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r� LIQUID WASTE PERMIT <br /> (�T SAN IOAOUIN[OUNTY PUBLIC HEALTH SER1W.ENVIRONMENTAL HEALTH DIVISION <br /> 2016.wESF.R AVE J'FLOOR,STOCKTON,CA 952iI212W)MR-L20 <br /> II''//'' NON-REFUNDABLE PERMTT EKMRPS 1 YEAR FROM DATE <br /> AA TE/IMED <br /> MBAODRESS�Z-b' E. KID[AK/cNl Ayi/ /WI <br /> APN l� 3 7`V- Z9 _ PARCF.LSITS:�[�UYJI <br /> • cmm, trnWV-TOPa BUILDINGPEIIMrrF 07404"70 _ <br /> OWNERNAME ADDRESS <br /> CmmP PHONE NUMBER <br /> coNTxwcroR IY iAL�J k, 644097 =NC. __ ADDRESS 54.SD E M ibF, VD <br /> oirraI LClal U57140 PNONE NUMBER 3b9- 132. <br /> GEOGRAPHICALINFORMATION: COORDINATES:x Y _TOWNSHIP_..RANOF._SECTION_ <br /> TYPEOFSEPTICWORK: I.NSTALLAT/ON WILLSERVE: NUMBER OF LIVING UNI'TS:—L— <br /> ■ NEW INSTALLATION IS RESIDENCE. NUMBER OF BEDROOMS: JS <br /> ❑ REPABVADOITION ❑ COMMERCIAL <br /> NUMBER OF EMPLOYEES: � <br /> ❑ DESTRUCTION ❑ OTHER <br /> ❑ ENGINEEREO'ALTERNATIVE w <br /> CHARACI'EROFSOILTO DEPTH OFJ': rLAV PIT/SUMPSOILCHARACTER: WATERTABLEDEFTH: <br /> O PEHCTcsF(S) HOW MAW AAPPLICATION <br /> Y SEPTIC TANK TYPE/MFG_CakRM,I PLL CAPACITY t2Od AALLBFJ AOFCOMPARTMENTS E. <br /> ❑ GREASETRAP TYPFIMFG CAPACITY-F NOFCOMPARTMENTS <br /> ❑ PKOT%PLANT DISTANCETONEARBBT: WEIL__ FOUNDATION_ NROPRTY LINE_ <br /> ❑ LIFTSFATION SIZE TMOFPLMP__ SAND OIL SEPARATOR(ENCLOSED SYSTEM <br /> A <br /> WELL LEACH LMH MOFLINES:�❑NGTH Oil {DCS PWNDATION PROPFircv LINE 70 <br /> INFLITRATOR CHAMBERS: _ <br /> ❑ FILTER BED WIDTN� LENOTH_ DEAN__ 9 Arciiaxuxaxr: WELL_ POUNMATION_ PROPRTY LINE_ <br /> ❑ MOUNDED WIDTH LENGTH_ pEPTX__ DRTA' Ei Nm ui: WELL FOUNDATION_ PROPERWLINE_� <br /> ❑ SUMR WIMN_ LENOOI_ DIM_ emAxC[10NFMW: WELL FOUNDATION_ PRMERTY LINE_ -c <br /> O DISPOSAL PONDS WIDTN_ 4&4(7X_ DEPT11• qqpp wMNIIN' ......; WELL_ FOUNDATION <br /> ^ PROPERTYLINE_Y SEEPAGE PITS, 7 WAMETER�4 DE--ia! 9WTnxa NNURtci: WELL{5a FOUNDATION�A PROPERTY UNE-le <br /> �POP rn <br /> I HEREBY CERTIFYTHAT I HAVE PREPARED THIS APPLICATION AND THEWORK WILL BE DONE IN ACCORDANCE WITH SAN FWQUW COUNTY ORDINANCES.STATE LAWS l-1, <br /> AND RULES AND REGULATIONS OF SAN FOAOUIN COUNTY. <br /> MI NIIMUM2AHOUR ADVANCE NOTICE REQU IRED FOR INSPECTIONS-PLEASE CALL a")4W3423SIGNEM 5M� _TITLE: CAN1"&W1L- DATE:IFv-�c <br /> lb 1,10 Z <br /> i l- <br /> ti ; 1. F.niDy -�t-�Ir ! <br /> --�- <br /> 1.. . <br /> --T-+ (-t-T- f <br /> t <br /> T- <br /> PU IC Ett <br /> agH <br /> 44 T 1 N <br /> DFUPARTMEXT IAEtMLV L �/4 <br /> APPLICATION A(C/;E;N E'D DY. �/y1 /1��I'�1y/ V ABPA EMPIAY.., DISTRIR ___ LOCATION YY <br /> WSPPCTPDBY-yam _ OAR' I UI'W" PRMRiMAL YES DATE: / : , <br /> • f EMYlVf�AI I.J NLN" yyixft O; LLTmig-� 4/F[Y "-.L SI <br /> PEIN)WE SC INFO MIOUNT X RECEIVED DAR PERMrtYJEAY10E 0.igIlERFF IM91. FEITKw <br /> OmIrE DY <br /> 2-l !l 370 2-834 5/L/ S&O Z <br /> RevIBe91Fw/ I - <br />