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OWNER ADDRESS PO Box 54153 <br />CONTRACTOR W-C MalatttY• inc. <br />CONTRACTOR ADDRESS Po Box 30326 <br />LICENSE -.1" C-42 C -C-35 Ornee S-21. A <br />CITY/STATE/ZIP Los Angeles 93054 <br />pm, 209-244-7090 <br />Cur/STATE/ZIP Stockton Ca 05213 <br />NUMBER 718243 EXPIRATION DATE 1'31'22 <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />BUILDING PERMIT # LAND USE APPLICATION # <br />U REPAIRIADDITION .. ENGINEER DESIGNED /ALTERNATIVE TYPE OF WORK: L NEW INSTALLATION <br />0 REPLACEMENT D OUT-OF-SERVICE SEPTIC SYSTEM X DESTRUCTION "P5° luck <br /> <br />INSTALLATION WILL SERVE: E RESIDENCE 2 COMMERCIAL <br /> <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />E OTHER <br />NUMBER OF EMPLOYEES: <br />0 <br />0 <br />0 <br />SEPTIC TANK TYPE/MFG CAPACITY ga # OF COMPAIRTMENTS <br />GREASE TRAP TYPE/MPG CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE rt <br />LIFT STATION SIZE TYPE OF PUMP 0 PKG TX PLANT CD SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />0 LEACH LINES 7 LEACHING CHAMBERS # OF LINES LENGTH OF LINES ii <br />DISTANCE TO NEAREST WELL /1 FOUNDATION ft PROPERTY LINE ft <br />0 FILTER BED WIDTH ft LENGTH ft DEPTI-1 fl <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY UNE ft <br />0 MOUNDED WIDTH It LENGTH ft DEPTH fl <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />0 SUMPS WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE It <br />0 DISPOSAL PONDS WIDTH ft LENGTH it DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />0 SEEPAGE PITS NUMBER WIDTH it DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION fl PROPERTY LINE ft <br />WATER TABLE DEPTH: <br />PERC TEST <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1068 B. HAZELTON AVENUE - STOCKToN CA 95205 -(209)468-3420 <br />NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS <br />Jog AogRegs 2275 Bacon Island road (GPO ,3" 7, q1/57127,(21.0.3 7 ciTymp stoat.. <br />EXPIRES 1 YEAR FROM DATE ISSUED <br />CROSS STREET Sam. isimd ROWI APN 12905014 <br />PARCEL SIZE <br />OWNER NAME Metro Water District Of Southern Ca PHONE 510419-3470 <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL HE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br />STATE LAWS AND RULES AND REGULATIONS OP SAN JOAQUIN COUNTY. <br />MINIMUM VANCE NOTICE REQUIRED FOR INSPECTIONS- PLEASE CALL (2091_95 -76 7 <br />SIGNED TITLE Safely Director DATE <br />a a c <br />pEPARTMEpIT USE ONLY <br />Application Accepted By ......"......L.—//_r_ Date . r P1:.>' ,, r• Employee 1134 /1 Lf- <br />Final Inspection By 17 t. i C„),S7( rl : Date S'71'`1( L1 0 SPECIAL PERMIT - Approved by <br />Character of Soil to Depth of 3 Ft: Pit/Surrip Soil Character: <br />COMMENTS LA.'? c_ 61.t- f ,... i cc 6--f—e icy/ , c IA ir 1 e.i.- Si 1, e,.." p ,- — )e.,....- <br />,ti-- f .. ik--- c,i,,..tt: v _ fr',.. ,- • ( ,, 1.--) r, oz., (if IT et <br />PE <br />Code <br />SC <br />INFO <br />Received Checkei Amount <br />Remitted Date Permit/ <br />6 , Invoice 6 Permit IDtt <br />q, 33 ) 0 7S- <br />ip_ <br />' I ' 1:f.S( <br />;bat, <br />L "7 <br />v <br />1 <br />,etivioex,Refoos5t _§ <br />SCULI <br />I I <br />42-01 <br />4/14/18 /234-/324" <br />ONSITE WASTEWATER TRTNINT SYSTEM PERMIT