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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> EEN JOAWN COUNT(ENVIRONMENTAL HEALTH DEPARTMENT BDD E MAN STREET-STOCKTON CA 35302.(209)E694620 p <br /> NON-REFUNDABLE PERMIT GALL 209 953.7997 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOE ADDRESS 32-57-1 5. He.05'TEIZ (L}?, cmr2er� -RI'T�-�f <br /> CROSBSTREET H w� . -!,-3 _C^4e4z.LV') _- APN_-�S+�� 14_r_^ ZaY _-_ _PARCEL SIZE D (Cc <br /> _ OM'NERNAEE JA✓AF—Q i AT/u -R <br /> JG-ELA LVe"C PHONE 833-r�� <br /> OWNER ADOAFFS D —Fjz`RI 4.wt-r TND�fz-T,.-N� cnrsTAiRaip 'TP-kc <br /> 1j I GA Crook¢ -- <br /> CONTRACTOR N11E OAK G-lrOGN��1ye-ON�' yYY 1 Tei^ PHONE <br /> COIIRACTOA ACOAEce '401 V- O Rr 5`r, dn6TaTFIb. L_O'OI CA CK 7-40 <br /> i <br /> 11DENSE �iC{2 I�CJB QT1ER NUSEER ___ ... E%PEiAT1O1N DAl6 _�� <br /> WATER TABLE DEPTH: R GEDORMXICAL INORR50.TNY1: Cocrdinat" X Y <br /> '( PERC TEST !___ BUILDING PERMITJ/___— __ ____ LANOUSEAPPLICATION#_— <br /> IT PE OF WORK: J REPAIR/AOWROH U ENnNEER DEaarvlD/ALTERNATIVE F, <br /> REAACE/ENT ❑ DesT1uKT <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ CGMMERCWL El OTHER l <br /> NUMBER DE LmNR UNITE: NIH.IER OFB®ROOMS: NIfI.6E11 OFEMBLwEFF: <br /> ❑ SEPTIC TANK TYPEIMFG <br /> ❑ OREASETRAP TV MF, CAP Iry 0&I AOF CoI.IceRTur-urs_______ <br /> NsTANCEPONEAREsr Weu X `clR1cA`ltklR PFoPERTYLIK <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PIES TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> p <br /> ❑ LEACH LINES ❑ t.EACHING CNAM6ERS AOF 4F4s LENGTH OF LINES It <br /> DNTANCETONEAREST wEu ft FoLNMTION ft PROPERTYLVE_-- ___R IV ) <br /> ❑ FILTER SED Wsm..—_..__._____._R LENGTH R DE-PTsl__—_ <br /> DISTANCE TO NEJiREET WtIL _11 4CtNDAICb ORWERTY LME_________R <br /> ❑ MOUNDED W,m R iENarH R DEPTH R <br /> DITANCE TO NEAREST WELLit MUNDATpN ___R PRCPERII'LN£ it <br /> ❑ SUMPS WOTH_______R LENGTH ft DEPTH___-----_—__IL <br /> Dm-NCE w NEAREST VRLL__.._--,.... R FGIMDADGN R PRGPERtt tEF _-.. __-it lO <br /> ❑ OISPOSALPONDS WmA __. R L(JIGTN ft DEPTH_ <br /> DI9TANCET6 NFlAEAT WCLL_____1l fOLNDn kIN _ R PkIIPERTYLMIEII I '� <br /> ❑ SEEPAGE PITS N.M Wmx ft DEPrH_. _. _ it <br /> DSTANCl TONEARESi HELL R FiUNUATK1u _._R P.CHTY LNE_—_—___R <br /> i HERESY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WLL BE DOME IN ACCORHANCE WTH SAN IOAQUIM COUNTY ORDINANCES, <br /> 89APE LALW AND RULEBAMD RFOULATIONB OF AM9I JOAOLIN COUNT'. <br /> INIMU HOUR ADVANCE W LICE REQUIRED FOR INSPECOON$-PLEAS,CALL 149)"a,7697 <br /> &GNED TIRE cRIJS V1-TtcFJT DATE <br /> I I <br /> I <br /> I <br /> I I I <br /> I <br /> PAYMENT <br /> RECEIVED <br /> NOV 3 0. <br /> I I I ! I I I I I <br /> It <br /> I , <br /> F <br /> DEPARTY.FNT I tSW <br /> ^^11ONLY f <br /> App9calbn Accepted By = Dale__ ,;,.*L � Area Ala <br /> Employee IDA <br /> ___— l <br /> Flnailmpectlon BY___..--- --- — DaM__ ___ ❑ SPECT LPERMR-Apprwad by <br /> CRre w Of Soll to DePN N 3 FI, PR/SUmP w Cheracr : <br /> COMMENTS <br /> 1r PE sC RaRelvAd CTna ArmwRPRrmW <br /> 1 Coded B k RtM Date-- I R rt! Invela■ PsrmttlD! <br /> �Z�� 11 1/.�l�llR.UO L�17 �i r� <br /> I _ <br /> 41L1 ONBREWASTEWATERTRTMNT SYSTEM PERMIT i- <br /> ;, R <br />