Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 E MAIN STREET-STOCKTONCA 95302-(209)468-3420 <br /> NON-REFUNDABLE PERMIT (� CALL(209)953-7697 FOR INSPECTIo rS ExpIREsjyEARFROM DATE ISSUEI) <br /> JOE ADDRESS z I O o r- t�� �"'•�� CITY/21P / tVy !60y <br /> CROSS STREET CIeAftt�& y7'-•�-t(' APN ' Z Zy PARCEL SIZE <br /> OWNER NNiE <'�y� ;I� '�- l�I ISK(^ G'C v' ✓J�.1 PHONE <br /> OWNER ADDRESS ?e Jtx C:ITY/STATE/Z[P ( eW <br /> Corrm%CTOR WPI PHONs 2'0,-1--78-C. - '5 f Co m <br /> C:ONTRACI'OR ADD1tE5S 2 CLTYlSTATEfJ.RP vLqx-�j�—� <br /> LICENSE ❑ C-42 ❑ C-36 01'14ER _— NUMREM O 84Z'I EXPIRATION DATE <br /> WATER TABLE DEPTH: R GEOGRAPIHCAL INFORMATION: Co*rdinat" X Y <br /> I u PERCCEST BU[LDINGPERMTT(f f� <br /> '70 k- IANDIISEAPPLICATION�f <br /> TYPE OF WORK: NEW INsul.1ATION REPAIRJADDITION Q ENGINEER DESIGNEDIALTERNATIVE <br /> Q REPLACEMENT Q DESTRLK TION <br /> INSTALLATION WILL SERVE: (W RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> SEPTIC TANK TYPEIMF(i_ JC t CAPACITY e O SW #of COMPARTMENIS <br /> ❑ GREASE TRAP TYPFJMFG _- CAPACCI'Y 0 AOF COMPARTMENTS p, <br /> DISTANCE To NEAREST. WELL R FOUNDATION ft PROPERTY LINE R <br /> U LIFT STATION SIZE TYPE OF PUMP (3 PKG TX PLANT 13 SAND OIL SEPARATOR(ENCLOSED SYSTEM) C+ <br /> W <br /> LEACH LINES 9(-LEACMG CHAMBERS *of LMES L.E:GTII OF LawES <br /> DISTANCE TO NEAREST WELL t o0 4- it t'oUNDgrmN ft PROPERTY LINE ft <br /> 0 FILTER BED WIDTH ft LENGTH _ft DEPTH. ft <br /> DISTANCE TO NEAREST WELL— ft FOINDATION T- ft PROPERTY LINE R �( <br /> 13 MOUNDED WIDTH R LENGTH ft DEPTH R ((^11( <br /> DISTANCE To NEAREST WELL._-` d FOUNDATION ft PROPERTY LINE R <br /> ❑ SUMPS WIDTH ft LENGTH tt DEPTH R <br /> DISTANCE TO NEAREST WErl. _ft FOUNDATION R PROPERTY LINE <br /> 0 DISPOSALPONDS WIDTH _.--tt LENGTII__—._-•— II DEPTH R �- <br /> DISTANCETONEAREST WELL. It FOUNDATION ft PROPtltTY LINE ft <br /> SEEPAGE PITS NuMBHx 3 WtDTe _ _.,.- R DEPTH <br /> DISTANCE TO NEAREST WELL C IT FOUNDATION ft PROPLRTY LINE it \TV <br /> I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATIA AND THE WORK WELL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> NCES,STATE LAWS AND RULES AND REGULATIONS OF SAV JOAQUIN COUNTY. <br /> ly 4 <br /> MINI!1 7?A OIIR A TICE REQUIRED FOR INSPECTIONS-PLEAS CALL(209)953-7697 <br /> SIGNED TtTLE DATE <br /> 1 <br /> i 1 <br /> .. s <br /> N <br /> i <br /> 1 <br /> kl <br /> 11 U 00d <br /> to 04 two V- <br /> I jj�jaE pmn EN r <br /> DEPARTMENT O' Y <br /> Application AeDate 3 2-/6 g <br /> "_ A:ex w— Eployee[D <br /> Final Inspection' DaJr3 g`j <br /> 0 SPRCIAL PERMIT-Appmvcd by- <br /> Cheracter of Soil to Depth of FI: PiriSump Soil Character: <br /> commovrs 'Lj6 J L-O T 0tE-4rG0/L0&& - <br /> -'�.� <br /> PE Sc Received Cbee Amount <br /> Code INFO B Remitted DowService nest IDvoloeN <br /> q z r 3 11-7 <br /> i2-01 ONSITE WASTEWACER PERMIT <br /> 05/30.2007 <br />