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, t <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 27463 Kennefick Rd CITY/Zip Galt, CA 95632 <br /> m <br /> CROSS STREET Liberty APN 005-210-14 PARCEL SIZE 6.2 Acres > <br /> 0 <br /> 0 <br /> OWNER NAME Fred/Linda Rhodes PHONE 916-826-4949 <br /> OWNER ADDRESS 27487 Kennefick Rd CITYISTATEIZIP Galt, CA 95632 <br /> CONTRACTOR Fred Rhodes Construction PHONE 916-826-4949 <br /> CONTRACTOR ADDRESS 27487 Kennefick Rd CITY/STATE/ZIP Galt, CA 95632 <br /> LICENSE C-42 F1 C-36 OTHER A NUMBER 732636 EXPIRATION DATE 4/30/2021 <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> PERC TEST # BUILDING PERMIT# d F` LAND USE APPLICATION# <br /> TYPE OF WORK: A NEW INSTALLATION REPAIRIADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: X RESIDENCE COMMERCIAL ! OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: ��- NUMBER OF EMPLOYEES: <br /> SEPTIC TANK TYPE/MFG P&L Precast __ CAPACITY 1200 gal #OF COMPARTMENTS 2 <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES X LEACHING CHAMBERS #OF LINES 3 LENGTH OF LINES 55 ft <br /> DISTANCE To NEAREST WELL 350' ft FOUNDATION 151 ft PROPERTY LINE 45' ft <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 ft PROPERTY UNE ft <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE 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 3 WIDTH 42" ft DEPTH ft <br /> DISTANCE TO NEAREST WELL 3751 ft FOUNDATION 401 ft PROPERTY LINE 451 ft <br /> I HEREBY CERTIFY THAT I HAVE P ARED THIS APPLICATION AND THE WORK WALL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> ST E LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MIN/MW 4 NCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 209 953-7697 2 J <br /> SIGNED TITLE W "1/ DATE 3^ <br /> i y <br /> DEPARTMENT USE ONLY <br /> Application Accepted B / Z-4-- Date _fZ r 10 Area Area � J Employee ID# <br /> Final Inspection By Date SPECIAL PERMIT-Approved by <br /> Character of Soil toDepth Pit/Sump Soil Character: <br /> COMMENTS oT {foil°F i <br /> Loy <br /> PESC Received hec Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO By ash Remitted Sery ice R uest# <br /> 42.01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4114118 <br />