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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 11691 Graves rd. CITY/Zip Manteca,CA 95336 u <br /> CROSS STREET 1161+1 yl <br /> /} �iJJAPN z-7-8o""n �v PARCEL SIZE f. 44 4 o <br /> OWNER NAME13 fl l� CSC &1r 5 M S I I PHONE �j F <br /> OWNER ADDRESS ' L r/I G 4;1(-* A11^ CITYISTATE/ZIP " LA `l <br /> CONTRACTOR Mike's Backhoe Service PHONE 209-456-2865 <br /> CONTRACTOR ADDRESS P.O.Box 650 CITYISTATE/ZIP Manteca,CA 95336 <br /> LICENSE C-42 C-36 OTHER A NUMBER 608554 ExPIRATION DATE 2020 <br /> WATER TABLE DEPTH: 3S' ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> 7 PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: /IIEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> ,- REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION AY tCfIff_ <br /> INSTALLATION WILL SERVE: Cj-<ESIDENCE ❑ COMMERCIAL OTHER <br /> NUMBER OF LIVING UNITS: 1 NUMBER OF BEDROOMS:2 NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG P&L Concrete CAPACITY 1200 gal #OF COMPARTMENTS2 <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL100 ft FOUNDATION 40 ft PROPERTY LINE 75+ ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS #of LINES 2 LENGTH OF LINES 80' It <br /> DISTANCE TO NEAREST WELL 100 ft FOUNDATION 50 fl PROPERTY LINE 75+ ft <br /> ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE it <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SUMPS WIDTH ft LENGTH it DEPTH it <br /> DISTANCE TO NEAREST WELL ft FOUNDATION fl PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> I HEREBY CERTIFY THAT 1 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 +� <br /> i F <br /> g <br /> ENT <br /> D <br /> S e el al t t a c h el d <br /> 1 `J 2020 <br /> QUIN COUNTY <br /> IRONMENTAL <br /> DEPARTMENT <br /> D ARTMENT USE ONLY <br /> Application Accepted By pllf�+,t.� Date L� -10 Area 99 Employee ID#1pi2r <br /> Final Inspection By Date IZ Z SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 Ft: PitlSump Soil Character: <br /> COMMENTS <br /> PE SC Received Check#/ AmountPermit/ <br /> Code INFO By Cash Remitted Data Service Renu ,t# Invoice# Permit ID# <br /> YZ de 19300 <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />