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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT MS E. HAZELTON AVENUE • SrocKroh CA 95205 -(209)468 -3420 NON-REFUNDABLE PERMIT CALL (209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED JOB ADDRESS 3°69 ci 5-e9E4.,,..pcis /14 cirazip Oakdale CA CROSS STREET C,/bYvi e k APN o7a6 OWNER NAME Earl - AFTYI C,011)1" OWNER ADDRESS 06 1 k, d vJ cs rol,' CITY/STATE/ZIP CONTRACTOR Mike's Backhoe Service PHONE 209-456-2865 CONTRACTOR ADDRESS CITY/STATE/ZIP P.O. Box 650 Manteca, CA 95336 LICENSE C-42 C-36 OTHER A NUMBER 608554 EXPIRATION DATE 2022 WATER TABLE DEPTH: 70 ft GEOGRAPHICAL INFORMATION: Coordinates X T PERC TEST # BUILDING PERMIT # 2 OO g1 5 LAND USE APPLICATION # TYPE OF WORK: INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED /ALTERNATIVE REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION V INSTALLATION WILL SERVE: j(r RESIDENCE SEPTIC TANK TYPE/MFG (')I P&L Concrete CAPACITY 1200 gal # OF COMPARTMENTS 2 UMBER OF LIVING UNITS: ( NUMBER OF BEDROOMS: 04. NUMBER OF EMPLOYEES: COMMERCIAL _ GREASE TRAP TYPE/MFG CAPACITY gal # OF COMPARTMENTS DISTANCE TO NEAREST: WELL 1°°' ft FOUNDATION 15' ft PROPERTY LINE 30' ft LIFT STATION SIZE TYPE OF PUMP 0 PKG TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) 'VEACH LINES LEACHING CHAMBERS # OF LINESa LENGTH OF LINES 55' ft , DISTANCE TO NEAREST WELL 100' ft FOUNDATION 30' ft PROPERTY LINE 25 ft CI FILTER BED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft MOUNDED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft SUMPS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft IdSEEPAGE PITS Numseia WIDTH 42" ft DEPTH 25' ft DISTANCE TO NEAREST WELL 150' ft FOUNDATION 65' ft PROPERTY LINE 20' ft I 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 Contractor DATE 2/17/21 PAYMENT a RECEIVED FEB 17 2021 AN .0AQUIN CO-INTY HEALTH DEPARTMENT ,ENVRON MENIAL PARCEL SIZE PHONE 06kr.4 q S-34/ OTHER S311(1aV 31IS DEPARTMENT U Application Accepted By S, ONLY Date Ph, 2/ Area Final Inspection Byt 4 jai. - Date k"1.—lakt. = SPECIAL PERMIT - Approved by Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: COMMENTS SeCand Ff2. Tier Ir. <;.sivi.. spoo,wqr perc sgoo-x ga9 Weli5 settdcl iks poi t.-mb reopret PE Code SC INFO Received Y F Check#1 Cash Amount Remitted Date Permit/ Invoice # Permit ID# LPII II) 1 3q9 rt 24 2/ i .,S6edzuest # s 3a3n 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14118 4_g_tiL Employee ID# r)A