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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNry ENNRONMENTLL HNT,DE,ARNIg{ 600EMWx STREET-STOCKTONCA95202- <br /> NON-REFUNDABLE PERMIT (209)6694QD <br /> CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> Joe ADORess x/•1.1'+1 E.• LONE TREE P-D cnrmPMRNTEGA <br /> CNONSSTREET JN TONG APN Z03-OSO-ID P �-O �• <br /> g ELSIa e <br /> OWNER NAME_ FF�•T —EVAN 4 Pnoxe 9�A�2,.— E} q <br /> oV/NER AOOREu I, I'}(o .0 -V a9JE fc-0 - cI1 wATEmP MANTLCyT GA 9S33(, <br /> CONTRACTOR_LIJr. OAK. PHONE 31179-03}S <br /> CONTRACTOR ADDRESS d4o )- W- OAlcL ST CRYBTATEMP "ODl, GA 4?5'2W-0 <br /> LICENSE 0"2 QC46 OTHER NUMBER EOPIRATONDATE <br /> WATERTABLF DMmI: ft GEOGRAPNICALINFORauTrox: COOrdI HN, X <br /> PERC TEST R I Y <br /> BUILDING PERMIT# LAND USE APPLICATION IF <br /> TYPE OF WORK: ❑ NNwlxs...... ❑ R,,pmw"=Ox <br /> ❑ <br /> ❑ RepLaci ME <br /> NTI ENWNEER DESIGNED/ALTFIINAINE <br /> ❑ DESTINIDTON <br /> INSTANUMMN WILLSENYE: ❑ RE81pENCe ❑ <br /> NUMBEAOF LJTING UNffS: CommgnCIAL ❑ DINER <br /> NUMBER OF BEDROOMS• NUMBER OF ENPLOTEEE: <br /> ❑ SEPTIC TANK TYPF/MFc <br /> ❑ G CAPACIIV gal #OF COMPARTMFM$ <br /> REAgE TRAP TYPE/MFG CAPAOfry gal #OF❑OMPARTMENTe <br /> OWANCE TO NEAREST; WELL R FOUNDATION R #OFCOTTLINE <br /> O LIFTSTATION SM ft <br /> TYPE OF PUMP D PKGTXPIANT Q SANDOILSEPNLLTOR(ENCLOSEDSYSTESO <br /> ❑ LEACH LINES ❑ LEACHING CHAMBERS #oFL.INEs <br /> LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELLft FOUNDATION R PROPERTY UNE <br /> ❑ FILTER BED Wmrn ft LENGTH ft <br /> DwaNCE m NEARESTwELL R DE ft <br /> ❑ MOUNDED ft FWNDATION R PROPERTY LINE <br /> WYlln R LENGTH ft <br /> DISTANCE To NFMEST R PTH R <br /> ❑ SUMPS fl FWNDAnon <br /> DE <br /> WIpTn I, R PROPERTY LINE R <br /> R LENGTH R DEPrH R <br /> DLaq, TO NEAREST WELL R FOJNDAnON <br /> ❑ DISPOSAL PONDS WmmR PROPERTYUNE ft <br /> ft LENGTX <br /> Dft De:TH ft <br /> BTANOE TO NEARE4r WELL R FOUNOATON R PROPELINER <br /> ❑ SEEPAGE PRS N,rgFR Wft <br /> W. <br /> ft DEPT <br /> DISTµCETO NEAREST WELL R FWNWTON R PROPERTYLINE R <br /> IHEREBT CERTIFY R <br /> THATI HAVE PREPAREDTHISAND N AND THEWORK WILL BE DONE IN ACCORDANCE DARDI <br /> N SAN JOAQUIN COUNTY ORNANCES. <br /> STATE LAWSS AND RULES AND REGULATONS OF SAN JOAQUIN COUNTY. <br /> mer' <br /> SIGNED M IMU R ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 <br /> TITLE_ CANSVLTAn/r DATES- <br /> I <br /> I <br /> I <br /> I <br /> ®,1 ZJW <br /> uj ON U 2 Q <br /> K UU <br /> , I � W N SOW <br /> CLU <br /> Lu TD a¢x <br /> = <br /> a M ¢ ' <br /> Z U.1 <br /> Q <br /> e,� r[�M ��• W <br /> fid` --L —ISM[ • TRfF NOW 99 b8 <br /> APPROarlon AOCepME By .-� DEPARTMENT USE ONLY 0� nn(, -T <br /> Flnal llnpecdon BY , Dale S-L k-I Area 51"!/--a <br /> m Employee IDk 1 <br /> CRaaeteroTSoil TODepDIOT6Ft Date O SPECIAL PERMIT-Approved by <br /> COMMENTS PltlSumP SON Character: <br /> PE Code INFO ROCeWed ChecloV Amount Permit/ <br /> B Cah RemMad OaM Service Re ,Nati Invoice* Permft ION <br /> e2cT <br /> IW"7 ONSITE WASTEWATER TRTMNT SYSTEM PERMR <br />