Laserfiche WebLink
CI SAND OIL SEPARATOR (ENCLOSED SYSTEM) LIFT STATION SIZE TYPE OF PUMP PKG TX PLANT <br />SEPTIC TANK TYPE/MFG <br />GREASE TRAP TYPE/MFG <br />DISTANCE TO NEAREST: WELL ft <br /># OF COMPARTMENTS <br /># OF COMPARTMENTS <br />PROPERTY LINE <br />CAPACITY <br />CAPACITY <br />ft FOUNDATION <br />gal <br />gal <br />ft <br />0 LEACHING CHAMBERS # OF LINES / <br />/ <br />, <br />LENGTH OF LINES / ft <br />ft PROPERTY LINE ..C- /71" ft <br />DEPTH ft <br />DISTANCE TO NEAREST WELL <br />SIGNED --2111- TITLE <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 />MIN 48 HOUR7yANC OTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 <br />DATE /12 27 -2 ) / <br /> ft FOUNDATION ft PROPERTY LINE <br />WIDTH ft DEPTH ft <br />ft <br />of,Air f / Date <br />Date <br />Pi Sump Soil Character: <br />LAND USE APPLICATION # BUILDING PERMIT # <br />TYPE OF WORK: NEW INSTALLATION <br />REPLACEMENT <br />REPAIR/ADDITION <br />0 OUT-OF-SERVICE SEPTIC SYSTEM <br />E ENGINEER DESIGNED /ALTERNATIVE <br />LI DESTRUCTION <br />0 RESIDENCE INSTALLATION WILL SERVE: <br />NUMBER OF LIVING UNITS: <br />0 COMMERCIAL <br />NUMBER OF BEDROOMS: <br />0 OTHER <br />NUMBER OF EMPLOYEES: <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - S TOCKTON CA 95205 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL J209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />JOB ADDRESS _13 /4/o,/,7/4").17,---- ci-rdzip 4G/it/AA? <br />CROSS STREET ...//1...,--51;;41 APN ( 2-- PARCEL SIZE 7 ci <br />OVVNER NAME 40.4 PHONE e - <br />LICENSE 00C-42 0 0C-36 OTHER <br />A .."7 <br />NUMBER 954z //7_5 EXPIRATION DATE <br />WATER TABLE DEPTH: <br />0 PERC TEST # <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br /> ft FOUNDATION ft PROPERTY LINE ft <br /> ft FOUNDATION ft PROPERTY LINE ft <br />11111111111111111111111111111111111111 <br />E' <br />11111111111111111 <br />ET <br />eE <br />.021 <br />UNTY <br />:N IRiN E TAL <br />LT EP • R MENT <br />A.44.1 Application Accepted By ,74 , <br /> <br /> <br /># PARTMENT SEONLY <br />, <br />Final Inspection By <br />Character of Soil to Depth o 3 Ft: <br />COMMENTS teN.,() IA:sr i r6eolzi, <br />PE <br />Code <br />SC <br />INFO <br />Received <br />B zi <br />,Check#/ <br />Cash <br />Amount <br />Remitted ate Permit/ <br />Request # _ Invoice # Permit ID# <br />( if:U 44(ie d 1 6112 .2t P-01 <br />Service <br />j R14 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 42-01 <br />4/14/18 :SSHITTICW HITS R._ LEACH LINES <br />FILTER BED <br />MOUNDED <br />IL SUMPS <br />DISTANCE TO NEAREST <br />CI DISPOSAL PONDS WIDTH <br />DISTANCE TO NEAREST <br />CI SEEPAGE PITS NUMBER <br />DISTANCE TO NEAREST <br />WIDTH <br />ft LENGTH <br />WELL ft FOUNDATION <br /> ft LENGTH <br />WELL lac./ '+ ft FOUNDATION <br />ft LENGTH <br />WELL <br /> ft LENGTH <br />WELL <br />WELL ft FOUNDATION <br />ft <br />Area Employee IlD#7' oefir <br />10 SPECIAL PERMIT - Approved by <br />ft <br />DEPTH <br /> ft PROPERTY LINE <br /> ft <br /> <br />DEPTH <br /> <br />) <br />' <br />ft PROPERTY LINE <br />ft <br />DEPTH <br />DISTANCE TO NEAREST <br />WIDTH <br />DISTANCE TO NEAREST <br />WIDTH <br />ft <br />ft <br />ft <br />ft <br />ft