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LIQUID WA. PERMIT <br /> SAN JOAQ111N COLINTY PIIALIC HLALTH SER ES F.NVIRONMI..NTAL HLALTII DIVI.S ION <br /> 104 L.W LRLR A V I°.J"FLOOR,STOCKTON,C A 952O21209146X-142O _ <br /> �-7 /" NON•f :PI(N)ARU:PERMIT F.XPIRF.S 1 Vf:AR FROM DATE;ISSUI:U <br /> JOB ADDRESS / 6 IN--) AP N -�7 >C � (7 •1) 7 C 1 <br /> 1'A RCf:I.SI%f::�L <br /> ('ITT/'LIP___ u-'�AnI�,(pJ+�' D/7{`•� .J �,�rZ.__ BUILDING PERMIT p_ aU . <br /> OWNER NAME_ AUDRE5S <br /> CI'I-YrzIP _ q 7959 D C&U;/ _ =AMQ <br /> 1'l1ONE NUMBER_ C Y 7 � <br /> CONT'RAC'TOR___.___ ___ ___-,- ADDRESS <br /> ClI'YI%IP _ PHONE:NUMBER <br /> GEOGRAPHICAL INFORMATION:COORDINATES:X ._...-_ Y• ............. _ 1 OWNSI IIP____RANGIi___ SECTION <br /> TYPE:OI;SEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: <br /> /teNLW INSTALLATION ❑ RLSIDLNCE- NUMBER OFIIEDROOMS: <br /> ❑ RrPAIR/ADDITION ❑ COMMERCIAL <br /> ❑ DESTRUCTION ❑ OTHER NUMBEROVEMPLUYiSP.S: <br /> ❑ ENGINEERED/ALTERNATIVE <br /> CHARAC'T'ER OF SOIL TO DEPTH OF 3•: PIT/SUMP SOIL CHARACI'ER: _ WATER TABLE UEP-1.11: <br /> ❑ PERCTEST(SI HOW MANY APPLICATIONp <br /> I SEPTICTANk TYPE(MFG_�Sf)1C2.0-�PCAPACITY Z-(.?,pzj NOF.C'OMPARTMENTS_Z� <br /> ❑ GREASETRAP TYPE/N1FG d CAPACITY N OF COMPARTMENTS <br /> DISTA NCE <br /> PKGTX PIAN .,PLANT '1.O Nf:AREST': WELLFOUNDA110N PROPHOY LINT[ 7C- <br /> ❑ LI FI'STATION $V,E _ IVPL OF PUMP..,._ SAND OIL.SLPA 14 ATOR(ENCLOSE 1)SYSTEM)..____._. <br /> N OF LINES:�LENGTII OF LINES: ac,/ _I �r <br /> LEACH LINE DI TAN('E TO NEAREST: WIiLI. FOIINDAI'ION PROI'liRT\'I.INI. <br /> INFLITRATOR CHAMBERS: <br /> ❑ FILTER BED WIDTII LENGTH DEPI'1/ OMANCE TO NEARE— WELL FOUNDA'T'ION PROPURTV LINL. ` <br /> ❑ MOUNDED WIDTII LLNCTll OEPTII DISI'ANCETONEARFGT: WELL I.00NOA'I'I0N PROP'ER'TY LINE—_-- <br /> ' ❑ sumps WIDTII LL•NG1II UEP(II OKTANC'ETONEARET: WELI. FOUNOAIION PROPLRTV LINE <br /> ❑ DISPOSAL PONDS WIDTII LENUTII OI:PTII DKTANC'F.TO NEAREST: WL:LL. FOUNDATION PROPERTY LINE <br /> ❑ SEEPAGE PITS N DIAMLTER ULPIII DISTANCETONEARI:ST: wlil,l. FOUNDATION PROPERTY LINE <br /> - <br /> I IIEREBY CERTIFY THAT 1 HAVE.PREPARED TIIIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES,STATE:LAWS <br /> AND RIFLES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> )MINT61 1M 24 HOUR A VANCE�TICE REQUIRED FOR INSPECTIONS-PLL�E�AA CALL(209)468.3423 <br /> SIGNED: l TITLE: LJl.11��. ',� DATE: (� - <br /> 1 <br /> 9 CII) <br /> 0o <br /> �0 <br /> APPLICATION ACCEPTED BY: i_i'` ATL' �rARLA._f.../ .EMPI ii�f.I.IDq__/.A�/-��)ItiTRic'T v _I.()('AIION� C <br /> .. _. .... .. __.___...._.DA(E:..._ .� _-1'ERMI'(FINALO V(:SDATE: C(J/�(�TNtiPi!CTO� �I... <br /> INSPECTED BY_ _ _ VVV++, VVV <br /> PE CODE SC INFO AMOUNT IEC !('ASH RECEIVED DATE PERMIT;RERVICE REQUEST# INVOKLA SEPTKIDA <br /> RT.MITif.D 11V <br /> - ' 77 <br /> AEAKED R.Is.ol <br />