Laserfiche WebLink
ANLICATION FOR LIQUIO WASTE PERMIT <br /> SAN JOAOUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE, STOCKTON, CA 95202 <br /> (209)468-3420 <br /> RON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED <br /> (Complete In Triplicate) <br /> MATION W HERESY MADE TO THE SAN"AWN COUNTY FOR A PERNUT TO CONSTRUCT ANDIOR INSTALL THE RIOW DESCRIBED. THIS APPIJCATMN 16 MADE IN COMPLIANCE WITH SAN <br /> ]VIN COUNTY DEVELORADAT mm CHAPTER 0-1110.3 AND THE STANDARDS DS OF SAN b WM COUNTY PUSIJC H TH,�/� ES.ENV�IIR/�ONMENTAL HEALTH DIVISION. <br /> ApDIE68Afl APN ' , - /j cffY �` � �- —_�31 <br /> EN'S NAME ADDRESS 1 PHONE <br /> fMCTOR I�/ AOd1E66 l �� !,, -J�7Z I RNIE/E 9 <br /> COMMCIOP ADd1E66 DCI PHDEE <br /> OF CVRD WORD: NEW METALLATION ❑ REPNWADDIMN D"TAMMN ❑ <br /> .'EpfK SYSTEM PERM TTEO IF MOM SEWER 16 AVA RLF WITHIN 300 FEET OF SUN01M.1 RBRC TEATM I I HOW FAANT <br /> A.0-s-! <br /> RUAIION WILL SONE: RESIDENCE COMMErRCIAI❑ OTHER ❑ ""� A �N _p •. - ,`,�,� <br /> FDI Of UMNO UNITS: NUMFDU OF SEDROOMS: NUMSNR OF SMPIAYFEI: T T'„Avi <br /> R EN Of SOR TO A DEPTH OF O FEET: Prrmuw s0E CHARACTER: ^ItfEN�TABIF UEFFIA <br /> IC TANIUUUEASE TMP ❑TYP M cAPACTTv IC TS i:E6 SS7.1 61 <br /> IRGTMENT mANT❑ DISTANCE TO NEAREST: WF31 -�FOUNDATION PROPERTY ME- <br /> UFT STATION 13 SIZE TYPE OF PUMPE SAND OMPARAT411 IENCLOSFD SYSTEMI <br /> i <br /> HMO DNF El M.A LLNOTN Of ONES derANCE TO NEAREST:M/ELL fOUNOATbN PROPERTY ME— <br /> Raw <br /> MERFFD ❑WIDTH LENGTH DEPTH- DISTANCE TO N,nRERR:WELL FOUNDATION PROPERTY ME <br /> — <br /> 40M ❑WIDTH }- LENGTH DEPTH DISTAME TO NCAIEST:WELLFOUNDATION PROPERTY ME <br /> LOE RTS �`�DEPrLE _BQE r MUSSRERi d6rl1NCE TO NEAREST:WETL �' FOIMDATN)N� /l PELOfENTV LME <br /> `6 ❑WIDTH IENOTH DEPTH INSTANCE TO NEAREST:VVELLFOUNDATION PPOPEIRY LJNE <br /> IML FONDS ❑WIDTH LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY IME <br /> ERY CERTIFY THAT 1 HAVE PPEPAIED TM9 APPLICATION ANO THAT THE VJOIK MALL 0E GONE M ACCORDANCE WRIT SAN.IOAOUN COIRTEV OIOMANCES ANO,FATE)AWB.AND mAF9 <br /> EGIMTIOHe OFTIIE SAN lOAdMICOVMY.NOME OWNEROROLENBED AOEM'S BIONATUIIE cERfIFlES TN1E fOLLIW/IIO:TCERTIFYTHAT MTNE PERFORMANCE OF THE WATRC FOR WNCN <br /> PENARN ISSUED.I MALL E NOT OV AMY POISON M SUCH A MANNER AS TO MMM SUR 1KT TO W AAANY COMPENSATION UWS OF CAUFORMA.- CONTR CTOWS HIRINGOR <br /> AMRACTID SI(NLATURE CERTIFIES THE MU H nN D:'1 CDIT,fY THAT M THE PERIFOPMANCE OF THE WINE(FOR WM <br /> WHICH THIS PERW IS ISSUED.1 SHALL EMPLOY PERSONS SUS.IECT TO <br /> (MM'S CCOO�II�'II�((�N,SATION/!UYVS OF CA�LX(OyW&' THE AMIJCjAA'NT MOST CALL/N�}ILH'O'HOURS IN ADVANCE FOR ALL Kamm INSPECTIONS. cOMgETE ORAWINO MID W. (J•(J <br /> M X \/ A nk Y / c-�a�N V 1LJ 1 I l f/1 \J GATE: I O V <br /> TITLE: <br /> PLOT PVN IDAAW TO WALEI SCALE ,-c— <br /> VANS <br /> VANS OP Sf1EETE OR ROADS NE,AfEST TO OR ROUNDING THE PROPERTY. S. LOCATION OF HOUSE SEWAGE DISPOSAL SYSTEM 08 PROPOSED <br /> JRINE Of THE MPERTY.WnTH ONRNSIONS AND NORTH DIRECTION. ERPM BION OF SEWAGE DISPOSAL SYSTEMS. <br /> WNR ENM OUTUNE6 ANO LOCATION OF ALL EXISTING AND PROPOSED 617PMCTUrlE6. S. LOCATION Of WELLS WITHIN MINUS OF ONE HUNDRED FIFTY FT.ON <br /> 1WING COVORED APEAS SUCN AS PATIOS.dSVENAYS.MD WALAS. Tl1E P11pPfPflY OR ADJ0S,/1D PROPERTY. <br /> - <br /> ............- .... .( .e .. .. <br /> ..... <br /> i._... _... _.. <br /> Y <br /> - t :_... <br /> �,� _ <br /> . <br /> C� <br /> C <br /> ..._.._ .._... \ <br /> SA-N ... <br />