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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN 2OAUUIN CGVN T ENVIRONMENTAL IILA1311 DEPARTMENT .104 E LA'FATA A- . J" Fl.- SlO *TON CA 95207 - (209) 449-3424 <br />NON-REPDNDABLE PEN7NI I' <br />JUB AUDRLSn ��5 <br />CROSS STRCET L�/ACL I <br />OWNERNAMLfr <br />OWr.LRADORLS5 =„J /_ <br />CALL (204) 95.1.7647 FOR INSPECTIONS EXPIRES I YEAR FROM DAII. ISSUED <br />-✓.. _ CmrLIP ._`'_G�1'_.G.�:al:.—�a4 -- <br />APN /-(3" 1-212-2-Y PARVELSM /_r3 el C.. <br />a [ N^l�LCRY/STATVZIl_ <br />CONTRACTOR / /-l/ <br />PRONC�_G - <br />CONTRACTORADOKESS <br />A� .� .• _. �P3d9�,I•� <br />�� Cm/STATU�Z.IPy- <br />LICENeF UC 2 <br />❑ C-16 Omit f i®'y_TT-.T. / <br />NUMCEA _�!_!_.l <br />EXPIRATION DATE <br />WATENTARLEDEPIMI <br />_, _..._D ^CEE`U7r:MPMICAL INPOR.IAC-Ruurddiin'tlra <br />WELL <br />❑ PERCTESTR <br />D PROPERTY LINE <br />LAND USE APPLICATION N ^� <br />TYPE OF WORK, <br />New INRTALLATION ❑ <br />REPAIR/AoMIOM <br />U ENCiNEERDISMNED/ALTERN.ATIVI <br />❑ RErLSCCMENT __ <br />D <br />DFXTRVCTIVN _ <br />INSTALLATION WILL SF.RL'F: O RrwlnF. m <br />❑ Co.IMERCY.a. <br />❑ OFxeR__. __-- <br />NUMRCROPLIVINCUm": _ NUMBER Ur tlCDROOMS: <br />_ ft FOUNOATWN moi^ <br />NLMALR OF EAIPLOYY.LS: <br />❑ SEPTIC TANK <br />TYPE.'M,G <br />CAIACTIY __,_ <br />REI .OFCOMPARIMENMS <br />O GREA.NETRAP <br />TYPVMFO _-_._. - <br />CAM.'" <br />_- __- jal MOFCOFAPAATMENTR <br />❑ PKO TX PLANT <br />DISFAN(.T.To NEANQT: WEU.__ <br />fl FovNGATKm_-___ <br />D PRopmv LINE.— it <br />Cl UrTSTATION <br />SITY,_ TYPEOFPONTP <br />NMINDATN)N <br />❑ SAND OIL SEPARATOR(EFICwmi)SYSTEM) <br />O LEACH LINES <br />❑ LEACHING CHA.NIBER.N <br />_.. ROFLINES___ <br />LCNotM OF LINES <br />DMT.NI:t ro N"Pul <br />WELL <br />A FOVNDATION—__,____ <br />D PROPERTY LINE <br />fl <br />❑ FILTER BED <br />w1DT11 <br />LAMOM <br />It <br />MrIM <br />ft <br />_--ft <br />DIATANCT To NEAREYT <br />WLLL <br />_ ft FOUNOATWN moi^ <br />R r0.CWEATY LINE <br />A <br />W <br />❑ MOUNDED <br />W16TN_ <br />__ <br />LRNOTM <br />.—_—_-fl <br />fl <br />DLPTM <br />A <br />__B <br />DIEFANt.X TO NAARM <br />W?A-L_--ft <br />NMINDATN)N <br />YRT)PERlYLINT <br />_A <br />U <br />❑ SUMPS <br />WIDTn <br />A LCNOTI <br />__D <br />DFPT1 __ <br />0 <br />DIRTANCLTONEARM <br />WELL <br />_ It TMOATION <br />____ <br />A monRTY INV <br />R <br />• <br />❑ DISPOSAL PONDS WIPTN <br />It LENOTH _. <br />—-�.._...D <br />Dt rm __ <br />R <br />---D <br />, <br />DIRTANCRTONKARTST <br />WELT. <br />D FNDATION _ <br />OO <br />A PXC Fkn UNF __ <br />V ` <br />❑ SEEPACE PITS <br />NLMot. _. _ <br />WWII' <br />_ft <br />Der1M � ---- <br />fl <br />DMANCETONLARCSF <br />WEU <br />_ -A VL!NOATION -_ - <br />It PROPER NLINE <br />B <br />1 <br />I NEREBYCF.RTIVY'111111 IIAVI', PRFPAREDTRISAPrLICAnONAhDTMF1VORKWILLBEDOINLIN ACCORDANCEWRIl SAN 2OAOVIN COUNTY I v <br />/�/ DEPARTMENT USE ONLY <br />Appliunon AttePIM BY - .. '-5--..:.. __.- nate _ /(! /7L U Ara �l! P.mpinyee IDV y{ <br />Fin.l I.'Pr .W. 0) - _D.It _--.... __ ❑ SPECIAL PERMIT-ARpmved by <br />C h ... clrr .I SNIT 1. Depth DI ) Ft: _ PIUSUmp Snli CpRncler: __ _„ <br />COMMENT'S .,ir -c ".,E-.-.rya,...$�oySy.1'Etut._._�i.st._.It1�.>�1sG1/._.LIrrT_.(!�.,iK.u.LtC./•i3 <br />_�!'Glt'4���'—re::�.dei„arc._�zF.,11s,�..as,tl��lr..c,.et,...r...r• .�ti �xdT...�.1/.ev.e��/d <br />PE SC Received CRKRI// A—' P.rm1U <br />Code 1!IPO By CnR Remltlyd D.Ie Serrfee Ne veal R IRvdce M P-1 IDR <br />