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SEPTIC TANK TYRE/MFG <br />LI GREASE TRAP TYRE/MFG <br />CAPACITY gal # OF COMPARTMENTS <br />CAPACITY gal # OF COMPARTMENTS <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />WATER TABLE TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X <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 A" t je../ I cmazip Cos <br />OWNER ADDRESS CITY/STATE/ZIP <br />ger, CONTRACTOR PHONE <br />CROSS STREET I 1 a APN c70 - 3 PARCEL SIZE <br />OWNER NAME FO VaVkt.- pws- ( T *4/C4 (ri PHONE <br />?C) fON( 73 <br />ith Li gil,c" <br />CONTRACTOR ADDRESS p r, ysc.i, to co <br />LICENSE DI JC-42 Li C-36 OTHER 14 NUMBER Cs, F*5-94 <br />CITY/STATE/ZIP 3/114v1 &i# c1c 3-?4:.7 <br />EXPIRATION DATE <br />NEW INSTALLATION <br />REPLACEMENT <br />BUILDING PERMIT # <br />L./REPAIR/ADDITION <br />OUT-OF-SERVICE SEPTIC SYSTEM <br />Hi ENGINEER DESIGNED /ALTERNATIVE <br />17 DESTRUCTION <br />Li PERC TEST # LAND USE APPLICATION # <br />TYPE OF WORK: <br /> <br />INSTALLATION WILL SERVE: C..-RESIDENCE E COMMERCIAL E OTHER <br /> <br />NUMBER OF LIVING UNITS: I NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />C.- (—cr.:Ye <br />Area Employee ID#V. 1AftitIki54 <br />C SPECIAL PERMIT - Approved by <br />it/Sump Soil Character: <br />ON Y <br />Date <br />Date-5- <br />of 3 <br />0,74ere-s--; --rv- <br />Application Accepted B <br />Final Inspection By <br />Character of Soil to Dep <br />COMMENTS <br />PARTMENT <br />. Agri, <br />IM 7 A- <br />it PAy, <br />ir,$41 <br />12 2021 <br />44014N c <br />tNoki*.°417kAlli <br />Soily <br />PE <br />Code <br />SC <br />INFO <br />Received <br />By <br />Check#/ <br />a <br />Amount <br />Remitted Date Permit/ <br />Service Request # Invoice # Permit ID# <br />it C d10--- IqZ1 <br /> <br />/7787 J;o0 11-11)-1/1 sizoos(g) <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 42-01 <br />4/14/18 :SS311(10 V 31IS