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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />P.O. BOX 98% 904 EAST WEBER AVENUE, 3TOCKTON, CA SIMM- 88 <br />C20% 481.3420 <br />IDI-IEFNINAILE MINT EMM I YEAR FIRM DATE 18111118 <br />ICvw*ba In TryNnW <br />JLMICATM N MMY MAM TO THE NVP JOAOIIN COUNTY OIST POR A FTO CON*TRMI ANNOH *STALL THE VMM OfR.YfMb. T M LO <br />AMMATM N DE MAN COS/VANCE YM NLN <br />JOAOM CMW" DffynAPUIW TMf. CKMMM O_T i 1 D.3 AND THE STA1DAMI S OF SAN JOACPAN COUNTY FlM )C HEALTH SbbTCE/. E KWOSINTAL HEALTH DMM M. <br />tONfR�ICT l 1T. _n7 l' A°°IIIH— �(O 7 A/i /�re i ]LUG' 3��7cj / <br />oft coMnwaTDRL_ ACOMM �J uC/ Flaw <br />TTFf Of SOPTIC wwar. NiW MSTALLATOR ❑ R4ANfAOORON OfSTRUOTNR ❑ <br />,SO MqC SYMM PaSKTTE D E PUMX SEWER M AVASANE WTHN MO FUT OF NIKMNOJ PMC TM1TI4 I I NOW MARY <br />PN7ALLATROM WILL SMTYf: IEMOOAx ❑ COMMACIALL ❑ OTHER ❑ <br />:?RIMER OP MM UMTS< MOL.rtl1 of NEROOMF: RIIARM OF MNSO VLiS: � [ <br />CHARACTER OF W& TO A OfPM OF 3 FM :, PFTMW SOIL CHARACTER WATER TAKE OF►II(_� <br />S4P"C TANK ORMASS TRAP ❑ T/AAMFO CAPACITY NO. CONMARTMMNY/ <br />wA TRSATMMTr m ANT 13 OMTANCf TO woAw: WILL FOUMATION MIOFELTY Low, 4' <br />LWT STArm ❑ FOL TYPE OF MAW SAND OIL SEPARATOR 4ENC OSM SYSTEM$ T <br />LNM ❑ No. • LE/IOTw OF WET_ I—L bISTANCt TO NEAREST: WEL -- FRorORY ENI j ^ <br />❑ WRTTH LENOTM_ f DAT* OMA CE TO REMEfE:7WB , FOUEAATM POP"" LON v <br />ATORROfO ❑ wOTM . LEHOTH Y,y CSTTH DMTAFCR TO WAA AM WILL FDUNFITOM I FIIOPIRrY uM 1 <br />SSIAfS Rrf ❑ OSPTH '" SOS , , /•� MIAlN = OW A CE TO NEMEIT: M� FOU ATON= FROFATEV \11f (� <br />IMAMS ❑ wwTH LDMTH__ PV Tw DISTANCE TO NEAREST, Wal MACATION MWME ITY LRE %'Tl <br />rf/POSAL PoINS 0VAM LIHWTII MFT* OWNCE TO NEAREST: WELL PJUMATTON PROPERTY LNf <br />I /AMY COM MY THAT I HAY! ""AND TNM APMHCATON AND THAT M WORK MUL - DONE N M.0010AIILY WSrM SAN JOAOLME MURTY 0RLTNAN028 AND STAT! LAWS. AND RULES <br />AIDRMUULATIOMS OF TITS SMI JOAOMM COMM HOW OVA"9A Llo",R DAMYRTY olom IM Comm TNS FOLIDWNN1CSNTMYTHAT NM PMOPWAANCS OPTMWDIK PORVA@M <br />THM POIMT M M KM. I SHALL NOT f W\OV ANY PERSON N NN.1H A MUNN AS TO MOM WSJWT TO WORLMAKS COW90ATOM MWS OF C"OMA.• CONTRACTOR'S MM OR <br />NM OONTRACTfq GMATUIE CE Ri1ES THE POUAVAIIN: l CORNY TW\T N TOR PUMDMNCE OF THE WORK FOR VWSCH T1M POINT R ORRO.1 SHALL OM M P9— SO6¢T TO <br />WOMW" C96AFEMOATT10" LAWS O►GLXKWH TIR A MMAAN.T W/ AT�CCAU 21 !OURS M ACVAMM FOR ALL RSMARSD MMiCTOFM. CONFUTE =WOO MlOW. <br />fl __. ��� TRIC ii.=24 <br />1 TRT' <br />PLOT <br />MAN DRAW TO SCM11 SCALE _ a <br />F. NMMS OF 9"MTS OR ROADS NEAMr TO OR 90LOMM M PROPERTY. 4. LOCAT1 w OF NUJ- SEWAOf STEM OR PROPOSED <br />A. OUTINE OF THE MOFEMY. VKM O/MI <br />AOOMS AND NORM DMTI <br />ECON. WARSOM OF AlWAO[ OIM'OSAL <br />S. OMIO <br />MHMORM OUTLNEf AND LOCATION OP ALL MISTM AM PFAMMOM STIR MMM, S. <br />LOCATOR Or Wal/ VRTHN RAOM OP MM IIR*d A FMTY A. ON <br />i............. ...........:,I................:......;.....:....... ......i............a .. <br />t5T � <br />..,. .. �EEMRC1NMBiTALMI <br />FOR M/ARIMMTT 1rf MM.r�-A <br />NRICAMN AC� OV �Jl A./L�U 'lr� DATE: 7— 7—p�JU7 ATEA: f�I� <br />TAHSC MT O11 ESNs MPBCTMw BY Ij DATE IR PSLAL emomm N Ov tr Jirir�tt042 CATs % J F" Li <br />0MOrODNAL COMAIMM. <br />PLYJ. HeeM 8w. - EJMro. 174 (3/E6) <br />