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ONSITE WAQ--T WATER TREATMENT SYS'M PERMIT <br /> SAN JOAQUIN COUNTY ENYIR(IIYMI.N IAl.HF.AI.f)1i1AIIfAR'I'MENT 304 E WEBE01f'-3rr FL-STOCKTON CA 95202 - (209)468-3420 <br /> !t <br /> NON-Rk.FUNDABLE PERIiI'iCALL 209 953-7697-FOR INSPECTIONS EXPIRES I YEAR FROM DATE ISSUED <br /> JOBADDRFLSs �� CITY/ZIP <br /> p 1� _ � <br /> CROSS S'1'RI'.Er �S%/ /� /� APN 2-z_.K- /3U - Z. >' / C. 2- > <br /> /u PARCEL SIZE C. <br /> a 0 <br /> A <br /> OWNER NAaI!'. �'X� r � C rAJ�" PHONE <br /> N <br /> OWNER ADDRESS /STATE/ZIP <br /> CONTRACTOR �`- ✓ EY % '- PHONE <br /> CONTRACTOR ADDRESS CITY/STATF:/ZIP <br /> LICENSE C42 ❑C-36 OTHER NUMBER EXPIRATION DATE <br /> WATER TABLE DEm it: I) GEOCRAPHHIALINFORMATION! Coordinates X Y <br /> ❑ PERC TEST # BUILDINGPERMIT# i'l�d'-c'V C%�2f jj LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION ❑ REPAIR/ADDITION ❑ ENGINEER DESIGNED/ALTERNATIVE <br /> ❑ REPLACEMENT ❑ DESTRUCTION <br /> INSTALLATION WILL SERVE: RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPEIMFG2,4�- CAPACITY gat #OF COMPARTMENTS <br /> ❑ CREASE TRAP TYPE/MFG CAPACITY gal #OFCOMPARTMENTS <br /> ❑ PKC TX PLANT DISTANCE TO NEAREST: WELL fl FOUNDATION it PROPERTY LME it <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) \ 1 <br /> LEACH LINES ❑ LEACHING CHAMBERS #OF LINES LENGTH OF LINES /AU J ft U <br /> DISTANCETO NEAREST WELL R FOUNDATION ft PROPERTY LINE I, <br /> V <br /> ❑ FILTER BED WIDTH fl LENGTH R DEPTH ft <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY LINE 0 V1 li <br /> ❑ MOUNDED WIDTH ft LENGTH it DEPTH- R V <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft t,',_ <br /> ❑ SUMPS WIDTH b0A. R LENGTH r''�C L� ft DEPTH k&k-Fz--- ft <br /> DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY LINE ft ter. <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION 11 PROPERTY LINE it IIf <br /> ❑ SEEPAGE PITS NUMBER wlDnl R DEPTH it <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE fl <br /> I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINANCES,STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MI M1111 24 HO R ADVANCE NOTICE REQUIRED FOR INSPECIIONS-PLEASE CALL(209)953-7697 <br /> SIGNED _ _ -_ t_ �..:E`- -- DATE <br /> FT I T , I C <br /> 1 ayl. t ft) <br /> 81 r <br /> 1 .. <br /> t <br /> n•' <br /> O} <br /> m <br /> 1 <br /> S N <br /> T O <br /> �C_� (//•/ DEPARTMk;NI' ISEO LV /� y <br /> Application Acceplyd `-l`•_ "�- Date Y xu I)S Area Employee ID# <br /> Final Inspection Dale 13SPECIAL PERMIT-Approved by <br /> Character of Sail to Del) of 3 FI: Pit/Sum Soil Character. <br /> COMMENTS rc-1 r f r '. rr r' r) �_['_ - 7 - /8_7 <br /> i'I. SI rcdA rd ` 1 Art U'�7� %...M Permit/Permit/ <br /> RIncaiceB - — Permit IM <br /> lode _INn _ it%/ t-nl� R+mnad %c,,kee/RMti�la <br /> 1 . ,1 <br /> ONsirF 'A is IF W ArFM Pr SallI <br /> 1• <br />