SU0007739 - Laserfiche WebLink

Home Browse Search

APPLICATION FOR LIQUID WASTE PERMIT SAN JOAQUIN COUNTY PUBLIC HEALTH SERV. S ENVIRONMENTAL HEALTH DIVISION 304 EAST WEBER AVENUE,STOCKTON,CA 95202 (209)468-3420 140PUREFUNDAPLI PfRTAll"PIRIS 1 YEAR FROM DATE ISSUED (OaleplSE.In TripRBBtRI APPLICATION IS HEREBY MADE TO THE SAN JOAOUN COUNTY FOR A PO-1 TO CONSTRUCT ANMMA NSTANL T11E WOW DESCRIBED.THIS APPLICATION IB MADE N COMPUANC'WRH BAN AAOUN COUNTY DEVM DPMENT TITtI,CHAREII 0-1110.3 AND THE STANDARDS OF SAN JOAOUM COUNTY PUBLIC HEALTH SERVICES,ENVIRGNMEMAL HEALTH O/VRION. JOS ADORESSAOR APNEG_n qjn Ei -J,�,4.r,/�PtZzI /] �J, �I CITY 5-fo4ACTO N LOT WE ZO R C-dZ•.S OMIJFR•f NAND_ i;2-N F,N D f`�\I A ADDEKBS ."1E/Ql IV` N1 EnZ t�Zt ��, !,B� 7R10NE p/E3 i--4-1-3 y 0 CONTMCTOR ML VE7 I�I�L17 -+ 5 0O9-T ADDPESB +1LA5 L+T LD -e'QA I✓N uCI PHO!4E-131-0,4-(? SUBCONTRACTOR AOOMASLII LICE PHONE TYPE M 4pHC.WORK: NEW INEIAD.ATION❑ READ PABUa MIN APpp "STRUCTION❑ NO SEPTIC SYSTEM PERMMED E PUBLIC SEINER IS AVAILABLE WfTHN 2—FETT OF BUILDING.) FERC TES'TMI AFPYa4R E_ l/ INBTALLATTON UWILL BFPNG RESIDENCE M COMMERCIAL❑ OTHER E A F F Z CE NUMBER OF LIMNS UMTS: NMSER OF BEDMOMS: NUEHSER OF ENPL.OYIN. CQ CHARACTER OF SOIL TOA DEPTH OF T FEET:, CL-A%( PITMOAP EOR CHARACTER: I-40PM��F0VVNNITER TNEF DEPTH / NI SEPTIC TAMBIGREASE TMP ❑TYPFMEO CAPACT' NIO.COMPARTMENTf PRO TREATMIDIT PLANT❑ DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY ONE UFT STATION❑ N2E TYPE M PUMP BARO 0E REPARATOR ENCLOSED SYSTEMA -1 �--• FEACMNG UNE ® NO.I UNOTH NGF UNE._I- SLOP IMBTAENCE TO NFARE Er:WELL (00/ FOUNDATION Ill PROPEiCfY UNE JQCTC�j HLTERSRD ❑WIDTH tENOTN_ OEPTN DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY INF MOUNDED ❑WIDTH LENGTH—DEPTH DISTANCE TO NEAREST:WELL MUNOATION PITO PLATY UNE .mAOE RTS 0DEPn1 23' WE 3" NUMBER_1pSTANCF TO NEAIEBT:WELL 100 !OUHOATION (OU PPIOPERTY FINE 2 1"'L BIMPs ❑WIDTH LPNOtH _OEPTH DISTANCE TO NFAREST:WELL _FOUNDATION PROPERTY UNE DISPOSAL PONOS ❑WIDTH tENOTN _OFPTH DISTANCE TO NEAREST:WELL__FOUNDATION PROPERTY LINE I HEREBY CERTIFY THAT 1—f PREPARED THIS APPLICATION AND THAT THE WONL WALL HE DONE IN ACCORDANCE WITH DAN MAGUIN COUNTY ORDINANCES AND STATE LAWS.AND ALINES AND IEGULATPONS OF THE SAN JOAOUN COUNTY.HOME 0%""OR UCt'NSED AOEM'S SIGNATURE CERTIFIES THE POLLOYANO:'I CEITIWYTHAT INTHE PERFORMANCE OF THE WOFRL FORRYASCH THUS PERMIT IS ISSUED,1 SHALL NOT EJAPLOY ANY PERSON N SUCH A MANNER AS TO BECOME SUBJECT TO WORUMAN.'B COMPENSATION LAVAS OF CAIJFORNA CONtMCTOPYS IRRING OR BVgCOHTHACTINO SIONAT U E CERTIFIES THE POLLOWTNO:'1 CERTIFY THAT N THE PERFORMANCE OF THE WORK POR WHICH TMS PFMIIT IS ISWED.1 MALL EAN'LOY PERRONR NRIB.IECT TO WOWMAN'S COMPENSATION LAWS OF CALIFORNIA.' THE APLVCMT MUSH CALL H NOW IN ADVANCE FOR AU..MGLMM INSPWTWNS. COM0.RE DRAWING BELOW. SIONED x �'-"- J"`fl 21 TRTE_ �/1 N U DATE: PLOT PUN DRAW TO SCALE;SCALE 'Is t.NAMES OF STREETS OR ROADS NEAREST TO OR BOUNDING THE PROPERTY. 4-LOCATION OF HOUSE SEWAGE DISPOSAL R ttM OR PROPOSED 1.DVIUNE OF TAB:PROPE/ITY,WITH DIMENSIONS AND NORTH DIRECTION. EXPANSION OF SEWAGE DIIPOSAL SYSTEMS. O.DIMENSIONED OUTLINE*AND LOCATION OF ALL EXISTING AND PROPOSED STRUCTVREc, e_LOCATION OF WELLS WITHIN TWHUG OF ONE HUMORED FIFTY FT,ON INCLUDING COVERED ATEA SUCH AS PATIOS,DRIVEWAYS.AND WALXS. THE PTOPUTTY OR ADJOINING P"OPERTY. .. ... .... a - .. _. alrLD N ... _ .. o .. W.� .% , Iv, 1Jri=v�w l b PAYM �V7 MAY 2 0 1988 9XW.CAOWN COUNTY pl18LIG!.HEALT1i 8EiViCEB NVIRONPoI M M HEALTH OhIslom POR DEPARTMENT USE ONLY APPLICATION ACCFPTED BY DATE: T SUMP NSA_ClOOONN.BY DATE f?-(d FNAL...T..BY OATS 2 I Ll ADOrt iMAENIS 'IRT AtCOUNTIM'J ONLY: MOI FAC• OA;/ 5 - PEco FQ INFO AMOUNT-ITm CI A.. RKBVED BY GATE SR/PD#1T PLUMBS{ INVOICE A 383 z; - Z-Pub.HeaIM Sow.-En-o.174(3/%)