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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR/NSPECT70NS EXPIRES 1 YEAR FROM DATE ISSUED JOB ADDRESS 1D029 E Eley Lane Stockton 95212 y0 ;> CITY2IP CROSS STREET Ruff APN 086-070-22 PARCEL SIZE 2.91 Acres OWNER NAME Bill&Katherine Williams PHONE 209-649-9894 OWNER ADDRESS 8027 W Howard Road CITYISTATE/ZIP Stockton,CA 95206 CONTRACTOR Affordable Fence&General Construction PHONE 209.948-4415 CONTRACTOR ADDRESS 2712 E Fremont Street CITY/STATEZP Stockton,CA 95205 LICENSE ❑ C-42 ❑..C46 OTHER B C13 NUMBER 605338 EXPIRATION DATE 10/31/2020 WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y 1 PERC TEST # BUILDING PERMIT# � � AND USE APPLICATION# TYPE OF WORK: ;t NEW INSTALLATION REPAIRIADDITION ENGINEER DESIGNED/ALTERNATIVE REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: D RESIDENCE 71COMMERCIAL OTHER NUMBER OF LIVING UNITS: 2 NUMBER OF BEDROOMSP / F 5+ j 1 J+T NUMBER OF EMPLOYEES: .� SEPTIC TANK TYPEIMFG CAPACITY My gal #OF COMPARTMENTS ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS DISTANCE TO NEAREST: WELL 1-7c) It FOUNDATION IO ft PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OFPUMP- -\ O PKG TX PLANT 0 SAND OIL SEPARATOR(ENCLOSED SYSTEM) ;K LEACH LINES kjEACHING CHAMBERS n Lu L$& #OF LINES LENGTH OF LINES $� ft DISTANCE TO NEAREST WELLLL f ft FOUNDATION ft PROPERTY LINE ❑ FILTER BED WIDTH ft LENGTH ft DEPTH DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE �` N ❑ MOUNDED WIDTH it LENGTH ft DEPTH ft ,VCO DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINER C3 SUMPS WIDTH ft LENGTH ft DEPTH ��[[TT1i1l O DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINEA,.. _ft L3DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH V�0� DISTANCE TO NEAREST WELL /It FOUNDATION ft PROP/E�RTTYY'LINE R(p UMF.tC,OUNT�/ IK SEEPAGE PITS NUMBER WIDTH a I ft DEPTH 7!' /J /v T,q DISTANCE TO NEAREST WELL ft FOUNDATION 41D R PROPERTY LINE IO ft ARTMFNT 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. MINIM[M 48 �06CEREQUI&&=INSPECTIONS-PLEASE CALL f2O9) 697 _` - 1 — _] SIGNED - - - :'s -'i s' Ef�tL�4/4._C'•� CO VV6V 21m DATE LC o Nori'h NLv %< Application Accepted Z L Date '2F) Area �// Employee ID# S Final Inspection By Date 7-773 U SPECIAL PERMIT-Approved by Character of Soil to Depth of 3 Ft: f Pit/Sump Soil Character, COMMENTS 14ew t m 11P>~ U0 '4c' .� IN i h feel L rP!/Sf GGkS PCr L kee.`a 1 2 rI LO — �UA E PE SC Received CCash Amount PeRon r Code INFO Cash Remitted Data Service R oast# Invoice# Permit ID# 1 . yell �1 e— fS- 5• • 5 � , � ��. 42-01 �J,�, /" ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14118 `�K—/f- `CJ J