Laserfiche WebLink
4'``//tONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> i n�S�(AN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT ISIS East Harefton Avenue-STOCKTON CA 962054232-(209)468-WO <br /> NON-REFUNDABLE PERMIT. CAL 9 933-7697 FOR INSPECTION EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOS ADDRESS ' CRY/ZIP u <br /> CROSSSTREET APN©I `2]—7-2Q�J 7 /}PARCELSIrZEc.J e4— <br /> OWNER NAME PHONE-73/9� �I(�a���^C�7'J/� CG-. <br /> OWNER ADOR63435 1 C1 P <br /> CONTRACTORj �)' J��` HONE <br /> 1 CON)RACTORADDRESS 0 lV- kz�,.it l CRY/STATEZP <br /> LICENSE X42 4C-36 OTHER A NUMBE1R\ _EKptIm--nATe <br /> WATER TABLE DEPTH! ft GEOGRAPHICAL INFORMATION: Coordinates X. Y <br /> PERC TEST k BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: _ NEW INSTAUATKTI REPAnuADOnnom ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT - DE6TNUCTION <br /> INSTALLAT93N WILL SERVE: RESIDENCE COMMERCUuL 7. OTHERS <br /> N ER O LN U ITS' NUMBER OF SEOROOMe' NUMBER OF EMPL !;::m= <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENT----2-- <br /> CI <br /> OMPARTMENTS❑ GREASETRAP TYPwMFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST! WELL fl FOUNDATION R PROPERTY LWE ft <br /> ❑ LIFT STATION SIM TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS #of LINES LENGTH OF La S fl <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE It <br /> ❑ FILTER BED WIDTH ft LENGTH - R DEPTH It <br /> DISTANCE TO NEAREST HELL It FOUNDATION ft PROPERTY UNE R <br /> ❑ MOUNDED WImH fl LENGTH it DEPTH it <br /> DISTAN\A)O WIDTHCELE TO LL ft FOUNDATION R PROPERTY LME R <br /> SUMPS WmTxfl T ft DEPTH $ <br /> DISTANCE TO NEAREST WELL R FOUR ATION It PROPERTY LINE R <br /> ❑ DISPOSAL PONDS MoTH ft LENGTH fl DEvrH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGEPITS NUMBER— WIDTH ft DEPTH ft <br /> M DISTANCE TO NEAREST WELL R FOUNDATION fl PROPERTY LINE ft <br /> a����ea.,...._... <br /> I HERESY CERTIFY THAT I HAVE PREPARED TMS APPLICATION AND THE WORK WILL BE DONE INWITH SAN JOAQUIN COUNTY ORDINANCES,LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN AOUIN COUNTY.HTV. <br /> yypl�p'.I1 NOTICE REQUIRED FOR I S- LL(20%)9537697 <br /> JGNE O lE /1 TITL��( DATEl1�2��1Z <br /> i - a <br /> rgt '^r� ,e aa��i <br /> �Gtcd �X Z�X i� '$u+•�tp�� Y <br /> 13t1U 18Cr•-A r a <br /> n <br /> ,F <br /> P` <br /> LAII+t"� /FT <br /> DEPA,7 USE NLY <br /> Application %cce - Date ( Z Area Em <br /> Fina111ISpBD ion B p�by <br /> Y Date � /�/ �SPECIAL PERMIT-Approved DY <br /> Chamoter of Soil m pfh of 3 Ft: PIVSump Soll Character: <br /> COMMENTS T6 <br /> I PE 1 SC Receiv Amount Parmm <br /> Code INFO 9 Cash Ra pitted Date ReVest# invoice# <br /> Semi" P - <br /> I LS 1 °!J <br /> !c <br /> � poi JO ENTAL T <br /> aE-DI HEALTH OLP <br /> �nY,nT ONSITE VAASTEMV.TER TRTNNT SYSTEM PERMR <br />