Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQOI9 COUNTY ENVINONMf.. ALHEALTNDEPARTMENT MEWERERAVE-31"FL-STOCETONCA95202 -OF <br /> NON-REFUNDABLE PERMIT CALL(209195_)- 697 FOR INSPE[I NnN EXPIRES I YEAR <br /> FROMDA <br /> JOB ADDRESS <br /> QT IF <br /> 7�L/17lL <br /> ' <br /> CR035 SlRi.ET , JP� P APN 1ai0"L'f PARCCL$[zE�/J a. <br /> OWNER NAME Ifl[J <br /> PHONE "-JIM <br /> IR <br /> OWYERADDRESS <br /> Q CrTY/$TARIZIP <br /> CDNTRAGEER 3',/� <br /> PNOVf <br /> CONTRACTORADOREEB CT'/STATOZIP <br /> LICENSE ❑C42 ❑C-36 OMER NUMBER ETPIRAT ON DATE <br /> WATERTABLEDEPTH: R CEOGMPxIGLINEORNATMIN: CanTdiRMtl % V <br /> ❑ PERCTE$T B BUILDINGPERMIT# LAND USE APPLICATION# <br /> TYPEOFWORX: NEWINBTALLATION ❑ REPAIR/ADDITION ❑ ENGINEER DESIGNED/ALMS ATIVE <br /> Y R6MACEMT'`IT � ❑ DLR0.UL'TION <br /> INSTALLATION WILL SERVE: RESIDENCE �COMMERCIAL ❑ OTHER <br /> N081RER OF <br /> LIVLiG DNr13: J NUMBER OF BEDROOMS: q/h�8 .Rp��NUMBBR OF EMPLOt8f5: r8 <br /> ❑ $EPTICTANK TYMIMFO !� `AO 4 2~981 #OF COMPARTMENTS A 1�I <br /> CAPACTfY <br /> ❑ CREASE TRAP TVP4YMF0 CAPACOV gal #OFCOMPARTMENES <br /> ❑ PKC TX PLANT DDEARCETONEARE3T. WELL R FOUNDATION R PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPEOFPUMP O SAND OIL SEPARATOR IENCLDSED SYETE" <br /> ❑ LEACH LINES ❑ LEACHING CHAMBERS #OFLINES LENGM(IFLINES ft <br /> DISTANCETONEARESI' WELL Itis FOUNDATION R PROPERTY LINE R <br /> FILTER BED wm" .2r R LEN(Tfll �c] fl Deeix_&~/f/ fl <br /> DIFLANCTTONEAREST WELL iaa ft FOUNDATON gO R PROPERTY LINE <br /> ❑ MOUNDED W.M. R LESTIM It DEPTH <br /> DISTANCE TO NEAREST WELL ft i'OUNDAMN ft PROP£RTYLINE R <br /> ❑ SUMPS WHO. ft LENGTH ft DEPTH fl <br /> DINTANCETONEAREST WELL ft FOUNDATION R PROPERTY LINE R <br /> ❑ DISPOSAL PONDS WIDTx R LENGTH R D[P2M 0 <br /> DISTANCE TO NEMEST WELL R POUNDATION R PMPERTY LINE R <br /> ❑ SEEPAGE PITS NLMBF.n WIDTH R DEPTH fl <br /> DISTANCETONGRtlT WELL ft FOU.NDADON' ft PROPF.RTYLINE ft <br /> 1 HEREBY CERTIFY THAT I HAVE PREPARED MISAPPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE W ETM SAN JOAQUIN COUNTY <br /> ORDINANCES,STATE LAWS AND RULES All REGULATIONS OF SAN JOAQUIN COUNTY. <br /> NINIMIIN Sa IIIIFR:\D NCII NUTIC11 Rf.VI IR4,D PUN i\HYELl10Y5-PLLANf.('11.1.1?1�4I4)J.]N9i <br /> SIGNED TITLEApp' <br /> DATE <br /> - 7 1�15Y PBFPa <br /> a <br /> G <br /> IF <br /> m <br /> Esb p D <br /> ,jt' r ' �PCEVEp <br /> 5- <br /> ,4 a PE 1�p5 <br /> E? A' a 10- 6 <br /> �W Spil�'�yHll,LeoM KI <br /> Z a <br /> Applitaf an Aaxepted B' r h - Data Ara ��/Y�— Employee 1D#_/%.AU&2 <br /> Final ImpNtlon O) Date (3SPECIAL PERMIT-Apiumed by P�-S <br /> CBaaeler of Soil to Dep of 3 FN Pit/Sump Soil Ch2M%r: <br /> COMMENTS �j_i- .-ti1j J�UtdA F$z - G <br /> Y TLAI f-0LJ i Zk SYcn-fv/ 't' d N4.1 <br /> PE SC ReteWed Cher Amount Date <br /> }Code IN�io R .,h Repdtted Serl Dat# InYela# Permit IM <br /> ITT.J1 9 J6 Ja/ 7 0 <br /> 1161 P A <br /> 4-024IDI 615D � <br /> I2I22ING1 ONSITE WASTEWATER PERMIT <br />