Laserfiche WebLink
CITY/STATE/ZIP <br /> <br />PRO <br /> <br />t0a\ARNY <br />,EVED <br />9, I 2004 <br />Di =Ls" <br />r)--PAR <br />a.-I" Jc..) <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTNIJNT. • - --304.E WEBER AVE - - STOCKTON CA 95202 - (209)468-3420 <br />NON-REFUNDABLE PERMIT CALL (209)95 2/197 FOR INSPECTIONS- EXPIRES 1 YEAR FROM DATE Issuer) <br />JOB ADDRESS <br />CROSS STREET <br />OWNER NAME <br />rtiVe Ca/ rt-CE-011 e_- e_ APN <br />IQ #1.10 "C C.C-CL tAtii Ct <br />OWNER ADDRESS Ct. VIIIe a$ct o ve_._ <br />coictix7 Se." Y-1 r <br />CONTRACTOR ADDRESS <br /> <br />a-I gl ifoo)--- <br /> <br />PARCEL SIZE __IC/242t <br />(Ixp6) 2-73 <br /> <br />PRONE <br /> <br />CITY/STATE/ZIP <br />LICENSE 0 C-42 D C-36 OTHER NUMBER ExDIRA-noR DATE <br />WATER TABLE DEPTH: GEOGRAPHICAL INFORMATION: Coondlnates X <br />:q1 <br />N <br />8 <br />I INSTALLATION WILL SERVE: <br /> <br />)cf SEPTIC TANK TYPEMFG*.gatefa lt____ CAPACITY ILO CO PI 4 oF COMPARTMENTS <br />PEG TX PLANT DISTANCE TO NEAREST: WELL ft FOCNDATION ft PROPERTY LINE ft <br />LIFT STATION SIZE TYPE OF Pump 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />TYPE OF WORK: • NEw INSTALLATION <br />GREASE TRAP TYPE/MEG cApAcrre gal 4 OF COMPARTMENTS <br />NUMBER OF LIVING UNITS: <br /> 1:1 RESIDENCE 0 COMNIERCIAL 0 OTHER <br />REPLACEMENT <br />NUMBER OF BEDROOMS: <br />X REPAIR/ADDITION <br />0 DESTRUCTION <br /> NUMBER OF EmPLOYEES: <br />0 ENGINEER DE-SIGNED /ALTERNATOJE <br />)1( LEACH LINES D LEACHING CHAMBERS ff OF LINES 4 LENGE i OF LiNES 114 ft <br />DISTANCE TO NEAREST WEI.I 1 ,-71) 0 FOUNDATION C, ft PROPERTY LINE C4121 n D F7LTER BED WIDTH ft LENGni ft DEPTH ft DISTANCE TO NEAREST WELL _ ft FOUNDATION 0 PROPERTY LINE fl 0 MOUNDED Wurrif ft LENO1 H ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft Cl SUMPS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft DISPOSAL PONDS WIDTH ft LENGTH n DEITH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft SEEPAGE PITS WIDTH ft LENGTH 11 DEPTH It DISTANCE TO NEAREST WELL ft FOUNDA TOON ft PROPERTY LINE ft <br />SIGNE <br />I HERFJ11 CERTIFY THAT I HAY E PREPARED THIS APPLICATION AND THE WORE WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES. <br />a 141Cbta <br /> <br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />19 <br />TITLE <br />R,ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 <br />DATE e —04 <br />PERC TEST (S) NUMBER <br />inumr <br />OM Mr "mma. linm ffe. tiV.4 <br />at aggro — <br /> <br />11"4111 <br /> <br />Alas <br />my, Alf <br /> <br />J10440 PA <br />ME <br />IMP <br />LAND USE APPLICATION <br />DEPARTMEN U NLY / <br />Character of Soil peCptli of 3.:JILC-E41"Ft: <br />Application Accepted By Date t. <br />Final Inapection By <br />Arm ... ( 7 E.,,,,yeg,,, a)/ gi sZe-',-e---._ Date et I: SPECIAL PERMIT - Approved by <br />Pit/ unap Soil Character; <br />Pif 144 44' vt — Am - -11-- / 3/ ' 3 4i 1 itre a "24..Ble-ri---e-of <br />, Q C ,j -fr-Ltiti 1144t4t 1;3.e 1 <br />corn M EN 1 sc,,, 6 4._ tf) <br />PE SC <br />INFO <br />Received <br />By <br />K. Checkig,-) Amount <br />Remitted Cade Date Permit/ <br />Service Request a Invoice* Permit ID* '''-' <br />te) 144,1924 /SO 144 /1,44 evOCCW Si <br />1-001 <br />1212102 <br />ONSITE WASTEWATER PERMIT