SU0010931 SSNL - Laserfiche WebLink

Home Browse Search

1qw, • APPLICATION FOR LIQUID WASTE PERMIT '�+ J SAN lOENVIR ENVCOUIRONMENTAL PUBLIC HEAL DTVI R b ENVIRONMENTAL HEALTH OMS N �'( {� P.O.BOX 388,446 N.SAN JOAQUIN ST.STOCK OEC fb9yQI-U3BS (n (201)4883420 f� • _` NOISLIEFUNDAR1 PERMIT EXPIRES Ir R Naperm i Y o cams) Is made is hereby mth to the Sen Joxyln Caney for • pe, a to cautru. nSlali tM Mork deacrlbd. This atpli ation 1a eWe in nevi o men with Sm Joaquin Caney Davalapexnt Tette, Uaptar 9-1110.3 Anda"' "IgwjOlYSLSY�lbtjc nith Services, Environmental Nes([h Dlvlaion. Job AddMe/or�A+PNrt 2gk1 N, Al•B.p� //��d �[ Dityi'EIOL6eL3y n Lot Siall. ' v Ownr'a Nre/FzrF/'l(/Lfa4ji jen Addresr.Pn4. AIRY 101 DY7 f/j& �. 9S7.J i Phone4[G��fobl�y Contractor y /3( �t FS�1/7�rYt Add.... d QD1�7�SY4-n (A LIci�Uy mss Phorn(yi^yn� Sub Contractor Ag /nQ,r�' Addressf -kW. L1d3Y?1 1 Pharyj Za6 TYPE OF SEPTIC WORN: NEW INRTALLATIOR I1 NFPAINADW1111% DESTRUCTION I1 PERC TESTW I I Ons WIT (NO SEPTIC SYSTEM PERMITTED IF PUBLIC SEWIL 15 AVAILABLE WITHIN 200 FEET OF BUILDING.) to"Use A'NRnWaI SE/r/ — Af ()I,_�Z Installation Will mecum: Rui Mice_ Comrrciel-9- Other Number of living mitsi. M adm r of hedroori_ Nuabef of .aploysesll_ N Uarwter of wit to •depth of 3 fsatx Pit/sup Soil Uaractar: water Table Depth d SEPTIC TANINRFARE TRAP 11 T t yep./Mfg Fv].rr•Lt cep.ci tv 7y�O(�No. Caprt..nL PER TREATMENT PWT II Distance to nearest: ll Faadat(on Property lin Z X LIFT STATICAL] Site_ Type of Pup__Send Oil Separator (enclosed systm) X LUCHIN LINE No. E Lamth of 11. Distance to Meamt: welt jj 1 FeWatlai;„�/I/ Property Lin qo/ Z NITER RH [] Width_Length_Depth_ Well_ Factlat(m_Property Lin ;� MOONED [I Wldth Larpth`Depth_ well Foudatian_Property Lin SEEPAGE PITS DK Depth—;L Site jj NL b r_ _ • • uatljgr2 FdtIonj&.L Property Lim 4i>/ r sumo i) Width_Length_Depth_ • • wall_ Faudatlm_Property Lin DMPOSAL PONDS Q Width_ Lrpth_Oa vh_ • • wall_ Fauraktl al_Property Lin I hereby certify that L hon prmard [Ma application and that the Mork Mill be dor in accordance with San JOAwln Canty OrdImAXAs and State Lwa, end Rules W RepJlatton of the Sm Joaquin coonty. Haw Owner or liconsed owt'a siofrture certifies the Mollwlng s •l certify that in the performance of the Mork for Which this Permit Is IsWd, I shalt net employ any person in such a Winner as to booms J bject to "Gun's cmPB(ratim Lwa of Col ifornle.• Ctotractor'a hirim or aub-contnctiro Aperture certifies Na foltwlng: •1 certify that in the parforaence of the Mark for Mich this permit is iza , 1 shall employ person subject to workmen's co i0f% taus of el ifornfa.• TY+PIBuaat wt" Nemo Y�le�r her I,sq*W McWedemu Complete drwim below. ��ll Q /(--pp.m..++ • SigndN Title•lime7yM✓ Datet� Lna PLOT PLAN (Draw to Sca(a) scale__• to 1. Mara of streets or roach nearest to or bonding the properly. 4. Location of hate Bawmas disposal system or 2. Outline of the property, with Amensn(aand North direction. proposed expansion of Bewpe disposal syatr. 3. Dimensioned wtlinm and location of all existing And proposed S. Loudon of wits within radium A 150 ft. on s[rtctures, including cowrad areas such as patica, driveways, the property or adjoining property. WALL walks. papa FOR DEPARTMENT USE ONLY Application Accepted by T�� Data: /P/3o/Yr Area• a-'/( Tank, Pit or Amp trapectim b/ Date / //Final Inspection by Additional Cormmis: y a•-iL 'mow- l ( r .� %/60 rJ4A 4/8/9 v ACCOODTIN ONLY: AID# FACS _„mss 1"• '+,e.•J�T_ • PE CODE FEE INFO AMOUNT BERMES SX RECER ED RY DATE SR I PERMIT Mason INVOICE D z o gl a87 jO yv��.n Ve�.cv d vt,Cwb g.Q.Gu.i.�` $(al(5f �codll 9, !�>Y.tlew} ,,.,Lw�r.•/ 3 min rPN`t w 8731 ay .t•%.+,.