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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 13845 Brennen rd. CIrYIZIP Escalon,CA <br /> CROSS STREET Mariposa Rd. / /� /' /APrN�c)07 Z�uV d PARCEL SIZE ! V <br /> OWNER NAME r 171/I I��C,7 vl r-�C1 hV�1�C,� L—r C PHONE v' <br /> OWNER ADDRESSa 3)as Lone� tie hr,/ CITY/STATEIZIP L1(C,1-V- l 5a�U <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 EF-C-42 ECC-36 OTHER A NUMBER 608554 EXPIRATION DATE 2020 <br /> WATER TABLE DEPTH: I ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ❑ PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION P.1 REPAIRIADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: VRESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: 1 NUMBER OF BEDROOMS:2 NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS <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 LEACHING CHAMBERS #OF LINES i LENGTH OF LINES 401 ft <br /> DISTANCE TO NEAREST WELL 150 ft FOUNDATION 10 ft PROPERTY LINE 25 ft <br /> ❑ FILTER BED WIDTH ft LENGTH ft DEPTH it <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 LINE It <br /> ❑ SUMPS WIDTH ft LENGTH fl DEPTH ft <br /> DISTANCE TO NEAREST WELLft FOUNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE To NEAREST WELL fl FOUNDATION ft PROPERTY LINE it <br /> SEEPAGE PITS NUMBER 2 WIDTH 3611 ft DEPTH 251 ft <br /> '\ DISTANCE TO NEAREST WELL 150 it FOUNDATION 10' ft PROPERTY LINE 15' It <br /> 1 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 TITLE Contractor DATE 8/12/2020 <br /> VFD <br /> 2020 <br /> DEPARTMENT USE ONLY u /� paCO <br /> Application Accepted By A� Date c3 O Area 1 I Empl UN <br /> Final Inspection By Date ;5'A� ❑ SPECIAL PERMIT-Approved by FP A( <br /> Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: FNT <br /> COMMENTSFcgilu/C O� 5 5"�PYiI <br /> PE SC Received heck Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO By IS Remitted S ice RlIquest# <br /> LU 10. <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4114118 <br />