Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> .. SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 18U E.HAZELTON AVENUE-STOCKTON CA 95205.(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS CITY/ZIP l/Y l+�Gpv Q f �^ L• n r �!3 -n��l -a9 —�1 <br /> CROSS STREET APN PARCEL SIZE 0 Y <br /> OWNER NAME Lam`CZI <br /> OWNER ADDRESS >,AL'1^- CITY/STATE/ZIP <br /> CONTRACTOR i�CitL•4d7iT HONE L�7'7 ��✓� '�[�7 <br /> CONTRACTOR ADDRESS (l CITY/STATEIZIP <br /> n <br /> LICENSE U C-42 U C-36 OTHER NUMBER L7 r GEXPIRATION DATE <br /> WATER TABLE DEPTH: it GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> C PERC TEST al BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION EPAIR/ADDITKN4 ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: RESIDENCE L COMMERCIAL L OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> O SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> O GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL ft FOUNDATION it PROPERTY LINE R <br /> O LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES <br /> DISTANCE TO NEAREST WELL Z,)Lj it FOUNDATION In it PROPERTY LINE S� a- it <br /> O FILTER BED WIDTH ft LENGTH it DEPTH <br /> DISTANCE To NEAREST WELL it FOUNDATION R PROPERTY LINE <br /> O MOUNDED WIDTH ft LENGTH it DEPTH it y �D <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE10 <br /> O SUMPS WIDTH ft LENGTH ft DEPTH <br /> DISTANCE TO NEAREST WELL it FOUNDATION R PROPERTY LINE SA U <br /> O DISPOSAL PONDS WIDTH ft LENGTH it DEPTH VIN <br /> DISTANCE TO NEAREST WELL it FOUNDATION it PROPERTY LINE C^A,- SC OU T' <br /> JK SEEPAGE PITS NUMBER WIDTH J f ft DEPTH y�. ' EPq�NTAL ,T <br /> DISTANCE TO NEAREST WELL��,/j.�(1�� it FOUNDATION " y R PROPERTY LINE n MENr <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 /> SIGNED �i TITLE L f! - DATE l2 <br /> rAI <br /> PARTMENT NLY ��/� �/� <br /> Application Accepted y Dete Area Employee ID# <br /> Final Inspection By Date ❑ $PE L PE MIT-Approved by <br /> Character of Soil to Depth of 3 Ft: PKISUMP Soil Character: <br /> COMMENTS <br /> PE SC Received Cho Amount permit/ode INFO ash emitted Date Service Request# Invoice# Permit ID# <br /> zS PD&3 350 <br /> 42-01 ONSME WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/i8 <br />