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LIFT STATION SIZE TYPE OF PUMP <br />LEACH LINES LEACHING CHAMBERS <br />PKG TX PLANT U SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />LENGTH OF LIHLL _ It OF LINES <br />ft <br />ft DEPTH <br />FOUNDATION <br /> <br />ft PRLIPERT't LINE <br />&WIRED FOR IN <br />TITLE <br />ONS PLEASE CALL (209 3-7697 <br />DA I E 1-20Y- 13 <br />SAN JOAOUIN Comm? ENVIRONMENTAL PfEAI TN DEPARTMENT 1868 E. HAIELTON AVENUE. STOCKTON CA 95205 - (2091468-3420 <br />PLF MIT f-4,1 L(20V 95,3-76 FOR INSPECTIONS Ex RES 1 YEA FROM DATE ISSUED <br />tl te._) Ls (L At--JArpoI.J <br />Taan4/371t.i 12-D <br />coNTRA,Toa D. A Ppr-a4Lts 71, SCitQs IL3c- <br />4-000 N. WII-Styt..1 WALI <br />LICENSE 'IC-42 C-36 0 THE <br />ONSITE WASTEWATEq TREATMENT SYSTEM PERMIT <br />OWNER NAM <br />NON-REFUN <br />1OTLJkuvrtA..) <br />OF S Mae- 055 - -0 3 PARCEL StzE S .0 <br />"ONE 244-1463 <br />Crrv/ZIP I n <br />CONTRACTOR ADVRE', <br />OWNER ADDRESS <br />NumB,-,„ V005 11 EXPIRATION DATE <br />CITY/STATE/ZIP OD I <br />PHONE 416114g- 1:315 C57 <br />CITY/STATE/ZIP Sircistsmi cus2c5 <br />Wits <br />INSTALLATION WILL SERVE: REssDENCE <br />NUMBER OF Limas UNITS. <br />TYPE/MFG 1200 <br />TyPPMF11 <br />DISTANCE TO NEAREST: WELL <br />COMMERCIAL <br />NUMBER (if BEDROOMS: <br />OAPAC!I <br />CAPACITY <br />8 FOUNDATION <br />cal I OF COMFARTMENI- <br />gal / OF COMPARTMENT'. <br />ft PROPERTY LINE cr) <br />OTHER _ <br />_ NUMBER OF EMPLOYEES: _ <br />If FOUNDATION It <br /> 11 DEPTH <br /> <br />IT I LAJNOATION ft PROPERTY LINE <br /> ft DEPTH <br /> <br />ouNDATION ft PROPERTY LINE <br />ft DEPTH <br />11 I. FIDA T ION ft PROPERTYLTJF <br />It DEPTH _ <br />It i-JNOATii,;Ni ft PROPERTY LINE <br />PROPERTY LIM- <br />‘...) SEEPAGE PITS NuMBETT <br />DISTANCE TO NEAREST <br />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 />DISTANCE 10 NEAREST WELL <br />_ WIDTH <br />WELL <br />, 1 . <br />i <br />...i...r.4 <br />iM1 h.• A L ' - <br />Pr' <br />I <br />Li ,,.,_, • • • a <br />...___ I _........ P i...- 1 Agri el a <br />1 ..., Fli <br />Li ...,.. <br />_ F-- . <br />4., <br />00 --- p • AN j <br />a v! tc ) • Otl <br />[ <br />1 <br />J ai ,i4 <br />... i <br />LAND USE APPLICATION # <br />It GEOGRAPHIC:At INFORMADON: Coordinates <br />—11 BUILDING PERMIT # <br />NEW INSTALLATION REPATF1/ADOITION <br />REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM <br />WA TER TABLE DEPTH: <br />PERC TEST s <br />TYPE OF WORK ENGINEER DESIGNED /AL !ERNA i <br />DESTRUCTION <br />Jon ADDRESS <br />CROSS STREi. <br />$SEPTIC TANK <br />GREASE TRAP <br />ft <br />t• <br />It <br />It <br />FILTER BED <br />L.1 MOUNDED <br />SUMPS it LE NG <br />DISTANCE TO NEAREST WELL _ <br />LI DISPOSAL PONDS WIoth ft LENGTH <br />DISTANCE 10 NEARES1 WELL <br />WIDTH It LENGTH <br />DISTANCE 10 NEAREST WELL <br />WIDTH it LENGTH <br />DISTANCE 10 NEAREST WELL <br />WIDTH