Laserfiche WebLink
SANJOAQt�COULIQUIHENTY PUBLIC AENVIRONMENT/WASTE PEONMP "YLTHDJVISIO 4�--F�R` N <br /> C { 3-� 2-di S cdAy of!1 304 E.WEBER AVE.,3"FLOOR,STOCKTON.CA 95202 (i v-1420 R C�U E C't' p <br /> NON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED I—{D FIA LIAO- <br /> V IB ADDRESS , 7. / b 'f3 [ „J + I N S Y C+ {i N1.� <br /> CITY/LIP .S-r�t. dr-� PARCEL SIZEIAPN ' <br /> OWNERNAME �47 14,00- �ADDRESS <br /> CITYILIP C PHONE <br /> CONTRACTOR ADDRESS <br /> CITY2IP !JNA PHONE <br /> GEOGRAPHICALINFORMATION: COORDIANTES: X Y TOWNSHIP_RANGE_SECTION <br /> PERC TEST(S) ( ) HOW MANY APPLICATION B: <br /> TYPE OF SEPTIC WORK: T@ NEW INSTALLATION ❑ REPAIRIADDITION ❑ DESTRUCTION <br /> INSTALLATION WILL SERVE: 0 RESIDENCE ❑COMMERCIAL ❑OTHER <br /> NUMBER OF LIVING UNITS:-y— NUMBER OF BEDROOMS:_ NUMBER OF EMPLOYEES:_ <br /> CHARACTER OF SOIL TO A DEPTH OF 3 FEET: 4 L- PIT�//SxUMP SOIL CHARACTER: WATER TABLE DEPTH <br /> ©SEPTIC TANK/GREASE TRAP TYPE/MFG �CAPACITY `J'i NUMBER OF COMPARTMENTS <br /> 7� i <br /> ❑PKG TREATMENT PLANT DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE—::f-O— <br /> • <br /> INE J <br /> ❑LIFT STATION SIZE TYPE OF PUMP SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> A LEACHING LINE NUMBER&LENGTH OF LINES l­J­'6L)� INFILTRATOR CHAMBERS <br /> DISTANCE TO NEAREST: WELL FOUNDATIONS PROPERTY LINE <br /> ❑FILTER BED WIDTH LENGTH DEPTH <br /> 'n DISTANCE TO NEAREST: WELL FOUNDATION: PROPERTY LINE 1�n ^� <br /> 13 MOUNDED WIDTH LENGTH DEPTH �HY,veEN7 <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE _6 <br /> J7 SEEPAGE PITS WIDTH -3 LENGTH Z 4•. DEPTH `` ,+ <br /> DISTANCE TO NEAREST: WELL FOUNDATION J PROPERTY LINE C�� <br /> ❑SUMPS WIDTH LENGTH DEPTH J�NON <br /> • CES <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE - T iI'VIS10N <br /> ❑DISPOSAL PONDS WIDTH LENGTH DEPTH <br /> DISTANCE TO NEAREST: WELL FOUNDATION PROPERTY LINE <br /> I HEREBY CERTIFY THAT HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDIANCFS,STATE LA <br /> /, AND RULES AND REG SAN.IOA01Iw COUNTY. <br /> l: - � <br /> SIGNET u � - "' G/ +iN C.� DATE: L 2e'j—d <br /> 2 <br /> J P5 <br /> Uj <br /> z, Q 4 I�r jjIi \` y <br /> 2 <br /> 12 <br /> f <br /> A . <br /> i <br /> FORDEPART NT USE ONLY /�/ �� <br /> APPUCATION ACCEPTED BY: DATE: v rV <br /> TANK,PR.OR SUMP INSPE B DATE: <br /> FINAL NSPECDON BY: <br /> coMMENrs: -Z+g 11b ST9A+LD ORRECT k`' SyS7tIr S w A7 <br /> R.sk 13ruA/ 814 Mt} SE E P <br /> DECODE SC AMOUNT I CHECK#/ RECEIVED BY DATE PERMIT/SER UEST# SEPTK:ID# <br /> INFO R'MTTTED CASH <br /> 2S o I5, v - <br />