Laserfiche WebLink
�v <br /> ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQVIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E WERFR AVE -3"O FL-STOCKTON CA 95202 - (209)469-3420 <br /> NON-REFUNiDABLE PERMIT CAI,1,(209)953-7697 FOR INSPECTIONS /EXPIRES 1 YEAR FROOM DATE ISSUED <br /> Joe ADDRESS Z O o J CITY/ZIP 4 clapliC %S- X _ L <br /> CROSS STREET l/ i'E'l-le -f.V J.&fiA, Y1 <br /> APN <br /> � + b91- © 3J-is PARCELS121F �j{ 14t►� p> <br /> OWNER NAME U�qLILtn 17G�fJ �'� `^`"� �rMsa✓l PHUN ) `J <br /> OWNER ADDRESS ( >_ � CITY/STATE/71P <br /> CONTRACTOR PHONE <br /> CONTRACTOR ADDRESS CITYISTATE/7-IP <br /> LICENSE ❑C•42 CJ-C.36- OTHER NUMBER EXPIRATION DATE <br /> WATER TABLE.DEPTH:_ fl GEOGRAPHICAL INFORMATION: Cnordinales X Y <br /> ❑ PERC TEST #_� BUILDING PERMIT# OQ. LAND USE APPLICATION# A -a12- �^ <br /> TYPE OF WORK: ^: NEW 1NS71'ALLATION ❑ REPAIR/ADDI'rIUN Q ENGINEER DESIGNED/ALTERNATIVE <br /> ❑ IREPLACFMF.NT ❑ DESTRIICTION <br /> INSTALLATION WILL SERVE;: ❑ RESIDENCE COMMERCIAL O OTHER Q <br /> NUMBF.ROF LIVING UNITS:--. — NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> SEPTIC TANK TYPElMFG— CAPACITY �1 dd.(1 go! #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPVMrG — CAPACITY go] #OF COMPARTMENTS_ <br /> ❑ PKG TX PLANT DjRT,%HC.ToNEA1iFST: WELI._ _ _ h F('A:NDAT)L)N _ fl PROPERTY LINE – it <br /> ❑ LIFT STATION SIZE TYPE.OF Pump._ ❑ SANK OIL SEPARATOR(ENCI.OSED SYSTEM) � <br /> LEACH LINES ❑ LEACHING CHAMBIFRS #of Lms 7� LENGTH Or LINES O fl <br /> DISTANCE.TO NEAREST �Vr:l.I t• co40 _ h FOUNDATION__- C Q Il PROPERTY LINE _�O IZ <br /> ❑ FILTER BED WIDTH -—ft LENGTH _ft DFPTII _ R <br /> DISTANCE'I'ONEAREST WELI. _ _ II FOUND4TION – _ R PROPERTY LINE _ h <br /> ❑ MOUNDED W1DY11 R LENGTH Il DFIlm fl <br /> DISTANCETO NEAREST WELL h FO(INDATION _ _ (t PROPERTY LINE. R <br /> ❑ SUMPS WIDTH — fl LENGTH_ A fl DEPTH <br /> DISTANCE TO NEAREST WELL fl COl!N{)AT;pN R PROPERTY I.INE R <br /> ❑ DISPOSAL PONDS WIDTH _ —n LENGTH_ – h DEPTH _ fl <br /> DISI'ANCLTO NEARES'1 WELL _ fl FOCNOATION _ R PROPERTY LINE fl <br /> SEEPAGE PITS NUMBER-,__—WI DTH_ — ­3 ft DEPTH 7 S ft <br /> DISTANCF 1'O NEAREST W'F.I.I h FOUNDATION ft PROPERTY LINE ft <br /> 1 HEREBY CERTIFY THA"r 1 HAVE PREPARED T111S APPLICATION A.ND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINANCES.STATE LAWS AND RALES-kND RC.GULATIONS OFSAN JOAQLUN COUNTY. <br /> MiN1N1�1M 2 HOLIR A VANCE NOTICE.REQUIRED FOR INSPECT NS-PIE <br /> I.(:091 953-7697 <br /> d(/ j/�I t1'i�OvJ�` <br /> SIGNED TITLE- DATE <br /> t-)MA" I <br /> tys - <br /> r----`---� � A cL �sE�op��^ G�AUSRC+OE•95 �- -� <br /> r � <br /> I -+MAI — <br /> I � �-----------------i eo�src�reru.� � <br /> r Torras a I GOWT z <br /> X F1AYDl <br /> urLI+WILDIN3 L___—�6D��_ Il QQo <br /> 0i MPE <br /> / �• V <br /> 71T11T Ir�`'� R���.K -� 2 I Vit- PIj��YME-j, <br /> lar <br /> --4-11-4-11- <br /> 1 11• �Tr - P4, sd <br /> 7 PARKIN& LOT MAVVEW <br /> Lu <br /> ` rw I,r� Ipd .y. ENVIAONPAR'� <br /> l� <br /> VA <br /> rV <br /> I , <br /> DEPARTMENT CSONL <br /> Application Acctp'<ed B Date- Area J4 Employee It* <br /> Final Inspectlor.a�' = Date ❑ SPFCIA[.PERMIT-Approved by _ <br /> Character o[S,oll to Dept ora Ft;_� Pit/Su p So bar ctcr: <br /> COMMENTS <br /> FE SC Received hccic! Amount Date Permit/ Invoice# Permit IDIt <br /> :.'ode lyra BV --rf-%h Remitled Service Request# <br /> I <br /> ONSITE WASTEWATER PERMIT <br /> 12122/2003 <br />