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r 4 ONSITE ` STEWATER TREATMENT SYSTEM 'RMIT SAN JOAQUIN COUNTY ENVIRONMENTAL FhwaCIH DEPARTMENT 304E WEBER AVE-3',. _-STOCKTON CA 95202 - (209)468-3420 NON-REFUNDABLE PER IT �/t CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED JOB ADDRESS I ,1 NI L ACITY/ZIP vVl,qM [i� CROSS STREET W�S L APN �( 0-�� PARCEL SIZE OWNER NAME V'"V I t—S •'`r�/W`"�^ PHONE OWNERADDRESS / .. / CITVISTATE/ZIP CONTRACTOR F �'--U C) I✓p ✓ V PHONE 1 v�� j CONTRACTOR ADDRESS Crl'Y/STATE/ZEP LICENSE ❑C-42 ❑C-36 OTHER NUMBER EXPIRATION DATE WATER TABLE DEPTH: -fl GEOGRAPHICAL INFORMATION: Coordinates i ❑ PERC TEST #! BUILDING PERMIT# LAND USE APPLICATION# TYPE OF WORK: 13 NEW INSTALLATION ❑ REPAIR#ADDITION f.krtNGINEER DESIGNED/ALTERNATIVE j O REPLACEMENT ❑ DESTRUCTION INSTALLATION WILL SERVE: ElRESIDENCE COMMERCIAL. ❑ OTHER --� NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: L NUMBER OF EMPLOYEES: • 7�J P O O U��O O gal #OF COMPARTMENTS L7 SEPTIC TANK TYPE./MFG CAPACITY ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS t ❑ PKG TX PLANT DISTANCETO NEAREST: WELL R FOUNDATION R PROPERTY LINE fl lv ❑ LIFT STATION SIZE TYPE OF PUMP -QuA _ ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) in ❑ LEACH LINES ❑ LEACHING CHAMBERS #OF LINES LENGTH OF LINES R DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY LINE U FILTER BED WIDTH a I fl LENGTH "-I ft DEPTH /A fi � ft DISTANCE TO NEAREST WELL 100 ft FOUNDATION fl PROPERTY LINE R It Ell MOUNDED WIDTH ft LENGTH A DEPTH _ I DISTANCE TO NEAREST WELT, R FOUNDATION R PROPERTY LINE fl ❑ SUMPS WIDTH ft LENGTH R DEPTH R DISTANCE TO NEAREST WELL_ ft FOUNDATION R PROPERTY LINE R ❑ DISPOSAL PONDS WIDTH R LENGTH R DEPTH R DISTANCE TO NEAREST WELL_ ft FOUNDATION It PROPERTY LINE, ft ❑ SEEPAGE PITS NUMBRR WIDTH R DEPTH ft ! DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY LINE R I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES,STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. j MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 iSIGNED TITLE y - - A�,wCa�7-nil _ DATE/(3—40�'f 90, T KSEE DETA/L S SHEET 9) 4 w P.Y.C. LEACHL/NE 4 ON CENTER TKP 15til I I I I I I I I I I I I 1 1 1 1 r' 1 a� #4 '°' a 'o� 1111111111 '�I;IIIIIIIIII I II ! I � il oiifiirl I 9 iq ! ti a a� a� DE ARTNIF,INT U NLY Application Accepted By Date Area Employee ID# Final Inspection By - Date -! ❑ SPECIAL PERMIT-Approved I Character of Soil to Depth -FI: it/Sump Soil Character: COMMENTS Z' - - S0 / zGG PE SC Received Checld## Amount Date Permit# Invoice# Permit ID# Code INro By casb Remitted 23 1 -N(1!540 -7 Gz-02.uU1ONSITE w WATER PERMIT I V2-2!20033/ /o s-L G �D�is>' % /'p��h t�-'V7 ��✓!1X'x'