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LICENSE II C -42 OFIC-36 NUMBER OTHER <br />CROSS STREET ''.; eC Rcl ApN„).°7-4,-e7 -,-7(7/ PARCEL SIZE <br />OWNER NAME CiOg 02 S';'.,'C., PHONE <br />OWNER ADDRESS ....3'6-e6.-. C .27",tv-PA (1ef CITY/STATE/ZIP Gc--7.5e-,/a1 c--,, eilr 3 L.;)0 <br />CONTRACTOR gele° PHONE <br />CONTRACTOR ADDRESS CITY/STATE/ZIP <br />EXPIRATION DATE <br />TYPE/MFG .0,7-1(/ Or SEPTIC TANK CAPACITY 410 Er gal # OF COMPARTMENTS <br />GREASE TRAP TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />ft FOUNDATION ft PROPERTY LINE ft DISTANCE TO NEAREST: WELL <br /><-eia <br />f4 <br />etca_ <br />WATER TABLE DEPTH: /70 <br />PIC NEW INSTALLATION <br />REPLACEMENT <br />REPAIR/ADDITION <br />IA Our-OF-SERVICE SEPTIC SYSTEM <br />0 COMMERCIAL <br />NUMBER OF BEDROOMS: <br />INSTALLATION WILL SERVE: 0 RESIDENCE <br />NUMBER OF LIVING UNITS: NUMBER OF EMPLOYEES: <br />0 OTHER <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAzELToN AVENUE - Srock-roN CA 95205 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL).,(209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />JOB ADDRESS ' ei7(S" Wei CITY/ZIP <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />BUILDING PERMIT # ,f3f)--.4cX"Yin3E LAND USE APPLICATION # <br />Ll ENGINEER DESIGNED /ALTERNATIVE <br />F1 DESTRUCTION <br />TYPE OF WORK: <br />PERC TEST # <br />MI 48 HOU NC NOT E REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 Sl8U(J'- ILIS TITLE 01-741-seer---- DATE /...2 "7/6--;)-6-7 SIGNE <br />Ack..4-47,Siv4imis cob 04,017"). <br />DEPARTMENT US <br />Date ) <br /> ON LY <br />Area L+ Mg Employee ID# <br />1 <br />Date?-3/1(7,02--'1 E SPECIAL PERMIT - Approved by <br /> Pit/Sump Soil Character: <br />s-y)-6441 <br />eiN <br />YIVI&A ItEct.."'"v <br />"I: 6 2020 <br />PA <br />PE <br />Code <br />SC <br />INFO <br />Received <br />13, <br />cCh_eck#t" Amount <br />Remitted Date Permit/ <br />Service Request # Invoice # Permit ID# Cash <br />q-211 f IT ati /-(f 1-1 9(e 5g z._ lbw° sa00$13ovio <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 42-01 <br />4/14/18 <br />L r <br />Character of Soil to Dept of 3 t: <br />CI;VIell/liENTS Leo-Gh <br />Application Accepted <br />Final Inspection By