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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SMA JOAGUIN COUNTY ENVIRONNENTAL HEALTH DEPARTMENT 1868E.HAIELTDN AVENUE-STOCKTON CA 95205-)209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697FOR INSPECTIONS XPIRES 1 YEAR FROM`DATE ISSUED <br /> JOB ADDRESS I J^906 CG fh C0 inafty _''QQ 11CITYZP \ Sl yy <br /> CROSS STREET //SOI D p1AY.I f i CA APN 7-"�`�L 0%,15 _ PARCEL SUE 11, g p <br /> OWNERNAME i]iIIY�CIr1CAr CfANq �p PHONE <br /> OWNERAODRESS _ �/1R'�ECOYAQ;1UtX Cm/STATEMP I`IAIV/'CA <br /> CONTRACTOR SUN(/AU A 5¢4JJAS, /� PHONE��609010 / pT <br /> CONmAum ADD11Ess 3319` .s '�A AAY 1 �� l cm/STATF/nP '�ur�cyll�C 9S 3tl V <br /> LICENSE DOC-42 00C-36 OTHER A NUMBER/�LL__-3= 1 L I IEXPIRATIONDATE <br /> WATER TABLE DEPTH: D GEOGIL"MCALINFORMATION: CDordinetw X Y <br /> ❑ PERC TEST i BUILDING PERMIT M YD LAND USE APPLICATION S <br /> TYPEOFWORK: NEW INSTALLATION C REPAIR/ADDITION II ENGINEER DESIGNED/ALTERNATNE <br /> ❑ REPLACEMENT h OUT-0F-SERVICE SEPTIC SYSTEM Ll DESTRUCTION <br /> INSTALLATION WI LL SERVE: ❑ RESIDENCE COMMERcuL ❑ OTHER <br /> NUMBEROFLNINGUNns; NIAIBERO EDROOMS' NUMBEROFEMPLOYEES' <br /> SEPTICTANK TVPE/MFG 2A46 P..L, CAPACITY '7000 <br /> GREASETRAP TYPVNIFG CAPACITY gal COMPARTMER MOF NTS <br /> _... gel OF COMPARTMENTS— <br /> DwTANCE TO NEAREST: WELL it FOUNDATION R PROPERTY LINE R <br /> O LIFT STATION SIZE TYPE OF PUMP O PKGTXPLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES ❑ LEACHING CHAMBERS AOf LINES LENGTH OF LINES It SII <br /> DISTM'PE TO NEAREST WELL_R FOUNDATION K PROPPERTYLINE II <br /> FILTER BED WIDTH it LEN fl DEPTH id It R <br /> DIRT EMEST WELL K FOUNDATION It PROPERTYUNE R <br /> ❑ MOUNDED WIM" N LSNG'fH R DEPTH X <br /> DISTANCE TO NEAREST WELL It FOUNDATION R PROPEBTYUNE it <br /> ❑ SUMPS WIDTH it LENGTH R DEPTH /t <br /> DISTANCETONEMEST WELL _ It FOUNDATION It PROPERTY LINE K <br /> ❑ DISPOSAL PONDS WIDTH R LENGTH R DEPTH A <br /> DKITANCETONEAREST WELL R RXJNDAT10N R PROPERTYLINE it <br /> ❑ SEEPAGE PITS NUMBER WIDTH R DEPTH N <br /> DISTANCE TO NEAREST WELL it FOUNDATI(RI it PROPERTY LINE R <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDMCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SM JOAQUIN COUNTY, <br /> MINIMUM 24 H UR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)9.53-769 <br /> SIGNED TITLE O(AAA/CY TE bTJJ'/ <br /> __ d _ wii+ceit� O <br /> m <br /> C= <br /> .a Mase' IT <br /> * Oro O <br /> n9 � <br /> 8 <br /> O <br /> v wnrva'�°` IT <br /> 14 <br /> „,a=Pe�e9 <br /> NTY <br /> ern„ c�rz K <br /> -- <br /> •"•••. 'n' amwc arz <br /> uxosuFc I mvnw PMnxn.nr. <br /> v uL <br /> ssnrc TUYI <br /> e ® a 5 <br /> b <br /> it,vin`pc 'caaucTcconMvrr .i0 �pO NLa/x tloWO,wG <br /> 00IIIIIIIIIA111100 Oil Aet! Pled Y F �+�� -- ate -L ��.�. IJ_ Area , 3,)44 EmploywlDX_I,""' -=�L A <br /> Final lnspectlon BY Data ❑ SPECIAL PERMIT-APpmveCDy <br /> Character of Soil to Depth of 3 Ft: It/Sump Soil Cherecter: <br /> COMMENTS <br /> IO la jfp ' <br /> oa <br /> E Sc Recelved eck4/ Amount PermlU Ac• <br /> Data Invokes '- "A DA <br /> Code IXFo B s Remitted Serviq R wet A <br /> 11 b s� y-P <br /> 4291 ONSITE WASTEWATER TRTMPM'PERMIT <br /> 42112 <br />