Laserfiche WebLink
TYPE/MFG <br />TYPE/MFG <br />(ohcre4 /?•1 C- <br />SIZE TYPE OF PUMP U PKG TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STocicroN CA 95205 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />(Q. 9 c • 72/ <br />wy 88 <br />p obj•es r c ed <br />CITY/ZIP La C1,, (.4 <br />APN OcJ2SOJ PARCEL SIZE <br />ET/11, PHONE <br />JOB ADDRESS <br />t - <br />CROSS STREET <br />OWNER NAME <br />PHONE <br />CONTRACTOR ADDRESS <br />OWNER ADDRESS <br />CONTRACTOR <br />I710 V)(,4-0( <br />0444,-41 1 V4(/ <br />7 7 zfi_e_ At-e-Pr 1 ciTyisTATEIzip e4e) ri, (4 9 cf <br />CITY/STATE/ZIP L 6ke d <br />070 - 3a q -c-662 <br />LICENSE 01(6-42 C-36 OTHER NUMBER VS-9409C EXPIRATION DATE 9/a 3 <br />WATER TABLE DEPTH: ) ft GEOGRAPHICAL INFORMATION: Coordinates X <br />REPAIR/ADDITION <br />OUT-OF-SERVICE SEPTIC SYSTEM <br />ENGINEER DESIGNED /ALTERNATIVE <br />DESTRUCTION <br />0 PERC TEST # <br />TYPE OF WORK: X NEW INSTALLATION <br />0 REPLACEMENT <br />BUILDING PERMIT # a 10 0 LAND USE APPLICATION # <br />DISTANCE TO NEAREST: WELL /oa <br />CAPACITY <br /> CAPACITY <br />ft FOUNDATION <br />/o20 0 gal # OF COMPARTMENTS <br />gal # OF COMPARTMENTS <br />o 3 o ft PROPERTY LINE ft <br />SEPTIC TANK <br />0 GREASE TRAP <br />LIFT STATION <br />INSTALLATION WILL SERVE: <br />NUMBER OF LIVING UNITS: <br />0 COMMERCIAL <br />NUMBER OF BEDROOMS: <br />XRESIDENCE <br />(3) <br />0 OTHER <br />NUMBER OF EMPLOYEES: <br />Application Accepted By <br />DEPARTMEIVI 7 E ONLY <br />Date Area 11/ci. <br />Employee ID# 124, <br />0 SPECIAL PERMIT -Approved by Final Inspection By el, 2_ Date 9 <br />Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: <br />COMMENTS ..cecoL4 S )er <br />PE <br />Code <br />SC <br />INFO <br />Received <br />Bxe-4 <br />.140c# Amount <br />Remitted Date Permit/ <br />Service Request # Invoice # Permit ID# <br />H?)1 In ("0-- -'/-3?7 * s E LI .05*21 G'e• 009-iN2- <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 42-01 <br />4/14/18 <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /># OF LINES (.3) LENGTH OF LINES 55 / ft <br />DISTANCE TO NEAREST WELL / /e) ' ft FOUNDATION lie ' ft PROPERTY LINE go 1 ft <br />WIDTH ft LENGTH - ft DEPTH ft <br />DISTANCE TO NEAREST WELL <br /> <br />ft FOUNDATION ft PROPERTY LINE ft <br />WIDTH <br /> <br />ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL <br /> <br />ft FOUNDATION ft PROPERTY LINE ft <br />WIDTH <br /> <br />ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL <br /> <br />ft FOUNDATION ft PROPERTY LINE ft <br />DISPOSAL PONDS WIDTH <br />ft LENGTH ft DEPTH ft <br />SEEPAGE PITS NUMBER <br />DISTANCE TO RAREST WELL <br />(3 ) <br />WIDTH 3 ' ft DEPTH e=7.5 / ft <br /> ft FOUNDATION ft PROPERTY LINE ft <br />DISTANCE TO NEAREST WELL /170 ft FOUNDATION ft PROPERTY LINE 410 ft <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />)40; LEACH LINES <br />FILTER BED <br />MOUNDED <br />SUMPS <br />0 LEACHING CHAMBERS <br />)1i :SSaIRICIEV aIIS SIGNED <br />MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 <br />TITLE frof7-act4- DATE g <br />e0 A,4 , <br />ROCrilitt417. <br /> ('6'2 1,, <br />mc4.44,4,47),