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:g 27 18, 03:45p River Rats Septic 9167762736 p.1 <br /> :' 1 <br /> ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNT'ENVHNONmENTAL HEALTH DEPARTMENT 1868 E.HAzELToN AVENUE-STOCKTON CA 95205-(209)488-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FAR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> Joe AoORFss CITYIMP o1- ti <br /> CROSS STREETAja w APN/] • PARCIELLSIZE <br /> M L c <br /> OWNER NAME EX\J I {yI �1�\ \� `� h *1 114C_ fw� PHONE lift <br /> OWNERAMRESS ��.+.��`- S C_, ;> �` CITYYIS-TATE/Z1P <br /> CONTRACTORv.', <br /> ME <br /> ''^^ / <br /> CONTRACTOR ADDRESS A U' CITY/STATEMP QV 5 Y > <br /> LICENSE r-C-42 `_C-6 OTHER NUMBER 44EXPIRAl10N DATE a <br /> WATER TABLE DEPTH: I It GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> C PERC TEST # BUILDING PERMIT* LAND USE APP'UCA-nON# <br /> TYPE OF VVORIC :J NEW INSTALLATION .�. �. 7 WPAiR/ADDITION J ENGINEER DESI <br /> REPLACEMENT t''_(:•it� lAfif,Tl OUT-OF.SERVICESEPTICSY3TEN DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMEK IAL rf OTHER <br /> NUMBER OF LMNG UNITS: NUNSER OF BEDROOMS: +� NUMBER OF EMPLoyam <br /> _i <br /> SEPTIC TANK TYPE/N1FG Oil {`L`% CAPACITY I T=�C' gal #OF COMPARTNENTS—,12 _-_ <br /> ❑ GREASETRAP TYPEAAFG CAPACITY gal #OFCOMPARTMENTS <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LIRE h <br /> ❑ Ll FT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES I- LEACHING CHAMBERS #OF LINES LENGTH OF LINES h <br /> DISTANCE TO NEAREST WELL �.Z�� it FOUNDATbN it PROPERTY UNE Yb.. <br /> r. <br /> ❑ FILTER BED WIDTH ft LENGTH it DEPTH fl <br /> DISTANCE TO NEAREST WELL ft FOUNDATION it PROPERTYLINE fl <br /> ❑ MOUNDED WIDTH ft LENGTH h DEPTH fl <br /> DISTANCE TO NEAREST WELL ft FOUNDATION it PROPERT'LWE fl <br /> ❑ SUMPS WIDTH ft LENGTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL_ft FOUNDATION n PROPERTY LINE fl <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH fl <br /> DISTANCE TO NEAREST WELL ft FOUNDATION fl PROPERTY LINE fl <br /> ❑ SEEPAGE PITS Numnut WIDTH it DEPTH fl. <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTYLINE ft <br /> I i I[REUY CERTIFY THAT 1 HAVE PREPARED THISAPPUCATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAOUIN COUNTY ORDINANCES. <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM Q UR ADVANCE NOTICE REQUIRED FQR INSPECTIONS-PLEASE CALL 1209)Xp9]53-7697 <br /> SIGNED TITLE V�- Cit - DATE <br /> YMENT <br /> CEIVE® <br /> y r <br /> . I <br /> I i1' I N 18 2018 <br /> ► cTUIN COUNTY <br /> 41IONMENTAL <br /> DEPARTMENT <br /> 1 <br /> YkIC 41 <br /> ` I <br /> L L\t'\Al.—IC DI A E O <br /> Application Accepted By Date Area Employee IDS <br /> il <br /> Final Inspection ByDate C SPC L PERMIT-Approved by <br /> Character Of Soil of F: Pit/Sump Soil Ch Iter: <br /> COMMENTS a <br /> S <br /> PE Sc Recelved Check/f! Amount Penni <br /> Code INFO B Cash emitted Date ServiceR uest# Invoice# PertnitlDfC <br /> Q 150., S <br /> 42-019 <br /> l 31 <br /> /Zb' g v ��1/r l ©I 'Cr- f�A <br /> �^IS4EWAT2.T SY M PERMIT <br /> fd +` 60- av <br /> Received Time Aug. 27. 2018 3:40PM No- 4046 � <br />