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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT I SGB E HALELTON AVFNI IP . RTnr —t I A ca— LIN ABLE anna LINDABLE PERMIT CALL (209) 953-7697 FOR IN.spfC7JONS EXPIRES 1 YEAR FROM DATE ISSUED JOS AOoREe3 _4001 tj Rd CiTYQIp MantexN05:)37 CROSS STREET Oleendw Ave APN`212'USU-U2 5 72 Acres PARCEL SIZE OWNER NAMES Jonnsron I — PHONE OWNER ADDRESS 7677 N Pershih;i Ave CI7Y(STATE2R S0.x:11anfOM90207 CONTRACTOR (AL C'AL Inc PHONE 20!11543,1799 CONTRACTOR ADDRESS 4230 Kiernan AVM Sta 180 CITYISTATEIZIP Mndaato1CA195357 LICENSE C42 C-36 OTHER ___------ NUMBER EXPIRATION WATER IABLE DEP TH: "' It GEOGRAPHICAL INFORMATICIN: Coordinates X 377131665 Latitude y ,21240232 Lmvipi le PC PERC TEST # t BUILDING PERMIT a _ ---- LAND USE APPLICATION k TYPE OF WORK: NEW INSTALLATION RSPAIR/ADDITWN ' EIIt:INE6R DESIGNED IAL TSRNA THE REPLACEMENT OUT-OFSERVtCE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE; (� RESIDENCE COMMERCIAL OTHER _ - ----�— —I NUMBER OF LIVINO UNITg' NUMBER OF BEDROOMs: 3 NUMBER of EMPLOYEES: I ❑ SEPTIC TANK TYPE(MFG _ CAPACITY gat NOFCOMPARTMENTS ❑ OREASETRAP TYPE/MFG CAPACITY Sat #OF COMPARTMENTS DISTANCE TO NEAREST: WELT_______,____, ._ ❑ LIFT STATION 912E ft FOUNDATION _ 6 PROHERTY LINE ft TYPE OF PUMP 0 PKG TX PLANT O SAND OIL SEPARATOR (ENCLOSED SYSTEM) O LEACH LINES LEACHING CHAMBERS _ #OFLINES LENGTHOFLINES It DISTANCE TO NEAREST WELL _ it FOUNDATION ., _ it PROPFRTYUNf� ft O FILTER BED WIDTH _ _ It LENGTIi _ _ R DEPTH _ DISTANCE TO NEAREST WELL _ _ R FOUNDATION � _ _ ft PROPERTY LINE It it 0 MOUNDED WIDTH k LENGTH DEPTH DISTANCE TO NEAREST WELL __ ____if It FOUR DATION It PROPERTY LINE It it O SUMPS WIDTH �___ ._._._. it LENGTH _ R DEPTH DISTANCE TO NEAREST WELL _ R FOUNDATION _ ft PROPERTY LINE it R O DISPOSAL PONDS WIDTH ft LENGTH ., .__ i[ DEPTH R DISTANCE TONEAREST WELL__ it FOUNDATION ----------- __it PROPERTY LIRE IT ❑ SEEPAGE PITS mum= WIDTH _ it DEPTH DISTANCE TO NEAREST WELL _ _ it FOUNDATION _ _ _ _ — it PROPERTY LINE It It I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY SIGNED TITLE llfadogmt -0-- 11812020 DATE rt r mCrr r � 4NL T" wr APNIIcatlon Accepted By _ v p;qe Area 104j/• Final Inspectlon By______ ` Dale -__. SPECIAL PERMIT -Approved by Character 0t Soil to Dept 3 Ft PItiSUmp Soil Character. COMMENTS /1/! rTL. o ►uN7.7 Ak fleNT 42 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 41)4/4/1A ` O✓1 "(_xl ■■■■■■■■ ■■■■■■■■ ■�■■■■■■■■/�■Hri oil I?�I��Im��■�C■C�Ci :a ; a �u� ■:�;®��c��m�mN��s�ava��am n■■■■■■■■a■■nu■■■■■■ rt r mCrr r � 4NL T" wr APNIIcatlon Accepted By _ v p;qe Area 104j/• Final Inspectlon By______ ` Dale -__. SPECIAL PERMIT -Approved by Character 0t Soil to Dept 3 Ft PItiSUmp Soil Character. COMMENTS /1/! rTL. o ►uN7.7 Ak fleNT 42 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 41)4/4/1A ` O✓1 "(_xl