Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY EWIRONMEPTAL HEALTH DEPARTMENT 304EWEBERAVE-3�FL-SPOCKTONCA95202 - (2091468-3420 <br /> NON-REFUNDABLE PERMIT CALL(20,9 953-7697 FOR IN$PELTI N$ EXPIRES 1 YEAR FROM DATE ISSUED <br /> 4',.iG ; �! F r:✓ : - crlYfLlr SI7 y�'i�G li"�I'_J�; " <br /> JOB Anonm /-` <br /> CR.STREET I✓ ^�fa1,.Z C`-O AP �I T' PARCELSLEE I-�'.-.� c C v <br /> JUN `1 2004 PHONE <br /> OWNER NAME <br /> OWNER ADDRESS 5.7 I LITY/STATFMP <br /> / <br /> ' CONTIGCIOR <br /> COM'RACYUR ADDRESS -'_ T1160' `!A _ \ CRY/SfATFILIP Uhf, <br /> Gf, <br /> LIEt K 11 C42 ❑C-36 IWmER NUMBER E%PIRATIONDATE <br /> WATERTABLE DEPTH: A GEOGRAPHICALINFORMATPON: C09NH ate% JC V <br /> ` ❑.!PERC TEST' R 11 1 BUILDING PERMIT# r' LAND USE APPLICATION v�-< <br /> TYmuvwu.K: ❑ NEW INSFALLATION ❑ REPAIWADOTNON ❑ ENGINEERDFSICNED/ALTERNATIVE <br /> ❑ REPIACymENT ❑ DEmumon "5 <br /> INSTALLATION WILL SERVE:-.-- O RPmnPACe_ ❑ ComMEROAL -.- ------❑-DI'l1ER <br /> NUMBER OELMNG DnIIS: NUMBER OF BEDROOMS: NUMBEROPEMPLOYEES: •, <br /> ❑ SEPTICTANK TYPF/MFG CAPACITY gdl NOF COMPARTMENT$ I F] <br /> ❑ GREASE TRAP TTPFJMFG CLAPACDY. gal - pOFCOMPARTMENTS S <br /> ❑ PKG TX PLANT DISTANCETO NEAREST: WELL R FOUNDATION fl PROPERTY LINE R <br /> ❑ LIFTSTATION SLiz TYPE OF PUMP ❑ SANDOILSEPARATOR(ENCIAXEDSYSTEM) _ <br /> y <br /> L ❑ LEACH LINES ❑ LEACHING CHAMBERS ROFLME LENOLH OFLMES <br /> DISTANCETONFAREST. WE R FOUNDATION R PROPERTY LINE f[ <br /> ❑ FILTER BED WmrH R LLNuTH ft DEPTH R <br /> 1 DISTANCE TO NEAREST WE _11 R FOUNDATMN R MOPERNUNE fl <br /> I`` LIMOUNDED wlomm fl LERTOt R DEPTH -- R <br /> DmTANCETONFAREtF WFJ.L ft FOUNDATION 0 PROPERTY LINE ft <br /> Cl SUMP$ WHIT# ft ulayH R. DEPTH ft <br /> DUTANCETONEAREST WEIR, ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS W. ft 12NGTx R DEPTH ft <br /> 6. E DISTANCETONGRFST W0-L R FOUNDATION R PROPERTY LME fl <br /> ❑ SEEPAGE PITS NUMBER Wltrtx R DEPTH R ' <br /> DISTANCTTONEARRST WELL R FOUNDATION ft PROPERTYLINE R <br /> 1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINAryCM STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIM 2f'H jD/UIR ADVANCE NOTICE REQUI RED FOR INSPECfI NS-PLEASE CALL(209)953-7697 <br /> MI E fY 6 G�{1 -"� /I- TITLE ' \- <br /> 11�G <br /> L I I II 1 I_ 1 I I -I IJI <br /> Ila <br /> _ .3.3.54 _ <br /> _ I <br /> LT. . <br /> TIS 17 3251119 <br /> 1.72AC®� 10.9AC <br /> 'SI I '221 I - <br /> f i�em I <br /> 0 120 �yti <br /> IN <br /> C ryl <br /> JPI UAL <br /> DEPARTMENT US¢ONLY ( HEALTH DEPART}.IF-!1T'T-/ <br /> Application Accepted 3, ( ITi DRIB -5�/f2L�4'.�/ Mea 21 a EmploymIm L-01 99 <br /> Fivallmpeclfon By Date ' ❑ SPECIAL PERMIT-APpmvW by <br /> r Characlerof Soil Io Depth of3Ft Ph Sump Soil Chonctee <br /> COMMENTS <br /> LPE SC Received Chet .!. Amouot DYe PermiU levoiee0 Permit lD# <br /> Code Inw e ! Cub NrlmftM SerNceR nnl# <br /> vuz. Ir `'6 Ga.DO 5.' fI : SRI <br /> t - <br /> `e 4202-00I ONSIT£WASIEWATERPERMIT <br /> 12 003 <br />