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Site address: 12001 S. HWY 99 RECORD ID: SR0081411 <br /> - 3Y20 <br /> r <br /> "��ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> - - - - - �--� 3A1 Jo4o11I11 COUNTY E11vIRONNEN141.HeAl rH DEPAPTMFIIT I865 E.H4IEI TOrI Av[.UE.SroCRTON CA 95205.1209)456-2420 <br /> NON-REFUNDABLE PERMIT CALL(209L953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> FCONVIRACTOR <br /> D /l4wyn99 Co'ILZIP L Mn KUELd APN T' ' _P4RtEL SIZE11 <br /> R NnME DSI, �R ADDRESS /ADO! S I I7 W 7 � CNYISIAlE2m mCln�ca ifA 4634G­PACTOR �L -112E (`n nJ S-rKYC TSD A) PHOHE ���-„fS/9S-0`15 J ADDRESS ��02 C0 CIPOI e- Cn .-l C-151-ooziP"(r�i°� CA •SJR o <br /> LICENSE DOC42 OLIC-06 DINER, _NUMBER 912,79 7_E%PITI-ooNDATE 19 <br /> WATER TABLE OFF-: I-�� R GEOGRAPHICAL INFORMATION: COOIAIIIeIRF % Y <br /> ❑ PERC TEST P l 1 BUILDING PERMIT II -/ 0721 LAND USE APPLICATION# --� <br /> TYPE OF WORK: II NEW INSTnLLPOON LI RERnm1A0UNIDN UENOINEEPDESIONEDIALTERNATWE <br /> ❑ REPLACEMENT 1.1 OUT-OF-SERVICE SEPTIC SYSTEM O DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE [jCOMMERCIAL 11 O1.ER <br /> NUMBE R Of LIVING UM IS: // NUMBER OF BED ROOM S: �Y--Y NUMBER OF EMPLOYEES: <br /> SEPTIC TANK TYPFJMFG 1... CAPACIIY I /A+V get YOFCOnIR+ AA1NTa <br /> GREASE TRAP TYPEIMFG CA'..”_1 __ get P OF COIAPART ITT! <br /> DISTANCE TO NEAREST:WELL- 6 FOUNDATION 75 R PROPEPTYLINE R <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLAN '❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> I <br /> _ LEACH LINES 11 LEACHING CHAMBERS // IS or LINES� LENGTH OF LINES II <br /> DISTANCE TO NEAREST K;L�lO�-r II fOVNDAl10N_��,IT PROPERTYI.INIF �� It <br /> ❑ FILTER BED WIGHT R LENGTH_ It DEPTH R <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY LINE _ R <br /> ❑ MOUNDED W.I., R LENIN._ R DEPTH R <br /> DISTANCE TO NEAREST WELL R FOUNnATION R PROPERTYLINE R <br /> ❑ SUMPS Woo. R LENGIII R DEPTH II <br /> OM7ANP.E TO NEAREST WEI.I II FOUNDATION R PROPERTY UNE R <br /> ❑ DISPOSAL PONDS W-N II LE.DTN 11 DEPT. R <br /> DISTANCE TO NEAREST WELL II FOUNDATION II PROPERTY LIME_ II <br /> ❑ SEEPAGE PITS NUARTER WIPTN R DEPTH R <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTYLINE R <br /> I HEREBY CERTIFY TWAT I HAVE PREPARED <br /> TTII LAWSPLICATION AND REGULATIONS WILL <br /> SO <br /> TITE LL F NE IN ACCORDANCE <br /> COANCE MTN SAN JOAQUIN COUNTY ORDINANCES. <br /> Y. <br /> U B R V CE O CE E O NS ECTIONS-PLEASE C LL 09 953-7 <br /> staNEo <br /> TITLE OLA e_ DATE /)-/17-201`) <br /> ------------- <br /> A tll <br /> R O� D��U L�OL7o <br /> M H <br /> Appllcetion Accepue BY Det. Ate_f� Employee IDB <br /> net.- ❑ SPECIAL PERMIT.ApprovedW <br /> Fine]InePKticn By pluBump 5.11 CDeregoI: <br /> CIWTAC�or f SRIt to Devil,M J Fl:__ <br /> Naseem Ahmed, Registered Environmental Health Specialist <br />