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APPLICATION FOR LIOUIO WASTE PERMIT �(� <br /> SAN JOAOUIN COUNTY PUBUC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 <br /> y (209)488-3420 <br /> ^���/ 0011-REFURDAULE PERMR EXPIRES I YEAR FROM OATS ISSUED <br /> IGNgLMr In Trip e <br /> APPLXATOIV M HEREBY MAOF TO THE a JOAOUN COUNTY FOR A PO*.rT TO CONVTIRJCT HOAR INSTALL TIE WORK OEBCMSM-TNI!APPUCATID14 N MADE N COWUAK7 VVRN SAN <br /> JOAOM COLn+RY DEVELOPMENT MIA <br /> CHAPTER 9-11104 AND TTtK PTMgMp OF SAN JOAGM COUNTY PUBLIC HEALTH fMIVKiR OMRONMENTAL HMTM DIVISION. <br /> JOS ADDRESSOR �T��//Y� Cm G Tn BUY <br /> OWH"rw NAME Q L' AODIIESS PHONE C_`i�:?wA <br /> CONTRACTOR A,L, ISeez2 ADDiESb�/�� <br /> M CONTRACTOR ADORE" I" 'AR1NF�- <br /> TYR OF SAHO wow: Raw INSTAUATION REVASVADOITNHN LI OMTRIXTION❑ <br /> M BWTIC SYSTEM PVF*/TTE W PLNKJC REWER P AVAPLADU WRHN 200FEET OP BtXUXMO.1 PYIC TMTNI[1 HJW aMNY <br /> INSTALLATION WILL BEING NFSOEM:F p COMLEfCLAL R OTHER a <br /> M1W91 aP WINO IINTTS:�n1.w1BET OF Bm1100W:��PIWAREIR OF PEfOY®: <br /> LT{AUCM OP TOG TO A 0WVHI OF S Fft1': /,1 P OR,'5W7 PrrMUI.W*00.CHAFACTER, �.I+ WATER TAELE OEPTIL_ ry <br /> S847MTANKXWIW"a TRP 13TYIW.__ A yaR _ZI CAPACITY ��L V HO.COMPMRAB/tS �C <br /> PRO TNRATMPrT NLANT❑ OMTANCE TO NENYST: VA31 FOLMATIQH PIWORY YIN! <br /> LIFT 4 MAU014 13 SIZE TYPE OF PUMP BAND OIL SEPARATOR 1EHCLOSIM SYSTVW <br /> N44I4NO MINE O NO.R LO WTH OF L&A G �[��lJ/l fT dsiANCE TO/lMlsit WRL,A ?I-0UNOATpN� PMIZRry II/l! S <br /> RUM am 13 WIDTH LEHOTH DMH DISTANCF TO NFARMt Nal FOUOATDN PROPERTY LRC <br /> toovom Q VWOMH LENGTH DEPTH OISTANCE TO NEAEST:WELL POLWVATDN PROPERTY LSE <br /> S®ASLO PRS ❑OETRH sm NUMM DISTANCE TO HEAFMT,W VA_'ANIMDATION PRDFHOYINE <br /> SINES 13 wivrm tFNQU_-DePTH DISTANCE TO NEA WV:WELL_NOINDATON RTOMI YLLME <br /> DISPOSAL PSI/Dr ❑WIDTH LENWTH _OB THE OPTANCE TO NSNEST:WELL_-FMU 110E PROPERTY LEE <br /> 1 HEREBY CERTWY THAT 1 HAVE PREPARED THS APPLICATION AND THAT THE WOM WILL at DOME N ACCORDANCE WFTH LAN JOAOUN COVNTY ORDWMNC01 AND STATE LAWS,AND FILM <br /> AND REGULATIONS OF THE BAN JOAOUINCOUMY.HON[OWNCRON LICENSE AOEIR'S SONATUR!comma THS Fouvw4IILOt'ICER IFYTHAT LATHE M9011 tLANCEOF TEVLOAR FORWIICH <br /> TIM PERI M IS/HUED.1 SHALL NOT SIAM.OY ANY MOONI N SUCH A MNAMM AS TO SECOMf*AR=TO WOFPOAW,-5 COAPENSATION UMS OF CAIJPO-' OONTRACTOITS ISFP/O OR <br /> Sl1f-MMMC'T*AO SISMATUE CE/RIES THE FOLLOWING:1 COMFY PIAT N THE PEROHMAHDE OF THE WOPR POM WHICH THIN MWAT M NOM.1 SMALL EMPLOY MOONS WBACT TO <br /> WOMMAN'*OOUPWSA/TRAIN LAWS <br /> SOO,FyCAIJPOHMA-' THE ArFLICArF RMT CAW.M NDUM IN ADI/ANOS Pon AU.Rada SDI www"ONS.COMPLETE DPLAWNa adDN.yam/ JQ <br /> TITLE: r -� _ DA/L •! / / p <br /> RAT RAN WRAW TO SCAM SCALE <br /> I.NAAM OF STRIWO ON 11DADS HEAPWW TO OR BOUNOM THE PROMITY. 1.LOCATION Of HOUSE SEWAO!ONIONM*V111EM OR PFOPOtm <br /> G. N!OIrTLOF THE PIOPE".WITH dhE0 <br /> N8 M AHD NORTH DIRECTION. EkPA *S <br /> wM OF WAG'DIBFOWAL WWrnw. <br /> 3. DDENOKWM OUTUNL*ANO LOCATION OF ALL UNITING AND PROPOSED STHUCTUNES, S.LOCATION OF NaWITHIN THIN RADSTS OF ONE HUNDRED HPrY FT.ON <br /> Nn„ <br /> CUJO1MG COV9m APNEAS BUCH N FATM ORNMAYS,AND WAMS. .......THE PDFERTY OR AD.OMWM FRDIIRY- L�1 <br /> .. .. ...._ .. ... <br /> .. .e......;.....•i <br /> ..........._......:.. <br /> T <br /> : <br /> ... .j....i......p.... ,. ... .. ... ...j.... ...p....,:......j. <br /> .:......:......�......0. 1 <br /> .. ....�. .....,.. ...... ....... ._ <br /> .........�.....�... :.....:.....v.... .......,......... ....... ..... .. .. ... <br /> .... .....j.....:.. .. � <br /> ..:.....:..... <br /> ... L......:.,...•.............e..... <br /> ... <... ..............d....1.....d......'.. <br /> t <br /> ...•. <br /> S <br /> Fft <br /> t ` <br /> i i <br /> ' tet► <br /> .a.... ..... .'........_............... <br /> "4�.�.."... :... ( <br /> .................... <br /> ...:............... <br /> r <br /> ... :.....:.:.. <br /> : <br /> v... <br /> ..... ......:...............,.....:.....i.....i.. ..i.....,..... ....... .... <br /> NOR OOARTRMI7 USR dA.Y <br /> APPLICATION ACCEPTED MY DATE: �%/ AREA: Z/I <br /> TANK-PR OR WW INSPLCTON BY DATE I I FINAL NSPECTON by BATE <br /> ADDITIONAL CMMbWfi! 2`)" �Q1'I Aft- /ALJ OR/ L.4AIICTNA,I wE P D K ;A M L.rAC Y}7 o <br /> T�uK . ZN y-ZOR &W Tb?R@IJFK <br /> I <br /> ACCOUNTIMJ ONLY: ABL FACS <br /> FR ODDS Fall BPO ANICIINTR9i91TE 116CSRA®In DA! NI r PCWIRP HUMINS INVOM S <br /> s�7 G <br /> fs <br /> Pub.HeaAh SYrV.-E!MIrD.174(3/W <br />