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I � <br /> ONSITE WASTEWATER TREATMENT SYSTEM PERMIT = 'f <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468.9420 <br /> NON-REFUNDABLE PERMIT — CALL_ (209J 953-7697 FOR INSPECTIONS _ _ EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 8000 W.Llnne Rd. <br /> CI7YILv Tracy,CA 95304 <br /> r <br /> =w <br /> _�F n�. In <br /> CROSS STREET APNJ` f1I-��� PARCEL SIZE 1-.5 JAC&5 <br /> OWNER NAME * Y6 / <br /> PNorE _ <br /> gn <br /> OWNER ADDRESS <br /> CIT1'/STATE21P <br /> CONTRACTOR Machado Backhoo.lnc. PHONE 209-634-4836 <br /> CONTRACTOR ADDRESS 22332 W 3rd Ave. CITY/STATE/ZIP St8vinson,CA 95374 <br /> LICENSE L C-42 C-36 OTHER <br /> //A�� NUMBER 732637 EXPIRAnoN DATE 02/2&2019 <br /> WATER TABLE DEPTH: 60 <br /> V ry GEOGRAPWCAL INFORMATION: Coordinates X_ Y <br /> LPERC TEST 0 � BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATNE <br /> _- REPLACEMENT - OUT-0F-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: �I RESIDENCE COMMERCIAL OTHER <br /> NUMBER OF LIVING UNITS: X NUMBER OF BEDROOMS:5 NUMBER OF EMPLOYEES:Na <br /> SEPTIC TANK TvPE/MFI; Concrete/P8L(rUn1:IHIH CA-ACITY 2000 gat D OF CDMPAR-MENTS-�_ <br /> ❑ GREASE TRAP TYPE/MFG CA-A(ITY gal ff OF COMPARTMENTS __ <br /> DISTANCE TO NEAREST: WELL .._. __ tt FOUNDATION —_-__ ft PROPERTY LIN[ _ ry <br /> ❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT Q SAND OIL SEPARATOR(ENCLOSED SYSTEM) 1 <br /> LEACH LINES LEACHING CHAMBERS #Or LINES LENGTH OF LINES I d o ft <br /> DISTANCE TO NEAREST WELI_�Snfi {t r(xINDATION���- It PFtoPF"Rry LINE �Q'r h <br /> O FILTER BED WIDTH ft LENGTH ft DEPTH <br /> DISTANCE To NEAREST WELL it FOUNDATION III PROPERTY I INE_ it <br /> ❑ MOUNDED WIDTH it LENGTH _ ft DEPTH ft <br /> DISTANCE TO NEAREST WELL-__A FOUNDATION ft PROPERTY LINE It <br /> SUMPS WIDTH ft LENGTH ft DEPTH It <br /> 3DISTANCE TO NEAREST WELL ft FOUNDATION _R PROPERTY LINE It <br /> DISPOSAL PONDS WIDTH ft LENGTH It DEPTH It <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br /> ❑ SEEPAGE PITS NUMBER WIDTH _ft DEPTH it U <br /> DISTANCE TO NEAREST WELL It rOUNDATION _ft PROPERTY LINE ry <br /> HEREBY CERTIFY THAT 1 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 /> 1 JIQ NOTICF REQ CTIONS PI EASE CALL 121221 953-762Z <br /> SIGNED <br /> TITLE DATE <br /> 0 <br /> My Co <br /> Cryry <br /> - MFNT <br /> T <br /> Application Accepted By Date Area Employee IDI <br /> Final Inspection By 4S-ti" A'✓Z Date- _ SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 7 Ft: Pit/Sump Soil Character: <br /> COMMENTS <br /> PE Sc Received CheckM/ Amount permit/ ---- <br /> Code INFOCash and Dab Service Request• Invoice a Permit IDS <br /> 4.-01 <br /> 4.14:19 �Gj�(� ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />