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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 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 5700 E.Nile Road CITY/ZIP Manteca,CA 95337 :n <br /> -1 <br /> !n <br /> CROSS STREET Union Road APN 22607003 PARCEL SIZE 15.3 D <br /> c <br /> e <br /> OWNER NAME Manteca Unified School District-Contact:Justin Geer,Constr./Energy Technician PHONE Cell:209.456.0295 <br /> OWNER ADDRESS 2271 W.Louise Avenue(Mailing:P.O.Box 32) CITY/STATE/ZIP Manteca,CA 95337 <br /> CONTRACTOR PHONE 2-0 D/ r T�1 o <br /> I <br /> 0 <br /> m <br /> CONTRACTOR ADDRESS P CITY/STATE/ZIP ^ Z <br /> LICENSE EXPIRATION DATE <br /> C-42 I C-36 OTHER ,i- NUMBER L i• 0 <br /> Ir <br /> 229) <br /> w <br /> a <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> w <br /> F1 PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# �^ <br /> TYPE OF WORK: NEW INSTALLATION REPAIRIADDITION ENGINEER DESIGNED/ALTERNATIVE f <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION Y <br /> INSTALLATION WILL SERVE: I RESIDENCE II COMMERCIAL X,OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP ❑ PKGTXPLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) A <br /> L3 LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES T YIyF <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ■/�`'/� NT <br /> ❑ FILTER BED WIDTH ft LENGTH ft DEPTH �/�,�j►®• <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE G <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH (� 2019 <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE (�ft <br /> C3 SUMPS WIDTH ft LENGTH ft DEPTH �O,q <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE j?'�UIN�O(/N�, <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH H �VT,q� <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE It gRTMFNT <br /> ❑ SEEPAGE PITS NUMBER WIDTH It DEPTH It <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> I HEREBY CEREZ8 <br /> T 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STAT LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> N/ 1NSUCTJONS-PLEAFE CALL(209) <br /> SIGNED TITLE DATE <br /> r" <br /> EPARTMENTUSE jONLY <br /> Application Accepted By A <br /> Date Area ee ID#�� <br /> Final Inspection By Date SP CIAL PERMIT-Approved by <br /> Character of Soil to It 3 Ft: Y IV 41 PiVSump Soil Character: <br /> COMMENTS <br /> PE Received Che Amount Permit/ ^� <br /> Code INFO ash Remitted Date Service Request It Invoice# Permit ID# 't <br /> �r M,A! 'h <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMITl <br /> 4/14/18 777 <br />