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n I <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT 't" <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 4683420 <br />NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS <br />Jos ADDRESS 22330 East Milton Road CIT,Zp Linden/95236 <br />DATE ISSUEI <br />CROSS STREET Fine Road APN 093-040-19 PARCEL SIZE 5 Acres <br />OWNER NAME Dan Cardoza D 2f-! PHONE 209-606-8310 <br />OWNER ADDRESS 22330 Milton Road CITY/STATE/LIP Linden/CA/95236 <br />CONTRACTOR Dillon & Murphy PHONE 209-334-6613 <br />CONTRACTOR ADDRESS P.O.BO%2180 CrTY/STATE21P Lodi/CA/95241 <br />LICENSE ❑ C42 E C36 OTHER NUMBER EXPIRATION DATE <br />O LEACH LINES <br />L f 4 <br /># OF LINES <br />WATER TABLE DEPTH: <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />Y <br />rk PERC TEST # 2 <br />BiIILDING PERMIT # <br />LAND USE APPLICATION #PA 1800065 <br />TYPE OF WORK: <br />NEW INSTALLATION <br />REPAIR/ADDITION <br />ENGINEER DESIGNED /ALTERNATIVE <br />_ REPLACEMENT _ <br />OUT -OF -SERVICE SEPTIC SYSTEM <br />DESTRUCTION <br />INSTALLATION WILL SERVE: ❑ RESIDENCE <br />❑ COMMERCIAL <br />❑ OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES:— <br />Q SEPTIC TANK <br />TYPE/MFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />O GREASE TRAP <br />TYPE/MFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />WELL <br />DISTANCE To NEAREST: WELL <br />ft FOUNDATION <br />ft PROPERTY LINE it <br />O LIFT STATION <br />SIZE TYPE OF PUMP <br />O PKG TX PLANT O <br />SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />O LEACH LINES <br />i LEACHING CHAMBERS <br /># OF LINES <br />LENGTH OF LINES _ <br />DISTANCE TO NEAREST <br />WELL <br />R FOUNDATION <br />ft PROPERTY LINE <br />O FILTER BED <br />WIDTH <br />ft LENGTH <br />ft <br />DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION <br />ft PROPERTY LINE <br />O MOUNDED <br />WIDTH <br />ft LENGTH <br />It <br />DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION <br />ft PROPERTY LINE <br />O SUMPS <br />WIDTH <br />ft LENGTH <br />ft <br />DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />R FOUNDATION <br />ft PROPERTY LINE <br />O DISPOSAL PONDS WIDTH <br />ft LENGTH <br />ft <br />DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION <br />ft PROPERTY LINE <br />O SEEPAGE PITS <br />NUMBER <br />WIDTH <br />It DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION <br />ft PROPERTY LINE <br />1 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 />MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />ft <br />ft <br />ft <br />It <br />ft <br />It <br />It <br />ft <br />ft <br />It <br />ft <br />It <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18 <br />it <br />P <br />