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ONSITE WASTEWATER.TREATMENT SYSTEM PERMIT <br /> SAN JOAOUW COUNTY ENVIRONMENTAL HEAL111 DEPARTMENT 400 C MAIN STREET•STOCILTON CA IUU-(200)!$8-3420 <br /> NoN•REFUNDABLE PERINT CALL 209)953-TE 97 FOR INSPECTIONS EXP1RE3 1 YEAR FROM DATE ISSUED <br /> JOEL ADDRVIS !220.3 &/[/ty 1W - - CRY/ZIP <br /> �3CCRom"fCT � u <br /> ' APN6b <br /> _PARCEL VIP�_ <br /> OWER NAME ///� <br /> OWHFF <br /> .A170R5S6 /lS SJ�� (:'•e V� lz CITY16TA7E17J► C' l7 �j .�0�p7 <br /> CONTRACTOR (M44"(fI (7V_q tAN 'A <br /> CopaRACTAR AOORESe 39 (1 O— 00* Ctri/STATVZIF ._ 5)(01(e4u C Wdi <br /> LITFm (0.42 '�C•36 OTHER _ NUMIER <br /> WATER TASLE DEPTH: '3c) ft GEOGRAPHICALIWORMATION: COOEdITlatea X.-'-- Y <br /> 11 PERC TEST N_`__ HtHLDINa PERMIT#___ LAND USE APPLICATION#_ <br /> TYPE Of URK: tALLATION REPAWADDITION ENGINEER OURMIDJALTERNATIVB <br /> REPLACEMENT ri OESTRUCTION <br /> INSTALLATION W11.1.SERVZ: /R�Ea10ENC8 L) COMMERCIAL _^^ ^D.OTHER <br /> NUM88R OF_LIrNo UN": NUMEER t1F BEDROOMS:_ NUMRER OP EMPLOYEE_8. � <br /> Q SEPTICTANK TYPE/MFG _ <—YI-f "If CAPACITY ______ 0i iPOFC(MIPARTMENTS�` <br /> C) GREASE TRAP TYPE MFO — _. CAPACITY_ 991 $OF COMPARTMENTS <br /> DISTANCE TO NRAREST: WELL� � R FOUNDATION da ` A PROPERTY LINE / R <br /> 0 LIFT STATION SIZE TYPE OF PUMP —D PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED BYSTFIR) <br /> �._...._..__....._..._.__._................._.........._..._...._...._._._.__...._._._.._._..._»__....__._._..._.._._�. _ . ._. ... ) <br /> LE'AC14LINES 7 LF.ACHING C HAM13ERS SOFLJNE8 LENGTH OF LINES _ft <br /> �C� R <br /> DISTANCE TO NEAREAT WELL _ FOLWDATION,;v fR— YPROPERTY LINE 100/ _R <br /> u FILTER TED WIDTH R LENGTH _ ft DEPTH _ ft <br /> DISTANCE TO NEAREST WELL_- 't -OUNDATION_ _,—ft PROPEIRIYLNE— ft <br /> u MOUNDED WIDTH _ ft LENGTH ft DEPTH _ ft <br /> DISTANCBTO NEAREST WELL---- ft FOUNDATION�� R PROPERTY LINE R <br /> SUMPS WIDTH _R LENGTH__ R DEPTH ft <br /> DISTANCE TO NEAREST WELL ft POUNDATION R PROPERTY LINE __TI <br /> Q DISPOSAL PONDS WIDTH R LEHOTHi _� ^• R DEPTHft <br /> DISTANCE TO NEARS T WELL _R FOUNDATION _R PROPERTY LINE____ft <br /> p� SEEPAGE PITS NuMEER � WIDTH�� _T R DEPTH <br /> / 1 DISTANCE TO NGRSST WELL_ 4w— R FOUNr7AnoN._Qa_—N PROPERTY LINE <br /> I HEREBY CERTIFY THAT I KAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAOUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULE'S AND RVOULATIONS OF SAN JOAQUIN COUNTY. <br /> �ItNGb9UM 2 HOUP, D /�NCE NOME RNOVIRED FOR INSPECTIONS-PLEASE <br /> CALL(209)893-7897 <br /> SIGNED //r �/ . TITLE_ uITW DATE % <br /> _ YMENT <br /> CEIVEC <br /> D 15 2020 <br /> h^ 1�AQUIN COUNIY <br /> - KMI IRONMENTAL <br /> H DEPARTMENT <br /> f DEPARTMENT I9977��;;..ONXY ��IDIC <br /> ApplY>:A41on Accepitld 8 C� G� Dtl1eS„?J�ro Area � E I <br /> FIn111 inaDTrtlan � Date . '� SPECIAL PERMIT.Approved by <br /> Choracetlr sof Solt Lo p I of !N; P P Sall Cheracter. <br /> COMMEr�Ts u re a r✓end 1 nes• ex�s �n <br /> PE SC Recoi/w heck#I AmountPermht�^ <br /> Code Impo ReEnitted a Service Ra Invalce N Pernik 101f eat d <br /> D ! S 300 ?,p <br /> i2-01 <br /> 10(4107 ONSITE WASTEWATER TRTMNT SYSTEM pEWt\T <br />