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-,,.•- 300 ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DvPARTMF TI 304 E WEBER AVE-31D FL-STOCKTON CA 95202 - (209)468-3420 NON-REFUNDABLE PERM I CALL(209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR PROM DATE ISSUED JOv ADDRESS eC(02�0 OWE L C Rol. CITY/Z1P Ttlo a N ro N '! CROSS STREET NeLj Nc o APN #001 2--3d <- PARCEL SIZE Y I , F-0 n OWNER NAME Dr -(_ f'O RE ST PPC,OV C, TS :j:Ne, PHONE (,on, y(c0 OWNERADDRESS 2,601 601 f5A5T L// ,5L 14 0-IEA -/ CITY/STATE/ZIP VAI`(P K,F/ -p5, (WT -�Q� .n CONTRACTOR P{ NE✓�C�`�J�/�� � �� CONTRACTOR ADDITESS CITY'/$TATFJZIP LICENSE ❑C-42 ❑C-36 OTHER_ NUMBER EXPIRATION DATE WATER TABLE DEPTH:_ ft GEOGRAPHICAL INFORMATION: CoordinI les X Y ❑ PERC TEST #_� BUILDING PERMIT# LAND USE APPLICATION Y TYPE OF WORK: A NEW INSTALLATION REPAIR/ADDITION ❑ ENGINEER DESIGNED/ALTERNATIVE Q ❑ REPLACEMENT ❑ DESTRUCTION ?V•" INSTALLATION WILL SERVE: ❑ RESIDENCE 1/r4 COMMERCIAL O OTHER NI:MBEROF'LIvING UNITS:_ NUMBLROF BEDROOMS: NUMBER OF EMPLOYEES: (L\` SEPTIC TANK TYPE/MFG-,"Qv&_/__ _ CAPACITYyUy!' gal #OF COMPARTMENTS L/ ❑ GREASE TRAP TYPE/MFG_ CAPACITY gal #OF COMPARTMENTS ❑ PKC TX PLANT DISTANCE TTo NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft ❑ LIFT STATION SIZE Ir�"T 3� TYPE OFPURIP601hRrts eZSE✓SIyL ❑ SAN DOIL SEPARATOR(ENCLOSED SYSTEM) ❑ LEACH LINES ❑ LEACHING CHAMBERS #OF LrNEs LENGTH of LINES LR DISTANCE TO NEAREST WEL ____ ft FOUNDATION_ _�_R PROPERTY LINE ft FILTER BED WIDTH ��ft LENGTH R DEPTH1 �J,l_ III DISTANCF.TO NFAREST WELL.Z�ft FOUNDATION R PROPERTY LINE �r:T�J R O ❑ MOUNDED WIDTH ft LENGTH ft DEPTH R DISTANCE TO NEAREST WELL__ _ft FOUNDATION R PROPERTY LINE R ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION R PROPERTY LINE ft ❑ DISPOSAL PONDS WIDTH ft LENGTH _ ft DEPTH R �, DISTANCE TO NEAREST WELL _ft FOUNDATION R PROPERTY LINE R ❑ SEEPAGE PITS NUMBER WIDTH Il DEPTH DISTANCE TO NEAREST WELL 1T rOUNDATION R PROPERTY LINE fl I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY INANCES,STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIM fOU*A6YANCE NOTICE REQUIRED FOR WSPEE/CTIIONS-PLEASE CALL(209) 90O53-7697 SIGNED �- .� _ TI"TLE_L--C)PI$TQOC-t 10 1'IVn DATE 7 O ,SEPTIC CALCULATIONS(UNCHANGED-It ALMKTIPUL9It 4 NUMBER OF EUPLCYEES -50 _ AVERAGC DXLY ROW(AOt)•50 EMPLOYEES r IWD/EM- UPs+Rt CALCULArp TMK CIPACTD- 1,175 GAL+ (0.15%7}0 GD PROPOSED T"IS 2000 faS> 16515.THEREFORE-D% i v .�yt�•�. 5011-T -PER GEOTEC—CN.REPORT 6 SPD.n,EREFORE'. RECUPED LEACH UHC LEN--re-(1200(BASE!MK CAPACM N PROPOSED BED AREA 390.}� I170.IiSC 1200 Sr. � =/ 1 SFFIIC SYSTT)+DETAILED VIEW I � -- SEFIX STMIA NOTES 1m 1 b ( Cw4D.R To PROPOSED N R-GRAATY SEWER SERCC a M 8114"ILLY- DO't. Psw i i PA�Oroem O 11 2.000 L,fAT SEPTIC DEPA TAM(PER SAN.gA01:iN CWNTY EE EWROM(Pf.AL HEAITN oEPAATYEM STANDARDS O CWECt DRAW P,ELD TO SEPTIC TAN%PER W.JOAOLM CO,-tm DI.IRpNYENTAL HEALTH DERA ENT STMI)MM. � O 001telil CT 1200 Sr HE (}0'140')SEPTIC DIVA LD PER SAN JCPALM COUNTY EWRO`XNTAL HEALTH:)EPAr(TMEHT ST-WOS. \ Tar ePsa 111 L111111111111 � 111111 DEPARTMENT USE ONLY Application Accepted�pth �'� DMte U� Arca -- Fri.,oyee It,'*J�1Finallmpection y DaleC1SPECIAL ERMIT-Approved bycharacterN acter Df�ao 3 Ft: PIUSump SDII Character; O r'_/��-EP1TS /VPlll �sA STSv�t S/Z�fi �'' —�- 2. PE SC Received 4JLbCLWP Amount D to Permit/ In - Permit ID# /'ode INFD py, Cash Remitted Service Request# C�cr-.G