SR0082012 SSNL - Laserfiche WebLink

Home Browse Search

ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 E MAIN STREET-STOCKTON CA 95202-(209)469.3420 NON-REFUNDABLE PERMIT E. CALL(209)953-7697 FOR INSPECTIONS /f EXPIRES 1 YEAR FROM DATE ISSUED Joe ADDRESS t a Y-S F1 $ ISz -AC4 G.-N �Q to iC"'MP 1CI��(yT/1 a CROSS STREET I 1�d� OD APN `� - PARCEL SIZE - g -t p80 OWNER NAME +!I-�I d• r i I y 1'iL0 S PHONE It 3—0601 }e OWNER ADDRESS -`C ku t CITYISTATE/ZIP CONTRACTOR 41T!_C..,L�_S 41_K�') e- so c PHONE CONTRACTOR ADDRESS le N 6" Ca:S 1S CITY/STATEMP a G. } LICENSE 'JC-42 11Cr36 OTHER " NUMBER(0053-VI EXPIRATION DATE i WATER TABLE DEPTH: It GEOGRAPHICAL INFORMATION: Coordinates X Y ❑ PERC TEST # BUILDING PERMIT# _ LAND USE APPLICATION# TYPE OF WORK: 0 NEW INSTALLATION e REPAIRIADDITION J ENGINEER DESIGNED/ALTERNATIVE ❑ REPLACEMENT H DESTRUCTION INSTALLATION WILL SERVE: + tIRESIDENCE F. COMMERCIAL 1 OTHER NUMBER OF LIVING UNITS: I NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: O SEPTICTANK TYPEJMFG CAPACITY gal #OFCOMPARTMENTS O GREASE TRAP TYPEWFG CAPACITY gal #OF COMPARTMENTS � DISTANCE To NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft C) 11 LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) N 17 LEACH LINES -1 LEACHING CHAMBERS i^ #OF LINES LENGTH OF LwN s ft II7�, '/ DISTANC TO NEARE T WELL ft F NDATION ft PROP�TY LIN ft ''1 ►! FILTER BED WIDTH h r ft LENGTH 1 ft DEPTH I 1/ ft y DIST E TO NEARES WELL �FOXUATIION ft OPERTY LI ftO MOUNDED WIDTH ft LENGTHft DE It DISTAN TO N REST WELLft PROPERTY LINE ft 11 SUMPS WIDTH It LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY LINE It 17 DISPOSAL PONDS %MoTN ft LENGTH ft DEPTH It DISTANCE TO NEAREST WELL ft FOUNDATION _ _ _ft PROPERTY LINE ft � O SEEPAGE PITS NUMBER WIDTH ft DEPTH ft DISTANCE To NEAREST WELL ft FOUNDATION ft. PROPERTY LINE ft 1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 SIGNED 6,�� TITLE cj��Pc:C-La r DATE I cz J�H �7' 1 ROO T�- 1 J I j I I V , ul , DEPARTMENT USE ONLY S Application Accepted Date 3 Q Area Employee ID# ��CJ Fina!Inspection By,-' Data U SPECIAL PERMIT-Approved by Character of Soil to Wpth of 3 Ft: P ump Soil Character: COMM TS It>(- o F AEC-0 o PE -SC Received Amount Date Permit% Invoice# Permit ID# Code INFO B 1 Cash Remitted rvice e t# �zro ifs- NIX— -LI g 230.e_0 o 0,Y-Old, 1 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 1014/07