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SEPTIC TANK GREASE TRAP TypEim„ P&L Concrete TYPE/MFG ft FOUNDATION PKG TX PLANT ft PROPERTY LINE ft CI SAND OIL SEPARATOR (ENCLOSED SYSTEM) SIZE TYPE OF PUMP LIFT STATION DISTANCE TO NEAREST: WELL CROSS STREET OWNER NAmECkitrifs 4 Li v1 /4 4( M c liwtm JOB ADDRESS 9751 Filildreth rrl ;zip Stockton, CA spN 430 I, PHONE CONTRACTOR Mike's Backhoe Service PHONE 209-456-2865 WATER TABLE DEPTH ( 0 ft GEOGRAPHICAL INFORMATION: Coordinates X BUILDING PERMIT # LAND USE APPLICATION # INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: OTHER NUMBER OF EMPLOYEES: ./RESIDENCE COMMERCIAL NUMBER OF BEDROOMS: ..11 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 INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED TYPE OF WORK: for.'012/ADDITION OUT-OF-SERVICE SEPTIC SYSTEM PERC TEST # NEW INSTALLATION REPLACEMENT ENGINEER DESIGNED /ALTERNATIVE DESTRUCTION PARCEL SIZE OWNER ADDRESS CITY/STATE/ZIP P.O. Box 650 Manteca, CA 95336 CONTRACTOR ADDRESS C ITY/S TATE/ZIP LICENSE C-42 C-36 OTHER A NUMBER 608664 EXPIRATION DATE 2°22 CAPACITY gal ft OF COMPARTMENTS CAPACITY gal # OF COMPARTMENTS Application Accepted Final Inspection By Date Date SS31143.3V 3.LIS # OF LINES 1 FOUNDATION 10' ft FOUNDATION ft FOUNDATION 30' UK:EACH LINES LEACHING CHAMBERS DISTANCE TO NEAREST WELL 100. ft CI FILTER BED WIDTH ft LENGTH ft DISTANCE TO NEAREST WELL ft FOUNDATION MOUNDED WIDTH ft LENGTH ft DISTANCE TO NEAREST WELL ft FOUNDATION SUMPS WIDTH ft LENGTH ft DISTANCE TO NEAREST WELL DISPOSAL PONDS Mom ft LENGTH ft DISTANCE TO NEAREST WELL ft FOUNDATION U,/SEEPAGE PITS NUMBER 2 WIDTH 36" DISTANCE TO NEAREST WELL 150* LENGTH OF LINES 40' ft ft PROPERTY LINE 15' ft DEPTH ft ft PROPERTY LINE ft DEPTH ft ft PROPERTY LINE ft DEPTH ft ft PROPERTY LINE ft DEPTH ft ft PROPERTY LINE ft ft DEPTH 26. ft ft PROPERTY LINE 6' ft 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. MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 SIGNED Mike Fuller TITLE Cont actor DATE 2117/21 V.* PA MEW' RE EINIED tI a FEE 1? 2.021 A.4 JO I MALT QUIN COUNTY RONMENTAL DEPARTMENT Character of Soil to12,th of 3 Ft: COMMENTS Area q Employee IDtt "arZe Character' l SPECIAL PERMIT -Approved by Pit/Sump Soil 14- cAm . A2 t A0 ),t) (Is tA) z S-e--H9C1C,k y aco Vc4 s y ro pe r- USE ONLY PE Code SC INFO Received Check#/ Cas Amount i e Date Permit/ Service Re uest it Invoice # Permit IDtt 47-1 0 I 5 3 1 gill Won 281 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14118