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ONSITE WASTEWATER TREATMENT SYSTEM IN STREET D <br /> EM PERMI -3410 <br /> GOO E CA65202 (209)668 <br /> SAN JOACLAK COUNTY ENVIRONMENTAL HEALTH DEPARTMENT EXPIRES 1 YEAR FROM DATE ISSUED <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS <br /> JOB ADDRESS <br /> z(D 3 S. aflNTPA C,Tygp -T RALy <br /> L.(n�NE <br /> -tAPN 2SZ-l6�-OI - 02.. _ PARCEL SIZE ,v3�L`C ' <br /> GROES STREET ��' -j� <br /> PMONE y 9 <br /> QWIEA NAME <br /> ,} p E(z -(� AUt• C�TYISTATFIZIP S f\N ,o SC lrll <br /> DYMER ADDRESS I •� � — jib-o3�s <br /> CONTRACTOR L.\V€Oy1R0NW►E1,j rt\L p"DNE _ <br /> . O IN• O PCS Sr. _CITYISTATE/ZIP L.O� G <br /> I A q 5 Z`60 <br /> CONTRACTOR ADDRRY -1T <br /> NLA6ER E%►SIATIONOATE . <br /> LICENSE QC-42 pC36 OTS -- <br /> WATER TABLE DEPTH: <br /> It GEOGRAPHICAL INFORMATION: Coordinate$ X Y <br /> BUILDING PERMIT# LAND USE APPLKATION#_ _ _ <br /> PERCTEST B -_ .--'-- - -- <br /> . _ -..R EPAOR/MDfl101 -.—ENCONEER DESIGNED/ALTERMTRt <br /> TYPE OF WORK: n NEW RpTALlA710M ❑ DESTRUCTION <br /> :7 REPLACEMENT <br /> COMMERCWL OTKER <br /> RISTALLATION WILL SERVE: � R{7� NUMB- <br /> NI <br /> LBR OF EMPLOYEES: <br /> NUMBER OF LMNO UNRS NUMBER OF BEDROOMS <br /> ❑ SEPTI TANK TYPL.IMIc __ CAPACITY -- -.--- gal NOF ARTAENB...--- - <br /> ❑ GREASETRAP TY1416llTCi ____.__...-_. CAPACnY._-__. gal NUFCOAPARTLENTS <br /> -_ R FO,MDATION-- A PI,,c,HTY L,,w _ It <br /> DISTANC[10 NBAR[ST- WELT _ -'-- <br /> ❑ LIFT STATION SIZE TYPE OF PUMP 0 PKG TX PLANT 0 SAND OIL SEPARATOR IE NCLOSE D SYS TE M) <br /> ❑ LEACH LINES L LEACHING CHAMBERS NOF LINES LENGTH OF LIES <br /> DISTANCE TO NEAREST WELL -_ft FOLMDATIIN- __ft PROPERTY LINE <br /> ❑ FILTER BED WOTK__---ft LENGTH- ft DEPTH--___-__----...--_ft <br /> DISTANCE TO NEAANT WELL _ ft FOUNDATION _-R PHOPERTYLw--..-_.. ft <br /> ❑ MOUNDED IN m ft LENGTH-- -- ft DEPT"- <br /> - <br /> - <br /> - <br /> - <br /> NT <br /> DMft TANCETONSWAST WEU— _R FOUNDATION ---_ FTAwfilt YLAE.+ <br /> ❑ sumps W— _ft LENGTH.--- $ DEPTH _ 0 ED <br /> DISTANCE TO NEAREST WELL -ft FOIIOATION __..ft PROPERWUW-- ft <br /> C3DISPOSAL PONDS W— _ _--R LENOTH- ft DEPTH -- 2093 <br /> DISTANCE TO NEAREST WELL _" FOUNDATION __ft ���P —� ft �J <br /> ❑ SEEPAGE PITS NumnaR „+Aw'ekytJFNcOUN <br /> pSTANcETO NEAREST WUL ft FOUDATION _—ft PROPEIRTYLINE�zzrf-rn SEN -AT N <br /> I HEREBY CERTIFY THAT I H AVE PREPARED THIS APPLICATION AND TN[MRK WILL BE DONE N ACCORDANCE VIM MN JOAOIMI COUNTroRD111AMC*!'A E{rMEN r <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAOUIN COUMTr- <br /> MwA44 HOUR AC,'.ANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(M)M3.7S97 <br /> SIGNED TITLE COLIt✓�-T ^Jr DATE 3- <br /> r <br /> ar� <br /> k <br /> - ---->t---------------------- j- -�----------- sa <br /> as ui (AGN M-tso-DN) <br /> MEN�T SE O�j}Y3 r, p �.Fp- L� <br /> Application Aece OEPART <br /> _ - __ _ - ` ETRp1OJee I(* C1 t'&JCT <br /> Final hnpectlon By l _ ❑ SPECIALPERMR-Approved by <br /> Character or So11 to Depth W B ft: PIU mp Soil Charaetsr: <br /> PE Sc Rscolved Amount Pam InwWa! Perm”DE <br /> _t '•e�+ B Cas ReMf"etl s" Service R oast N <br /> �- <br /> !' I f <br /> 42-01 <br /> tomes > ONSITE WASTEWATER TRTMN £R <br /> T SYSTEM PMR <br /> Com., <br />