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WATER TABLE DEPTH: 90 --SO <br />NEW INSTALLATION REPAIR/ADDITION <br />REPLACEMENT (//44.. OUT-OF-SERVICE SEPTIC SYSTEM <br />INSTALLATION WILL SERVE: <br />NUMBER OF LIVING UNITS: <br />II COMMERCIAL <br />NUMBER OF BEDROOMS: 3 <br />fg•-• RESIDENCE <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />BUILDING PERMIT # LAND USE APPLICATION # <br />ENGINEER DESIGNED /ALTERNATIVE <br />7 DESTRUCTION <br />E OTHER <br />NUMBER OF EMPLOYEES: <br />PERC TEST # <br />TYPE OF WORK: <br />CI Paymear Receivegvo <br />SA 0 N <br />kie.41.EN4LAI7A1 couAm, <br />Ty DWI ' <br /> <br />AfEryr <br />"Li 1 2021 <br />DEPARTMENT USE ONLY <br />Date 3//// Area 1-1 /C? Employee ID# <br />LI SPECIAL PERMIT -Approved by <br />L <br />Date 3/31 <br />Application Accepted <br />Final Inspection By <br />Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: <br />COMMENTS —rovt repi4ce 1el1 o <br />Cr <br />14hk• A) -le Is ,.1 • p <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 />JOB ADDRESS <br />CROSS STREET <br />7o C3 Eickea b it y <br />APN OSI<O6DI CI <br />CITY/ZIP Zur.4: <br />PARCEL SIZE 4 7 <br />IJ e"..v 46-7 (;) e.. 261- PHONE OWNER NAME <br />CITY/STATE/ZIP OWNER ADDRESS <br />CONTRACTOR Lf...C.i,141Z Z 4/47 PHONE <br />CONTRACTOR ADDRESS -3:7 /6 CITY/STATE/ZIP <br />Cief/e// NUMBER 4/5yo vc--- EXPIRATION DATE LICENSE D rbt.-42 EF C-36 OTHER <br />SEPTIC TANK <br /> <br />TYPE/MFG CAPACITY 1).00 gal # OF COMPARTMENTS <br />El GREASE TRAP <br /> <br />TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL JA r <br />ft FOUNDATION <br /> <br />ft PROPERTY LINE $Z ft <br />LIFT STATION SIZE <br /> TYPE OF PUMP 0 PKG TX PLANT <br /> <br />SAND OIL OIL SEPARATOR (ENCLOSED SYSTEM) <br /> <br /># OF LINES <br /> LENGTH OF LINES ft <br />ft PROPERTY LINE ft <br /> ft DEPTH ft <br />ft FOUNDATION ft PROPERTY LINE ft <br />ft LENGTH ft DEPTH ft <br />WELL <br /> <br />ft FOUNDATION ft PROPERTY LINE ft <br />ft LENGTH ft DEPTH ft <br />WELL <br /> <br />ft FOUNDATION ft PROPERTY LINE ft <br /> ft DEPTH ft <br />ft FOUNDATION ft PROPERTY LINE ft <br /> ft DEPTH ft <br />ft PROPERTY LINE ftft <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 />MINIM M 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />SIGNED TITLE /'‘i,-74AL-17-r---- DATE WV <br />PE <br />Code <br />SC <br />INFO <br />Received <br />By , . . . _ ..c, jk#K <br />Cash <br />Amount <br />Remitted Date Permit/ <br />Service Request # Invoice # Permit ID# <br />Li d 0 q i 1 s-- wy-60 • iv i .9.JA ,3 ,::, 311121 ,S. V-00 &33c--',1 <br />42-01 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18 <br />LEACH LINES I LEACHING CHAMBERS <br />DISTANCE TO NEAREST <br />FILTER BED WIDTH <br />DISTANCE TO NEAREST <br />El MOUNDED WIDTH <br />DISTANCE TO NEAREST <br />SUMPS WIDTH <br />DISTANCE TO NEAREST <br />DISPOSAL PONDS WIDTH ft LENGTH <br /> <br />DISTANCE TO NEAREST WELL <br />SEEPAGE PITS NUMBER <br />DISTANCE TO NEAREST <br />WELL <br />ft LENGTH <br />WELL <br />WIDTH <br />WELL <br />ft FOUNDATION <br />ft FOUNDATION