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JOB ADDRESS 16 vo ov..14‘16“..1 <br />CROSS STREET .r."• <br />OWNER NAME SAL 5024..r A <br />Cirdzip F12-C C.Ak C."14A40 °IS" 2-3 I <br />APN 113- 2420 - PARCEL SIZE • C AC • <br />PHONE ( 6-1 (90 ••' 3f <br />cc el,K) pr12.1) cr . <br />OINK Ge0 E/OVIRO r.) net e-NJTA <br /> CITY/STATE/ZIP WVC CA C311, <br />PHONE <br />OWNER ADDRESS <br />CONTRACTOR <br />WATER TABLE DEPTH: <br />PERC TEST # BUILDING PERMIT # LAND USE APPLICATION it <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />MINIMUM 4 OUR AD E NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 <br />TITLE Pa-0) 14.‘6-11- • DATE 2 -#F 2* I SIGNED <br />42-01 <br />4/14/18 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209)468-3420 <br />NON-REFUNDABLE PERMIT CALL (209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />TYPE OF WORK: NEW INSTALLATION <br />REPLACEMENT <br />REPAIR/ADDITION <br />OUT-OF-SERVICE SEPTIC SYSTEM <br />ENGINEER DESIGNED /ALTERNATIVE <br />DESTRUCTION <br /> <br />INSTALLATION WILL SERVE: 0 RESIDENCE 0 COMMERCIAL <br /> <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />OTHER <br />NUMBER OF EMPLOYEES: <br />0 <br />0 <br />SEPTIC TANK <br />GREASE TRAP <br />TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft <br />0 LIFT STATION SIZE TYPE OF PUMP PKG TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />ID LEACH LINES LEACHING CHAMBERS # OF LINES LENGTH OF LINES <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />0 FILTER BED WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />0 MOUNDED WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />U SUMPS WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />U DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />ID SEEPAGE PITS NUMBER WIDTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />e2,46, <br />044.7 ito <br />Area Employee c:% <br />k by <br />Application Accepted y ......--Z.--2,_,„ Date ,,,7 ir j <br />Date I 6/7.4.224 r] SPECIAL PERMIT - Approved by <br />V eig I / <br />Final Inspection By <br />tf- 71/41CC/ 1)° <br />P <br />E2. U E ONL Y <br />Character of Soil tADepth of 3 Ft: Pi Soil Character: <br />COMMENTS rer-r 1.--6... ti, 39 *7 ;4 1 -, A <br />PE <br />Code <br />SC <br />INFO <br />Received <br />B <br />Checke <br />Cash <br />Amount <br />. Remitted Date Permit/ <br />Service Request # Invoice # Permit ID# <br />9pa 533, <br />0.... <br />/(0(e0 tis'd VI•ii S.00 832.1-1 :SS311aCIV glIS .94v <br />4\ <br />t.) <br />DEPARTM <br />if 44-40,, <br />CONTRACTOR ADDRESS 401 J. Otegg• rr • CITY/STATE/ZIP USD CA cirist D <br />LICENSE C-42 Li! C-36 OTHER C NUMBER 2. I r" EXPIRATION DATE 4 -70-7-4