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■M 10-08 1:99 PM (PDT) TO: +1 209-969-0138 From: +1 209-869-3877 Page 1 <br /> ■ , ''� ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> ® SAN JOAQUIN COUNTY ENYiRONL1:ENTAL HEALTH DEPARTMENT 1868 East Hazelton AVonue-STOCKTON CA 98206-6232-(209)46$-3420 <br /> IF <br /> ■ NON-REFUNDABLE PERMIT <:AG£ c�EXPIRES 1 YEAR FROM DATE ISSUED <br /> ■ JOB ADDREsO <br /> \� <br /> CROSS,$TREET V - r APN %- ✓ PARCEL SIZE T�. c <br /> OWNER.NAME <br /> Mas F� <br /> OpR£S3 ♦'9 7 CITYISTATEfZIp <br /> OWNER AQ <br /> CONTRACTOR �•1�� 3' _PHOIJE— �n <br /> . rill NC <br /> CONTRAC7DR ADDRESS Y� -Q � CITYISTATPIZIP ��'✓��►`� <br /> LICENSE C-4.2 ,:C-36 OTHER NUMSER� +E$i�1RATiON DATE !� 1 <br /> ___----------............................ ..._... .. - <br /> WATER TABLE DEPTH: v _It GEOGRAPHICAL INFORMATION: COOtdI041,05 X Y �/ <br /> PERC TEST #___—�—__ L8UILDING PERMIT#__ LAND USE APPLICATION# - �• <br /> TYPE OF WORK: .. NEWINSTALLATION REPAIRIAODITiom .. ENGINEER DESIGNED TA—LTE RNATME <br /> REPLACEMENT _•_ DESTRUCTION OE vpt% <br /> i INSTALLATION WILL SERVE: h RE510FJVCE COMMERCIAL OTHER. <br /> -------------- .............. <br /> NUMBER OF BECROQNIS: :� NUMBER- ,,,,,....qe,NUMBER OF LIVING UNITS: ` OF EFINLOYEES: /T O 9 018 <br /> Q SEPTIC TANK TYPEIMFG CAPACITY�— — gal #OFCOMPARTMCNTS'/AQUI E <br /> EI GREASETRAP TYPe1MFG CAPACITY gal #OF COMPARTNIENT C+ N <br /> 41 <br /> DISTANCE TO NEAREST: WELL fl FOUNDA'fIQIJ.•___—••_--_____ ft' PROPERTY LINE D pM N TM <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP, D PKGTXPLANT D SAND OIL SEPARATOR(ENCLOSEDSYSTEM) <br /> NT <br /> '5L LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINeS <br /> vrf�-�tJ <br /> DISTANCE TO NEAREST WELL tt' FOUNDATION �.Q _ft PROPERTY LINET .�k fl <br /> ❑ FILTER BED WIDTH _It LENGTH — It DEPTH 11 J <br /> DISTANCE70 NEAREST Wr:'I•L 11 FOUNDATION _ ...................It PROPCRTY UNE <br /> ❑ MOUNDED WIDTH LENGTH' _R DEPTH __ _ _ft <br /> / 0.DISTANCE TO NEAREST WELL. ft FOUNDATION—_ H PROPERTY L!Nl5 <br /> LTL $t)t•9P�tM1lflMlLl y - _ N.1 .. n.,...H 1 fi <br /> Ot.^,TANCCTo Nr:M&ST VVELI, _ - _ ft <br /> ❑ DISPOSAL PONDS WIDTH <br /> R LENGTH -----' tT DEPTH.— :. <br /> DISTANCE TO NEAREST WELL. It FOUNVAT:ON N PROPERTY.LINIF h I <br /> ❑ SEEPAGE PITS NUMBER WIDTH It DEPTH. C !f <br /> DISTANCE TU NEAREST WELL R FOUN,DAT:ON R FRW'EHrY UW I! j <br /> ,,.•............. .... ........ E <br /> I HEREBY CERTIFY TH T I HAVE PREPARED THIP APPLICATION AND THE WORK PALL BE DONE:N ACCORDANCE VOTH SAN JOAQUIN COUNTY ORDINANCES, 4� <br /> 9TATq LAWS AND RULES AND REOULA710N$OF SAN JOAQUIN COUNTY. <br /> 1 -^ <br /> SIGNED / / � � TITLE _ ^ L•,:�.• DATE '�J <br /> -r--•T•---•_' <br /> r- _.. <br /> i <br /> I , I i- <br /> � -,.. .... .. .. PPPPPP ._ <br /> 1 <br /> R <br /> WWI <br /> ______ _ ___ <br /> _ <br /> rr <br /> EW _ ' x 1'( <br /> PE — <br /> i <br /> - I <br /> NIS <br /> 1 <br /> Application Accepted. ato a�. Area Employee Ipi <br /> Final Inspoction By, _ ll'VIITt� _ ______ Data O t SFE IAL PERMIT.-/ipp'roved ty <br /> Character of <br /> J of Soil to hof 3 Ft: PIV5' m Soil Cneracter: <br /> COMMENTS <br /> C/ -G� -- — <br /> AjPE SC Receival Che kill Alnuunt Date JIIU IriyoiceJi PermiLlD# <br /> Code INFO: ByCash Romitted ServiceRequest$1 _ _ <br /> -..... <br /> a�-Ot Cwt• 9360 7'�7 ONS'TE WASTEWATER TRTMIJT SYSTEMPERR4IT <br /> Received Time Oct, 8. 2018 1 :49PM No. 4242 <br />