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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT
<br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTME14T 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)458-3420
<br /> NON-REFUNDABLE PERMIT _ CALL
<br /> (209)953-7697Fos INSP3:cT3ons EXPIRES 1 YEAR FROM DATE ISSUED
<br /> .308 ADDRESS .`..� iLn-•s- -.... ....................
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<br /> OWNER NAME
<br /> OWNER
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<br /> WATER TABLE DEPTH: R G606RAPHtCAL INFORMATION: Coordinates X_...__._...
<br /> PERC TEST Il, 1 BUILDING PERM#T# _7............_..,.._.. ......LAND USE APPucaiGN
<br /> TYPE OF WORK: REW INSTALLATIONP_4 A —
<br /> REPAIRIAaD2TWN 1. ENGINEER DESiiGtow TERNATm
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<br /> OUT SEPnC SYSTEM A,` DESTRUCTION
<br /> I INSTALLATION WILL SERVE: ycslornCE �u CaMIxERatu OTHER_ _
<br /> NUTABEA OF LIVING 3.INi'r5 _-.,._ UMBER OF BEDRo0M5 N#JitD£ii OF EIdPLOYE£5:,._._.,,
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<br /> EACH LINES LEACHING CHAMBERS____.....................-........_....................._ 1!OF LINES .._a_,.,_ LENGTH
<br /> DISTANCE To NEAREST WELL....�I ............. It FOUNOATION",—„_,4t,___.—....l2 PROP;rRTY LINE,_„ "- it .'
<br /> 0 FILTER SED Wltrra_._ .. ___ fl LENGTH, _ #[ DEPTw fl !'
<br /> DISTANCE TO NEAREST WELL ,. I# ✓_� PROPERTY WNE—,—,��_,,,_� 'c.•
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<br /> d MOUNDED IT LENGTH.___,...
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<br /> _.-.._.__._.,._._.,..._,.,_._.__,,...._,._Ii DEPTH }
<br /> DISTANCE TO NEAREST WELL 't FOUNDATION PROPERTY LINE. �_ _ ;
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<br /> 0 DISPOSAL PONDS WroTw _._.___ ... ._._. _. t IENG7H , f# DEPTH
<br /> DISTANCE 70NEAREST WELL .._ _ It T-Oi3M0ATiDN..__..,�_._._...___1t
<br /> PROPERTY L3D3£ ,..,,,�!`y
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<br /> I HEREBY CERTIFY TWAT 3 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 24 N UR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL f2O93- "' '
<br /> SIGNED .............. TITLE,_. 1C ,
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<br /> Pe r r .._ Dele..._ I SPECIAL PERMIT-Approved by
<br /> Character of Sol!to" epth of 3 Ft;__._ PI Sump Soil Character:.__...___..
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<br /> P'E SC —l Rvicei�veo a-k Amount IPermit/ 1 permit IDW
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<br /> Code— INFO I & Oastt Remitted , Service Request
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<br /> 42.01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT
<br /> 4124112
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