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ONSITI ASTEWATER Tk-TATMENT SYSTE1V, _,�RRMMIT#O9U- 3 l <br /> SAN JOAQUIN COUNTY ENYIROwwrAL HEALTH DFPABI'MEwr ? 364 E WESER AVE-3'FL-STOCKTON CA 95M -(209)168-y120 <br /> PION-REFUNDABLE PERMIT <br /> CALL 269 953-7697 FOR ENSPECTIoNs EXPIRES 1 YEAR FROM DATE ISSUED <br /> JORADUREBS V "ArCITY21P <br /> CROA45TREEt /� AFN PARCELStz£ b <br /> OWNER NAM% ZPHONE <br /> OWNER AODRRss Inc <br /> ,p CrrYlSTATFgAP <br /> CONTRACTOR R-� !tom• PHONE 3 XA_r O <br /> CONTRACTORADOR-- Cm'ISTATE/EIP O <br /> I <br /> j LICENSE �2 OC-36 OTHER NUMBEst EILPIRATK)N DATE 1� <br /> WATERTABILDE►FH: ft CEOCRAPHfCALINPORMATToN: Coordinates X y L <br /> ❑ PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALi.tT1ON LJ REPAIRIADDmoN 0 ENGINE%RDEsIGNEDlALTEaXATTYE <br /> O REPLACEMENT O Devmu nm <br /> INSTALLATION WILL SERVE: RFSIaENCL ❑ COMMERCIAL (3 OTHER <br /> �y NUMBEROp L1YINGUNITS; NUMBEROPBmROOMLS; _ NUMBFJt OF EMPLOYEES: <br /> Jy SEPTIC TANK TYPFJMFG CAPACITY dla"1rJ P1 NOFCOMPARTMENTS <br /> ❑ CREASE TRAP TYPEIMFG CAPACITY gal NOF COMPARTMENTS R� <br /> © PKC TX PLANT DISIANC£TO NLARUT: WELL , It FOUNDATION 6—Ln., It PROPERTY LINE !716-- ft I <br /> ❑ LIFT STATION SI7l TYPE OF PUMP A SAND OIL SEPARATOR(ENCLOSED SysT'P.M) <br /> LEACH LINES 3 LEACHING CHAMBERS M OF LINES LENGTH OF LINES �) ft <br /> DISTANCE To NEAREST WELL 1n R FOUNDATION ft C/PROPERTY LINE J N <br /> E) FILTER BED WIDTH ft LENGTH A DEPTH ft <br /> DISTANCETONEARFST WELL ft FOUNDATION R PROPERTY LINE ft <br /> CI MOUNDED WIDTH ft LENGTH ft DEQ ft <br /> SUMPS C3-IN <br /> DISTANCE TO NEAREST WELL fl FOUNDATION ft PROPERTY LINE ft <br /> WIDTH_92, ft LENGTHft DEPTH_ - .0 R <br /> FO <br /> DISTANCETO NEAREST WELL ft UNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENOT" ft DEPTH it <br /> DISTANCE TO NEARG9T WELL F'OUNDATKIN /I-Yl It PROPERTY LINE fl <br /> ❑ SEEPAGE PITS NUMBER W[D 1 ft DEPTH A <br /> DLSTANCRTONEAREST WELL ft PROPERTY LINE ft <br /> I <br /> I <br /> I 1 HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> i ORDINANCES STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> C MINIMUM 24 HOUR ADV N F:NOTICE.REQUIRED FOR INSPEC?)NS-PI.F.A.SE CALL(204)453-7697 (S <br /> SIGNED AP-4e TITLE_ .-IF <br /> DATE a OSS <br /> IL <br /> I <br /> DEPARTMENT V7 11.�t.Y ENVIRONMENTAL <br /> Application Accepted BY �� Datr CS Atca HE41.11-1 DEPARIWNfe,ID# T crG� <br /> Final Inspection By Date 7/a�/�•� 13 SPECIAL PERMIT-Approved by <br /> Character of Sell to Dep -par-3k) PI mp Soil Ckanc44 <br /> COMMENTS N' f9L- --2v4 E„J tr4 ; LIS- r tL C <br /> M.x E 150 FT, AL, wriud <br /> PE SC Received Amoeot Perwil ID# <br /> Code 114Po BY Cask Remitted Date <br /> Service Reaneg# <br /> 42.tf 11-7 10. it yo 32.0-elo 12/2qLags"04-311.2 <br /> s. <br /> e2-02-041 7arG/d-S -1-51-1���1- - „-.Y-- OZ J <br /> 12ra'2003 <br />