMBER <br /> GEOGRAPHICAL INFORMATION: COORDINATES'.X Y TOWNSHIP RANGE_SECFION <br /> TYTE OF SEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS:_ <br /> ❑ NEW INSTALLATION ❑ RESIDENCE NUMBEROFBEDROOMS: <br /> ❑ REPAIR'ADDITION ❑ COMMERCIAL <br /> ` ❑ DESTRUCTK)N ❑ OTHER <br /> NUMBER OF EMPLOYEES: <br /> ❑ ENGINEEREIPALTERNATINE - <br /> CHARACTER OF SOIL TO DEPTH OF I-: PIT/SUMP SOIL CHARACTER: WATER TABLE DEPTH: <br /> PERCTESISI HOW MANY 4 APPLICATION PA - I L OOD G <br /> ❑ SEPTICTANK TYPE,MFO CAPACITY D OF COMPARTMENTS_ <br /> ❑ GRGSETRAP TYPE"MFG CAPACITY B OF COMPARTMENTS_ <br /> ❑ rKCTX%ANT DISEANCETONEAREST: wELL FOUNDATION_- MHUNRTY LINE_ <br /> 6m <br /> ❑ Lin STATION SIZE TYPE DF NMe SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINE ROFLINFS: LENGTHOF LINES:_~ pgTNNOLTDNIa R WELL_ FOUNDATION_ PROPERTY UNE_ <br /> INFLITRATOR CHAMBERS: <br /> BNIP <br /> ❑ FILTER BED wRFTH IENOTR_ DEVIN_ MBTAIKRTOHSARRTT WELL FOUNDATION_ PROPERTY LINE <br /> ❑ MOUNDED wIDTH_ LENGTH_ DEPTH YRIANCEMNYRTAT: WELL FOUNDATION_ PROPERTY LINE <br /> ❑ SUMP$ R'IOTX- I DEPTH_ OSHA I,LAUJFY. WELL- FOUNDATION- PROPERTY LINE_ <br /> IIIR <br /> ❑ DISPOSAL PONDS WIDTH_ LENGTH_ DEPTH_ OWIANRTONIIAAI WELL FOUNDATION_ PROPEJOYLINE <br /> ❑ SEEPAGE PITS R� DIAMETER_ OEfT1_ OLPTANORTONSARLR. WELL_ FIIUNDATION PROPERTY LINE_ ' <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN CAUNTY ORDINANCES STATE LAWS l ♦I <br /> AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. \h <br /> [MUM26 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(20%)461-7427 <br /> SIGNED: /nem _—lkl- �ITLE: rjTcLD TL(f)4 DATE: 5!2 OY Mi <br /> v I m I. <br /> yU, N <br /> �IF'R1� 1— <br /> y> �.yy,_ <br /> n.F.._. <br /> !2 SANJcLA.CkJfNC0 N7Y <br /> I�I I 4 4I MACKVILLEI� ROAD MR 1, <br /> 7. ti TE Y§ _T TB3 <br /> VR <br /> DEPARTMENT USE ONLY �2 (/ <br /> APPLICATION ACCEPTED BY'.' ..Y-To� ARL/IJ AREFMPLUYEER. IOj� /t/ t/+/ <br /> DISTRICTyLOCATIN� <br /> INWFD ECTBY: DATE: FIRNI INALO VESDATE INSPECTOR. / <br /> r <br /> COMMENTS: <br /> PE[Wf SC INFO M10OMAEX 0.ECEIVED pATE. PPAMIT.3ERNICE 0.EOUESTM HNVOKFI SERKIp <br /> M D <br /> '? 35-6 '/ob- L (BI'1 <br /> Sal <br /> R[N6EOw•IHI <br />