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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT
<br />SAN JOAQUIN COUNTY ENVISIONMP,NTAL HEALTH DEPARTMENT 304 E WESER AVE - 3'FL - STDCKTOX CA 95202 - (2e)) 460-3420
<br />NoN.REFt 1NDA.31 T. PERMIT CAL L 4209) 953-7697 FOR INSPECTIONS EXPIRES I % :EAR FROM DATE ISSUED
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<br />CROSS STREET 4/.:>7),Y4C-Ke2/101, APN 1 OS- - 04-C - IT PARCEL SIZE I. 1C" (4
<br />OwNER NAME ...CA ;it A;,,e7X2.1.0 ..,426 RE B.1 IX 1/4/ .PHON ...,...___,E`.---_,,,e.2„7„,„/6
<br />OWNER ADDRESS CETWS'TNIVZH, (e441-451Y) . ''..4;;•-• 3
<br />CONTRACTOR "Fie-ef,'Cd1/6444-1
<br />CONTRACTOR ADDIRESS,0
<br />ITCENSE )SC-42 0 C-36 OMR )4 NUMBER
<br />CITV/STATEIZIP 57/at 4...72,7,/ (-7..,z4 9
<br />Emi ilus DATE
<br />PHom 93/- /IX/ 0
<br />(7)
<br />it
<br />SK LEACH LINES 0 LEACHING CHAMBERS
<br />DIATANCE 10 NEAREST
<br />FILTER BED Asilom _
<br />DISTANCE TO NEAREST
<br />MOUNDED Wpm
<br />DISTANCE TO NEAREST
<br />LENT,TH OF LINES Str.(7 ft
<br />WELL FOOS DM ON '"'74-It PROPERTY LINE It
<br />ti LENGTH H DEPTH 11
<br />WTI I. A FOUNDATION El PROPERTY LINE ft
<br /> It LENCTIlt ft Dtri R It
<br />WRIA., It FOI:NDADON n PROPER:I' L:NE it -,
<br /> # (Jr LINTS
<br />WATER TOILE. DEPTH: D GEOGRAPHICAL INPORNIATION: CarsolIVRIES X
<br />i 0 PERC TEST (SI NUMBER LAND OSE el/PERIM ION 4
<br />TYPE OF WORK: pc... NEW INSTALLATION
<br />0 REPLACEMENT
<br />REPAWALtornos a ENGINEER D ICNED LTERNA
<br />3 Drsri4LCUON
<br />INSTALLATION WILL SERVE: Ci RESIDENCE )(COMMERCIAL U OTHER
<br />NIJNISEk OE LIVING UNITS:
<br />CI SEPTIC TANK TYPE:MEG
<br />GREASE TRAP TYPELOAFG
<br />C3 'MG TX PLANT OtslAsccru NEAREsr: WELL
<br />NUMBER OE BEDROOMS: NUMBER OE EMPLOYEES:
<br />CAPACITY1.41.0___ *41 4 OF COMPARTMENTS
<br /> CAPACITY gai OE COM PA
<br />ft FOUNDA LION fl PROPERTY LINE
<br />LIFT STATION Sim
<br />
<br />TYPE OF PUMP
<br />
<br />LI SAND OIL SEPARATOR (ENCLOSED SysTEm) -P
<br />
<br />CI SUMPS WIDTH Pt LENGnI R Wpm e
<br />DISTANCE TO NEAREST WELL ft H.NNUATios ft 1,mm/qv usE it
<br />DISPOSAL PONDS Wooru ft LENOIR tt DEKI1 B
<br />DISTANCE TO NEAREST WELL a MAI ARAI ION R
<br />WIDTH
<br />ft PROPERTY IINT. A- SEEPAGE PITS a," tl LENGTH 11 ft
<br />DISTANCE TO NEAREST WELL ,ii.t..2> - i" ft POUNDATION _.e.,.../:)...: P.DEPT"PREPER-57TY L'IN.' 1. It
<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 JOAQI1N COUNTY,
<br />MUM HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS -PLEASE (ALL 1209) )S3-7647
<br />SIGNE nTLE DATE
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<br />Application Accepted B
<br />Date 5 - At F.mpIGyD l1IS J 4 '1
<br />Final Inspection ft
<br />Chum:ler of Suit iu De of 3 Fl: PlI)Sump SDK alai-Baer:
<br />COMMENTS .sAol—(0 ola re9--
<br />Date (Le/2? /er - D SPECIAL PERMIT - Approved by
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