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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE -STOCKTON CA 95205 - (209) 468-3420 <br />NON-KEFUNDABLE PERMIT GALL (ZU9) 953-7697 FOR INSPECTIONS EXPIRES 7 YEAR FROM DATE <br />JOB ADDRESS 7095 East Sedan Ave. CITyIZIP Manteca 95337 <br />CROSS STREET Main Street APN 226-100-18 PARCEL SIZE 1.37 <br />OWNER NAME Mike and Deana Thornton PHONE 209-629-3780 <br />OWNER ADDRESS 7125 East Sedan Ave. CITY/STATEIZIP Manteca 95337 <br />CONTRACTOR Chesney Consulting PHONE 209-402-1652 <br />CONTRACTOR ADDRESS P.O. Box 3794 CITY/$TATEIZIP Turlock, CA 95382 <br />LICENSE L. C-42 L C-36 OTHER RCE NUMBER C75479 EXPIRATION DATE 6.30-2020 <br />WATER TABLE DEPTH: 15 ft ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br />PERC TEST # <br />BUILDING PERMIT # <br /># OF LINES <br />LAND USE APPLICATION # <br />TYPE OF WORK: <br />:: NEW INSTALLATION _. <br />REPAIRIADDITION <br />_. ENGINEER DESIGNED/ALTERNATIVE <br />WELL <br />REPLACEMENT <br />OUT -OF -SERVICE SEPTIC <br />SYSTEM DESTRUCTION <br />INSTALLATION WILL SERVE: I. RESIDENCE <br />L_ COMMERCIAL <br />L OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK <br />TYPEIMFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />❑ GREASE TRAP <br />TYPE/MFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />ft PROPERTY LINE <br />DISTANCE TO NEAREST: WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ LIFT STATION <br />SIZE TYPE OF PUMP <br />❑ PKG TX PLANT <br />❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ LEACH LINES <br />i LEACHING CHAMBERS <br /># OF LINES <br />LENGTH OF LINES <br />It <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ FILTER BED <br />WIDTH <br />ft LENGTH <br />ft <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ MOUNDED <br />WIDTH <br />ft LENGTH <br />It <br />DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ SUMPS <br />WIDTH <br />ft LENGTH <br />It <br />DEPTH <br />ftA�l <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE <br />❑ DISPOSAL PONDS WIDTH <br />ft LENGTH <br />It <br />DEPTH <br />-QA .. ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINEy,�, <br />ElSEEPAGE PITS <br />NUMBER <br />WIDTH <br />ft DEPTH <br />iVVi[;r <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE <br />(LChI• <br />QEPA RTMENTUS ONLY r <br />Application Accepted By �� �� Date .z LJ?0 Area �- / Employee ID#_t>A <br />Final Inspection By Date L SPECIAL PERMIT -Approved by <br />Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: <br />COMMENTS <br />PE SC Received Check Amount Date Permit/ Invoice # Permit ID# <br />Code INFO Bm Remitted Service Request # <br />y as 52 364 <br />Asa <br />42.01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4114/18 <br />F�E/v -r <br />/ AFD <br />'R 282020 <br />AQUIN Cp <br />E ARTM fVr <br />