Laserfiche WebLink
ONSITE WASTEWATER TREATMEN-AYSTEM PERMIT /aa� <br /> SAN JOAQUIN COUNTTAENVIRONMENTAL HEALTH DEPP.RTMENT —"OlikWESERAVE-3"FL-STOCKToNCA952B2-(M)46&3A20 <br /> NON-REFUNDABLE PERMIT 6 "CALL(209)953-7697 FOR INSPECTIoNs EXPIRES I YEAR FROM DATE ISSUED <br /> JOBADDAMS 67.te-11 C{ y�J�n.� 12 CITYaIP Lad; 95147- <br /> IT <br /> 5147- �)c A a <br /> CRUSE STREET •�1 S ' APNJ 6 �Z2 Zj ZL �S1Is �PJwRC/E�L90.[I_'l.Il !T f o <br /> OWNER NAME TYpA/•Yypk- �-11'T,1 fnrJL_ 4 Y414 J/bedT- /'J�LykyI <br /> OMNERADDRM 1 f10 W1I FTWN IZQ CLEY/STATEa1P l QQu ca -1-I <br /> CdITMCTOR I9 G I C�e FTVI/1/NSQY1 f ('S SOC PRONE <br /> CONTRACTOR ADDRESS 7- ' FL..1 wad, CrrY/STATEa1P L gu— f!R �$2'fo <br /> LICENSE 13 C42 0C-36 OTHER NUMBER EXPIRATIONDATE S <br /> WATERTABLEDEIFN: fl GEODRAflHGLUWORMATION: Cpprdlneln X y ` <br /> 10 PERCTEST(S) NUMBER A{ LANDUSEAPPUCATIOND <br /> TYPE OF WORK: O NEW INSTALLATION O REPAWADOrt1ON O ENGINEER DESIGNED/ALTERNATIVE <br /> O REPLACEMENT O DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMEMAL Q OTHER <br /> NUMBEROFLIVINGUNFry: NUMBEROF BEDROOMS: NUMREp OF EMPLDVEFS: N <br /> ❑ SEPTIC TANK TYPIVI CAPACITY Eat #OFCOMPMTMENT3 <br /> ❑ GREASETRAP TYPFIMIO CAPACITY Bel EOFCOMPARTMENTS <br /> ❑ PKG TX PLANT DDTANCE TO NEAREST: WELL ft FOUNDATIDN B PROPERTY LINE R <br /> ❑ LIFT STATION SIZE TYPEOFPUMP ❑ SANDOILSEPARATOR(ENCLOSEDSYSrEm) <br /> ❑ LEACH LINES ❑ LEACHING CHAMBERS ISOF LINES LENGTH OF LINES R <br /> DIRFANCETONEARM WELL ft FOUNDATION R PROPERTY LINE R <br /> ❑ FILTER BED WIDTH A LENGTH R DEPTH ft <br /> Dv;SANCETONEAREST WELL ft FOUNDATION R PROPERTY LINE ft <br /> ❑ MOUNDED WIDTM R LENOTH ft DEPTH N <br /> DISTANCETONEARTST WELL ft FOUNDATION R PROPERTY LINE ft <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH R <br /> DISTANCE TO NEAREST WELL ft FOUNDATION R PROPERTYLINE R <br /> ❑ DISPOSAL PONDS WIDTH A LENGTH ft DEPTH R <br /> DmTANCETONEARFRr WELL ft FOUNDATpN R PROPERTY LME R <br /> ❑ SEEPAGE PITS Wmrn R LENGTH fl DEPTH R <br /> DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY LINE R <br /> I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE GOAL IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM N HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-707 �T <br /> SIGNED TITLE L DATEP�T_ <br /> a - <br /> 57 <br /> 4t) I kill I <br /> 0 <br /> r <br /> 1 E <br /> � CJ <br /> j AO IN <br /> QI <br /> e7 PJlEr I <br /> �. DEPARTMENT E NLV .p <br /> $�A^pp�lkaTlo%cceD Dvh 2J' O Ann Empby«IDq ���T /9Q <br /> .,i n ' Dandc. $i ❑ SPECIAL PERMIT-AppmvW by fff <br /> CluOmlerel Soil MO FC PiVSump Sell CNmder. <br /> COMMENTS D .90 <br /> AII <br /> d/ <br /> PE SC Reee,M C tt Amounl Permit/ <br /> CDOe INPO CveR RemlpeE D IS Svrvke Re uesip Invoke6 PermHl <br /> Z-1 - 3 2.-oo . <br /> ONyS <br /> �ITE WASTEWATER PERMIT <br /> S f- o�- TZ�C�sa/ <br />