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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-WO <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 2288&2696 N.Murray Road CITy/LP Linden/95236 <br /> CROSS STREET Highway 26 APN 105-100-20,21 PARCEL SIZE 156 Ac. <br /> t7 <br /> OWNER NAME Michael Machado PHONE(209)601-5277 <br /> OWNER ADDRESS P.O.Box 555 CITY/STATE/ZIP Linden/CA/95236 <br /> CONTRACTOR Dillon&Murphy PHONE(209)334-664 <br /> CONTRACTOR ADDRESS P.O.BOX 2180 CIN/STATEZP Lodi/CA/95241 <br /> LICENSE ❑_C-42 ❑_.C36 OTHER NUMBER EXPIRATION DATE <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> PERC TEST #I BUILDING PERMIT# LAND USE APPLICATION#PA 1W0009 <br /> TYPE OF WORK: NEW INSTALLATION REPAR/ADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF.SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMERCIAL ❑ 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 /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ FILTER BED WIDTH it LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH It LENGTH ft DEPTH A <br /> DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE ✓�r -�,�NT <br /> ❑ SUMPS WIDTH It LENGTH ft DEPTH ft V �D <br /> DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH 39 ^ A <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE 47019 <br /> 7 O,Y <br /> El SEEPAGE PITS NUMBER WIDTH ft DEPTH R Qo)v c "`/// <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft N aM�C'LrUv <br /> I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES.�1 c I_v{` <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. 'nFIyT <br /> UM 48 lij2URADVANCE D FOR INSPECTIONS.PLEA 953-7697 G <br /> SIGNED TITLE Party Chief DATE <br /> i <br /> DEPARTMENT USE ONLY <br /> Application Accepted By Date 1 Area G Employee ID# <br /> Final Inspection By Data ❑ S IAL PERMIT-Approved by <br /> Character of Soil to pth of 33 F� PINSump Sol[Character. <br /> COMMENTr4I°rCr-e- �; 7 <br /> 11- <br /> Q 0-',1 !!t C <br /> PE SC Received Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO B Ca Remitted Service Request# <br /> Z d �Zi q <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />