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tr � <br /> ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 20442 River rd.. frf CITY/ZIP Ecalon,CA -) j <br /> CROSS STREETya., ^1' eY► Rd� APN o?ySa3oS� PARCEL SIZE A(j C +�•� p <br /> OWNER NAME ChIll"Ck 1Ola 5}eVen 3 Q11;Soyl PHONE <br /> ] y 1 A N <br /> OWNER ADDRESS I�7.0 9o SSocyfj CITY/STATE/ZIP �1�C FT D%'1 f (.A <br /> CONTRACTOR Mike's Backhoe Service PHONE 209-456-2865 <br /> CONTRACTOR ADDRESS P.O.BOX 650 CITY/STATE/ZIP Manteca,CA 95336 <br /> LICENSE ❑❑C-42 ❑DC-36 OTHERA NUMBER 608554 EXPIRATION DATE 2020 <br /> WATER TABLE DEPTH: 50 ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ❑ PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: ❑ NEW INSTALLATION ❑ REPAIR/ADDITION 7 ENGINEER DESIGNED ALTERNATIyLE <br /> 'fZ REPLACEMENT FI OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION 1 Z R►�F <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS:1 NUMBER OF BEDROOMS:2 NUMBER OF EMPLOYEES: <br /> SEPTIC TANK TYPE/MFG P&L Concrete CAPACITY 1200 gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL1001 ft FOUNDATION 25 ft PROPERTY LINE 75 ft <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP ❑ PKGTXPLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> J4 LEACH LINES II LEACHING CHAMBERS #OFLINES I LENGTH OF LINES 90, ft <br /> DISTANCE To NEAREST WELL 100 ft FOUNDATION 25 ft PROPERTY LINE 40' it <br /> ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION I't PROPERTY LINE It <br /> SUMPS WIDTH 2' ft LENGTH 14' ft DEPTH 10' ft <br /> DISTANCE TO NEAREST WELL 150' ft FOUNDATION 75 ft PROPERTY LINE 10 ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE It <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 <br /> SIGNED Mike Fuller TITLEContractor DATE <br /> AYN►ENT <br /> See at tacked CEIVEp <br /> Y 0 6 2020 <br /> AN XIAQUIN COUNTY <br /> EP V RONMENTAL <br /> ill DEPARTMENT <br /> DEP AR TM EN U VE ONLY <br /> Application Accepted ` Date ✓ 6 Z 20 Area Employee ID# <br /> Final Inspection By Date 2&VU SPECIAL PERMIT-Approved by <br /> Character of Soil to epth of 3 FY PiUSum Soil ratter: <br /> COMM TS <br /> LO �0 <br /> o S a.rt <br /> PE SC Received heck#/ Amount Date Perm iU Invoice# Permit ID# <br /> Code INFO B Cash Remitted a is Re uest# <br /> q,17)0 1157 #300 <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14118 <br />