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I Page 3 of 8 <br /> F <br /> APPLICATION FOR PERMIT k� <br /> I SAN JOAMIN LOCAL HEAILTH OISTRiCT Tl�� <br /> F a 1601 E. PA7.EL:TON AVE.. STOCKTON,OA +L I <br /> Colmhom,(2091466.15781 <br /> pMM1T EXPIRES 1 YIEAFt I-ROM d_i4TE ISSUED <br /> p',I <br /> (coMplare in Ttlpli eEe1 <br /> L <br /> Apptwaaor;it,Ff4ribs'Irlada Io the San Jdin Locni kfrahh L•hvNk TUI A Imimh no contra andtar-iutah ow xeod I.rrt-, }T�a bpP4kAIl-in a <br /> ' lnxtlt ur cnr^Cq'an[e+:5".i Sen l�aQ-sn{aun3'Oidi•Ienaa Na.54n'ar aEpygJ CP l�.EI.7 •ruff V.alrP P unzl 3lla FluiM:antl!10[I�". ai ffio"a JWifluln ' <br /> Lursl HaNm Dittrtt ,t � •,� /'y// I <br /> Jah Adl.eu .-5,t-a.+ C'IY tot Sirq PM <br /> i <br /> -• ¢wNr�3lame AdAreet ,� e �Rai" --_ <br /> Contrxttw - Rf. :, j[,�,Adarrss _67_It�cmzc W-M- <br /> TYPEO]VVIIVPUMP: NEW WELL PI Y41511-1-ITUE-AC£M1ENT0 "OE5MucriL'N :1 <br /> mrYP IHSTALLAfla-V r] SYSuMT AEPAIIII YJTFYER,❑ <br /> FF O tANU 10 WAAEST; ',UpiriC TANx SEtVER LMS -CrSPOSAL FiLD,. PROP I LME <br /> VOUNDATMN AGFl;C JL1WtE WELL OTHER WUL. . __ p15!SUMPS <br /> MT€Ts7€P USE T-M Of WGU FROOM.AREA (,6y,S,trRIJ0i0'-Y SP#CIFICAT!^N$ ........l. <br /> Lt lixjealt"Al 111OPsn enw-n i-i Manieca C).-a-cA Wail Lrcnrsiinn QiT pt W.41 Cas,q <br /> y I}TJSomtsiKiPovltq FI(1-15 -yl PpH 0 Tracy 'n h1w 01 rmir u Specfllcailans <br /> I-I fhlty} i.-I n:hnt I7 Imiu fheptls of Grout U-"t ,.T.. TYpe of Ornue <br /> 1 1 wngarwr ...._.Afprrrxs-13cp�[`h fJ�S fasiwn ace li"JnOmTea ItY- I <br /> Napoli Wwe Gvw• � TYps 4T PmK+ H.P. � Slate Vlarli ffwrr r,a/ <br /> FWal 17esintclion 1 I We"Qt"rn 15,14"Mdi�l Imp 54-I <br /> E mmts....... 'L—_T----- 1.714r Aia's.+il dF}aWw fa! _ <br /> TYP1'n6 Sf,Prgr 1Ril11K: NEW INSTALLATbnN 1 1 FIEPAMADDIMN I i GESTPUCf10U 1 t talo sepli swslnt»petrlied II p iest serer is <br /> Avp,"t M r ich-M i'mu - <br /> rrisrahSmarr <br /> FNumber cA Lamp units:® Nu-bm gal bed,'fhs <br /> GNrazbef of soil to a depw or 3 i1wr 1-^ ..- -.-�- Waaet iable depth - --- ` <br /> SEPTiC TAME ?7 TVWM r <br /> t'Q _ taCle'-iry, _ NO.-Laa'¢afaTCrit <br /> PKG.TRFAVUENT PL.T..;i ,r .' .. Welhdd LM�Wittin*6 5 <br /> �pivar>Kh tA,»nmp; 4'6n@ l 4 fpurnlit;a-r PnrPrrrlr L?°a <br /> Ll1t II1NG LI4E ❑ No_b LaNth ar i4wA 'Ulai ytrglh'ue- z._. <br /> FMIFIR BELS 1:1 a ai;Xe lo'trmreii` r'44fefl+_`. }' Frvadodan - -.___.Piapxiry Lim. <br /> SEEPAGE PITS i I E4PIT. LI Soo N+anrgi 'r y <br /> SUMPS I I Oiaeencn sr�A611 11 Vfe11 FQuII 71tiLY Pi Q04-7w <br /> MSPOSAI.PONDS M ',.I Q-04-7w lea <br /> 1 AerCbq cartAY that I ham prepimd Wit ypplka6o4,6.d rltpt dy wars wiz',bo Mnn 1- With 53x 1oaovt5 taunty wdnanoes.rime Iswc.aM <br /> 0,4et MW AOW"tOM W the 94fA AdM"Le[al'ileYth Dall1ct. <br /> F <br /> Herts owner or Lseesrd�upeni s*i"I"canifies I"loll ysp:"I-rnnily iNi In ltrapeaTotmerice of the w ib lot whieh Ihfs pmK-ir W ittwoa,I o wll nal , <br /> -V*v eery po o-hr VAK enp-rr n as tw 6+a oeiiiw%Vb*'to PMPIkftb"%{C+ 1�51ra.4vi;f'Af Ck offyA-deiYhKibew fdriwV v P&eankmcknp tlpnaiano <br /> cen'fias the funowipm ti n Ofv that hi rtraipe�mnianre a1 mit we k far wH h alisyar"k 4w md.I shat)errrplvy pjraen7 Iub;Kt to rr0lktivh'd CaMoftriA <br /> ttPn•ii'vl d1 Ca4tdrNa. - ': 1 - '- <br /> ,the mu I ser it req:irod roe o d-aerrg a im Iwo, <br /> Tired Sc. idle!_ F2 RS -- Off1w /J <br /> 9E!PAA7MENT UM ONLY !/ I <br /> Vrt or Gnrlt Inspection by -- --- -- Ilam F:nsl Inspec•_nrt by !I pansf+ <br /> i <br /> Ai1dCdFe! <br /> Stk �Con�r-wrvii: <br /> YtBJ ' �❑Msm"ca M-71w 0-Tr*" 375,&7i Appkwfl-RaltraA cPim 10:Emiom-git . .. <br /> Wirth'PrrmhJServic"Iddi @,Hamilton AVE.,P.O.Nail 780!3,Sik.,CA 95'7Uf i <br /> ifff AYIW4INT InU '1 wxtOUVT afMITTLD �iN iaLCfririd 6w DATE +4RiYf'WJ. <br /> Fy. <br /> tytax <br /> � I <br /> F410TEXTPAGE <br /> - <br /> F , <br /> kl <br /> /21/2011 <br />