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I < ;«> <br />CITY/ZIPi <br />WAy <br />PHONE NUMBER <br />GEOGRAPHICAL INFORMATION:COORDINATES: X Y ------------TOWNSHIP RANGE SECTION <br />NUMBER OF LIVING UNITS: <br />NUMBER OF BEDROOMS: REPAIR/ADDITION <br />10DESTRUCTIONNUMBER OF EMPLOYEES:OTHER <br />ENGINEERED/ALTERNATIVE <br />CHARACTER OF SOIL TO DEPTH OF 3’: _ PIT/SUMP SOIL CHARACTER: ^1,WATER TABLE DEPTH: AOi---- <br />PERC TEST (S)HOW MANY APPLICATION # <br />SEPTIC TANK TYPE/MFG CAPACITY # OF COMPARTMENTS <br />GREASE TRAP TYPE/MFG CAPACITY #OF COMPARTMENTS <br />DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE <br />SIZE TYPE OF PUMP SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />ft # OF LINES: LEACH LINE DISTANCE TO NEAREST:WELL.PROPERTY LINE <br />FILTER BED WJDTK LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE <br />MOUNDED WIDTH LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE <br />SUMPS WIDTH LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE <br />DISPOSAL PONDS LENGTH DEPTH DISTANCE TO NEAREST:WELL FOUNDATION PROPERTY LINE nftSEEPAGE PITS DIAMETER DEPTH 5DISTANCE TO NEAREST:WELL.FOUNDATION PROPERTY LINE <br />AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS <br />'r <br />; -i <br />I <br /> LnI" [If- i- <br />t ri |oo' <br />LP-I <br />r 1 <br />I i t i i-g 4 200?r <br />£2^4^:APPLICATION ACCEPTEd/Y: <br />.OCATION <br />INSPECTED BY: <br />DATE. YES DATE: <br />COMMENTS: <br /> <br />PE CODE SC INFO CHECK!:ash DATE <br />INVOICE#SEPTIC ID# <br />2 <br />REVISED K-15-01 <br />PKGTX PLANT <br />J <br />LIFT STATION <br />2 <br />:.f <br />RECEIVED <br />UY <br />-’AYt/Ifc.N I <br />Cz m <br />I- <br />T' <br />■' H htt I <br />o <br />j 1 i I i I N r riY-j <br />DEPARTMENT WSEOI <br />—_______date^ 'ZH | <br />Kl I zn non-refun <br />JOB ABDRESS |U|(Jf ) |y LOW&fa. I <br />WIDTH <br />.PERMIT FINAL^ <br />DATE:41^^02^ <br />AMOUNT <br />REMITTED ________________ <br />35T|> <br />PARCEL SIZE:^ <br />PF.RMIT/SERVICF. REQUEST* T" <br />flO ZJ?57?J <br />©PN <br />s- 7 <br />JCE NOTICE REQUIRED FOR INSPECTIONS -J^KaSE CAL1J209) 468-3423 <br />_____title( <br />J <br />: i : <br />' : : ' <br />i I h j ;loitiu iC.HEAltH SI i1'11!’ <br />r“ ~ V ... <br />t i tt i <br />t ! <br />TYPE OF SEPTIC WORK: <br /> NEW INSTALLATION <br />' I—— <br />. - 44-L.-, LJ i 1.. .( J — 1 n h j yq <br />i • <br />LENGTH OF LINES: 4Q <br />INFLITRATOR CHAMBERS: ^5 <br />s. <br />j. I <br />fl1 <br />■I <br />bi <br />:=S <br />INSTALLATION WILL SERVE: <br /> RESIDENCE <br />ft' COMMERCIAL <br />LIQUID WASTE PERT <br />JOA°UWCE0 WNFTHFRP AVE11" SERVICES ENVIRONMENT AL HEALTH DIVISION <br />304 E. WEBER AVE 3 FLOOR, STOCKTON. CA 95202 (209) 46K-3420 <br />NON-REFUNDABLE PERMIT expires I YEAR FROM DATE ISSUED <br />BUILDING PERMIT lt_ <br />ADDRES*443 N- SceOA <br />PHONE NUMBER61KL C Bob <br />ADDRESS. 4(TO N - IM iLSfiN <br />Ht-i c <br />1 1 ' r' ■ <br />o <br />iah.Y <br />Ix??abea <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION Z ------------------------------ <br />AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />MINIMUM^ HQUR ADVANCI <br />SIGNED: UdJlVL J DijJWAA <br />TOOmmE' 1 ' <br />' H i n <br />iniinl ir.SeAITHSI il,H <br />c z. iNWIONMEnWhlM.I.u <br />EMPLOYEE ID# t W I J DISTRICT <br />ISPECTOR: J,tjL J <br />FOUNDATION 5CH <br />i- ' ’ I ;L■'■■H-'...4 <br />i ! u t! i H ill/ <br />; ■' 1 1 j <br />11. L. • <br />OWNER NAME l/AL Yn ZWCJATgS <br />CITY/ZIP STTO(ZTOnJ 95905__ <br />CONTRACTOR. r> A UAgp- isH < SZVS <br />CITY/ZIP STbckTONJ . z7A 9?) 205 <br />b <br />I