Laserfiche WebLink
L <br /> L ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> WKyoN CA 9530E-(20)468-U120 <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> L NON-REFUNDABLE PERMIT CALL(209)957-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB AESS I I V`I � 1 4�- COYZP l <br /> DDRS ^ <br /> ~ \ <br /> CROSSSTREEI " -� APN `J i ti ' - CT'J PARCELSVE <br /> / N '9 fV 63 ON PHONE <br /> L OWNER NAME - <br /> OWNER ADDRESS j I 4 `, N'r `/ CITYISI'ATFJLIP �- V 5 C R� 1 <br /> CONTNACTOR <br /> 1 <br /> COM <br /> MCTORADDRESS "1 L CITY/STATE2U`_ <br /> L %Y <br /> LICENSE ❑C<2 ❑C-36 OLHER NUMBER EXPIRATION DATE <br /> WATER TABLE DEPI'N: ft GEOGRAPHWALINFORMATION: Coordlmler X V <br /> PERC TEST p BUILDING PERMIT# LAND USE APPLICATION#Y De - lr 11a 9 I S <br /> L TYPE OF WORK: ❑ NEWINSTALLATION ❑ REPAIR ADDITION O ENGINEER DESIGNED IAL ERNAT E <br /> ❑ REPLACEMENT O DE41'RUCTON <br /> INSTALLATION WILL SERVE: ❑ REMDence ❑ COMMERCIwL ❑ OTNE0. <br /> NUMBE0.0F LIVING UNITE: NUMBER OF BEDROOMS: NUMBER OF EMPLOYCE4: <br /> L L3SEPTICTANK TYPE/MPO CAPACITY SAI #OFCOMPARTM <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY pl pMCOMPARTMENS <br /> ❑ PKC TX PLANT DISPAHCETONEARE41': WELL fl FOUNDATION ft PROPERTY LINE ft <br /> L ❑ LIFT STATION SIZE TyPEOFPUNW ❑ SANDOILSEPARATOR(E.LOSEDSVETEM) <br /> ❑ LEACH LINES ❑ LEACHING CHAMBERS OULmE3 LENGTNOFLIMES fl <br /> METANCETONEARESf WELL B FOUNDATION ft PROPERTY LINE ft <br /> ❑ FILTERBED WIDTH ft LENGTH fl DEFrH ft <br /> DISTANCETONEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> 6. ❑ MOUNDED WIUTN ft LENGTH fl DEPTN fi <br /> DISTANCETONEAREST WELLft FOUNDATION It PROPERTY LME fi <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCETONEAREST WELL ft FOUNDATION fl PROPERTY LINE S <br /> LLlDISPOSAL PONDS WIM ft LENOTH ft DeWH ft <br /> DISTANCETONEAREST WELLft FOUNDATION ft PROPERTY LME R <br /> ❑ SEEPAGE PITS NUMBER WIDTH ft DEFTH P <br /> DISTANCETONEAREST WELL ft FOUNDATON ft PROPERTY LINE ft <br /> L I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINANCES,STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM SA HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 12M)9534697 <br /> L SIGNED — f TIME s DATE <br /> I <br /> 4-1 <br /> it <br /> 144 71 <br /> 1 AC Jul <br /> G <br /> i 1 1 <br /> L <br /> U <br /> ( I NN IS' <br /> �:•DEPARTMENTU EONL L Z <br /> L •Application AmePMd By - �.0 "� C— DMI I 1 Lf 0 G Arm Empbys IDN J l /1 Y' <br /> Fimi lmpeclioo By Dale ❑ SPECIAL PERMIT-ApprovM by <br /> Charmkr of S R b Depth Df l Pt: PIUSump Snil CIMm[Hr: <br /> LCOMMENTS <br /> _ PE SC RmelVed I—ChCl Y/ Amount Date PermiD Invoke# Permit IN <br /> Code IneO R 'Cu Remined Servke mUN. <br /> 9� )J <br /> <3-03-0h1 ONSITE WASTEWATER PERMIT <br />