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Date Final ImpectIon By <br />Character of soli <br />COMMENT <br />PCYV:VIA. 1 <br />SPECit. PERMIT - Approved <br />Soil Character: <br />ONSITE WASTEWATER TREATMENT SYSTEM PERM T <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Me E. NAZELION AVENUE - STCOKTON CA 95205 . (209) 4584420 <br />NON-REFUNDARI R PERMIT CALL (209) 953-7097 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />Joe Arzeksa ISNC) I S leY(IX VII' M..) C...0tArt CiTT/ZIP o <br />CROSS STREET H APR el q - 24,0 - .5- PARCEL STEE 2"' <br />OWNER NAME OD --ext ViPkte; / 47w2AL4--z, 44e-rti‘4J PHONE <br />OWNER ADDRESS i I 0 AtiRAAS, Atn‘ CITY/STATE/ZIP vol, 611-7,444-- <br />CONTRACTOR V\IP5k- 0 W.:A ?-Ar...V-ii\re., 1440NE. (2 °CI ) 3744 <br />CONTRACTOR ADDRESS ...." MZI-iii*. i') k I Si-. erre/sum/zip CA q62t4 n <br />ucenst Doe-42 00C-36 on A EXFIRAll ON DATE 2-0 20 <br />11.,1 <br />WATER TABLE DEPTH: WU t 401 ft GEOGRAWECAL IsFORMAT1ON:C news x <br />0 PERC TEST # BUILDING PE Lo USE APPLICATION # <br />TYPE OF WORK: NEW INSTALLATION <br />" REPLACEMENT <br />PMRIADOH ENGWEER DESIGNED /ALTERNATIVE <br />OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> <br />INSTALLATION WILL SERVE: X RESIDENCE <br />NUMBER OF LIVING Wars: <br />COMMERCIAL <br />bROOMS: <br />ili OTHER <br />Mono: OF EMPLOYEES: <br /> <br />SEPTIC TANK TYPE/MFG J- <br />O GREASE TRAP TYPE/MFG <br /> <br />CAPACITY Z WC> gal *OF COMPARTMENTS <br />CAPACITY gal 9 OF COMPARTMENTS <br /> <br />DISTANCE TO NEAREST: WELL 5c) it FCUNDATION ft PROPERTY UNE <br />CI LIFT STATION RI7E TYPE OF PUMP 0 NC TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />— , <br />LEACH LINES LEACHING CHAMBERS INF 1\trIrSt,r2-S 0 DF Lises LENGTH OF UNE9154.11- 3) <br />DISTANCE TO NEARES T WELL I '...?:b It FOUNDATION ILIA,' ft PhoPERTY LINE i 0 <br />a FILTER BED Worm 11 LENGTH 11 DEPTH ft <br />DISTANCE TO NEAREST WELL ft roufoATiGN ft PROPERTY LEIE It <br />0 MOUNDED Worn ft LENGTH <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />C3 SUMPS WIDTH _ ft LENGTH 11 DEPTH ft <br />DISTANCE TO NEAREST WELL It FOUNDATION It PROPERTY LINE <br />DISPOSAL PONDS Wore ft LENGTH ft DEPTH It <br />DISTANCE TO NEAREST WELL ft ft PROPF.RTY LINE ft <br />10( SEEPAGE PITS NummER Wien. <br />FOUNDATION <br /> <br />413)' ft DEPTH 25 <br /> ft FOUNDATION I PROTIERTY UNE DISTANCE TO NEAREST WELL 159 ft <br />1 mEREBY CERTIFY ThAT HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOACILINI COUNTY ORM <br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />SIGNED <br /> 48 HOU LAXE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 <br />TITLE .PI'Dy'Cir all.,(Ct-LritA ttr DATE I 42 I 1C441 <br />.- <br />— II . ,.. <br />4 -4 <br />. V 200 i -- .., 44 : .•c• M .1 . . -. 11111111A___111111111111 IIIIIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIIII _ a. <br /> <br />IIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIIIIIIIMIIIMIIII iiii <br />I , <br />Application Accepted By Clidift. . <br />EPARTMEN <br />DaW tills LL1_..._ qq._ Empioyee IDA eAttre.—__ <br />PE C <br />Coôa 1 O <br />I Recalv.d <br />B <br />tIecI/ <br />O1t <br />Atnoulit <br />Remitted Date Permit/ <br />Service Raocitmost 0 <br />5/11' *1 Ste trii6-3 2- ! <br />42411 ONSITE WASTEWATER TR TMN T SYSTEM PERMIT <br />Ar1.0113