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SALINED
<br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT
<br />Sto4 .:Ca.c.n.11N CCA:NTY EUvIRONstEorrta. HEALTH DEPARTMENT SO E WIN STREET • STocAroN CA 06142 -{2.09) 468-?,420
<br />NON-REFUNDABLE PERmiT CALL f299),953-7897 FOR INSPECTIONS EXPIRE.S 1 YEAR FROAA DATE iSsuEp
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<br />LICENSE -42 , C-38 OTHER NUMBER 6.1!S-i; Yr- EXPIRATION DATE
<br />WATER TAELE DEATH: ...), LA..; ft GEOCRAPNICAL INFORMATION: Coordinates X —,..„..,..
<br />. . PERC TEST , ; IBUILDING PERMIT # LAND USE AiPuCAflON #,
<br />riPE OE WORK: : NSTALLADON ::: RE0-ATRJATION‘ : : 8ER DEsiONED ;ALTERNATIVE
<br />RE PLACEUENT :1. OUT-OE-SERVICE SEPTIc SYSTEM 1 ,1-, DESTICN:TION
<br />NSTALLATION WILL SERVE: 174• REsisEroca ....." CUE AL C OTHER I
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<br />NWASER Cr,LIVING ,LINITS: J _ _ NUUSER OP SEORGG44S:
<br />414. SEPM, TAW T .1ErfArG CAPACrry galS i Ciii.ti,AVT4dEtCS
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<br />GREASE TRAP T ,:T;E;k4Fc.;
<br />DISTANCE TO NEAREST: WELL
<br />ft F01.3310,...T)W /2
<br />Cl LIFT STATION SIZE TYPE OF PUMP 3 PKG TX PLANT LI SAND OA. SEPARATOR 4E CLOSED SYSTEtA) 1
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<br />LEACH LINES LEACHING CHAAASERS A Or LiNrS
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<br />LENGTH DE LINE `. it '''., :
<br />Cit'S'IANCE TO NEAREST vPELI, ft ft ! t ‘ie,.; ' ft. F.::;:kiNCATiON ,,,,r) Prit7.,PERTy Lwr, -
<br />Cl FILTER BED %tom ft LEiilTH ft ft I
<br />DISTANCE TO NEAREST WELL ft FOu:NOATI.ON RD"I'Prt
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<br />l OPERTY LINE tt. !
<br />Cl MOUNDED Worm ft LENOTH „ . IIDEpTH
<br />0,6 TA NOE TO N !SANEST AtE!!..I. ft rOU'N'ATK1'...N AI ,
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<br />I!",,OPERr/ k..;'NE
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<br />Cl SUMPS Wters It LEnr.47,1 ft OCPTH
<br />DiATANcE TO NEAREST WELL ft f‘nOtt ft paper:117y 1..aa4 It .
<br />Cl DISPOSAL PONDS wtriTH ft LENc;TH ft DEA:rn it 1
<br />D;sTANCE TO NEAREST WELI. ___,,,,,,._ft rOUNOATION ft pRoPt•tIrrf L,NE,
<br />Z.- SEEPAGE PITS NUU8Eli .....e Wei3Th -3 -
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<br />PROPV,RT( 1..mgri' C . DisrANcs To tortaxEST 'f.t.t.i. .15-e? ft FC,..'it,e,s, nori :LC ' ft
<br />IEREBY CERTIFY THAT HAVE PREPARED DAS APPUCADON AND THE WORE Wa.L RE DONE IN AC CORDANCE WITH SAN JOACRAN COUNTY OROMANC.ES,
<br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY
<br />CROSS STREET
<br />OWNER time
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<br />COMMENTS
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<br />' ova* ("; / )(;-,, , , . ,- :•:, SPECIAL PERMIT • Approved by
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<br />Pit Sump Soil Character!
<br />PE 7 sc p.ivtd ,177.cileticiti 7 Amou- . . . • igiimiti (---- ,
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<br />Code ' itiro ! Ely C.14/1 Ripretittibd , , , Service Retreat 0 i, inv°4" 4 . ,N±4."14111:41 1
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<br />faSITE 1WASTEvvATE;1"TR TIANT SYSTEM PERMrr 42,to
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