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crryizip Lodi, CA 95240 JOB ADDRESS 6021 E Kettleman Ln. <br />ApN 049-230-11 PARCEL SIZE 16.8 CROSS STREET CUITY <br />PHONE 209-463-2517 CONTRACTOR Haley Contracting <br />BUILDING PERMIT el_ LAND USE APPLICATION # <br />REPAIR/ADDITION <br />OUT-OF-SERVICE SEPTIC SYSTEM <br />ft DEPTH <br />DISTANCE TO NEAREST WELL 400' ft FOUNDATION 560' <br />FILTER BED WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br />CI MOUNDED WIDTH ft LENGTH ft DEPTH <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br />SUMPS WIDTH ft LENGTH ft DEPTH <br />ft DEPTH SAN <br />42-01 <br />4/14/18 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STocnToN CA 95205 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL (209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X <br />tr, <br />0 <br />INSTALLATION WILL SERVE: <br />NUMBER OF LIVING UNITS: <br />RESIDENCE COMMERCIAL <br />NUMBER OF BEDROOMS: <br />OTHER <br />NUMBER OF EMPLOYEES: 120 <br />TYPE/MFG .1ex\5en WeLcAsV._. CAPACITY WM) gal # OF COMPARTMENTS 2. <br />TYPE/MFG CAPACITY <br /> K <br /> <br />SIZE 113-j7_ TYPE OF PUMP 0 PKG TX PLANT 1:1 SAN • OIL SEPARATOR (ENCLOSED SYSTE <br /> aftlAitagt__ Prilial le ,IIL Ai A e <br /> <br />LEACHING CHAMBERS infiltrator # OF LINES 4 LENGTH OF LINES 100. <br />Em„174 <br />HEALr <br /> ft FOUNDATION 550' ft PROPERTY LINE 220' <br /> <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 /> <br />DISTANCE TO NEAREST WELL <br />DISPOSAL PONDS WIDTH ft LENGTH <br /> <br />DISTANCE TO NEAREST WELL <br />SEEPAGE PITS NUMBER 4 <br /> <br />DISTANCE TO NEAREST WELL 500' <br />WIDTH 36" <br /> ft FOUNDATION ft PROPERTY LINE <br /> ft DEPTH 25' <br /> sel) <br />Celleel; <br />o, 202 <br />iN <br /> <br />" s•(:)(1., <br />lifeNrAivlY <br />d IRTAik.Nr. <br />84/N/M 48 HO <br />SIGNED <br />D 'NCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 <br />TITLE <br />ii \cti <br />1111111 II <br />111111 I <br />D PARTMENT S <br />- <br />ONL <br />Date 447 R-7 Area <br /> Date (IC/ AN t SPE <br />Pit/Sump Soil Character: <br />teme.emer4 <br />-0 <br />-0 <br />*oeitsi/ <br />Employee ID#_MAftbtral9 <br />AL PERMIT - Approved by <br />5 Do <br />Application Accepted By <br />Final Inspection By <br />Character of Soil to Depth of 3 Ft: <br />-t) 15eic <br />PE <br />Code <br />SC Received <br />INFO <br />Ctc„....z:ziEV 'Amount <br />Remitte <br />Permit/ Invoice # Permit ID# <br />q).tet vs-1 .23 iS <br />(at <br />q 1 1 <br />eryice.gu # <br />54of g <br />2M O7c/Pa 6i 4 I c2 IL SPsho <br />ft PROPERTY LINE 210' <br />ENGINEER DESIGNED/ALTERNATIVE <br />DESTRUCTION (0. <br />TYPE OF WORK: NEW INSTALLA no <br />REPLACEMENT <br />SEPTIC TANK <br />GREASE TRAP <br />LIFT STATION <br />LEACH LINES <br />gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL ft FOUNDATION PROPERTY LINE <br />ft FOUNDATION ft PROPERTY LINE <br />DATE <br />COMMENTS t <br />16% , <br />icAt. <br />PERC TEST # <br />AA? <br />Pkitk <br />Ar <br />A N• <br />(I*( C AAA" C° <br />OWNER NAME Delta Packing - Berton Costamanga PHONE 3214538 <br />OWNER ADDRESS 6021 E Kettleman Ln. CITY/STATE/ZIP Lodi, Ci 95240 <br />CONTRACTOR ADDRESS 4228 Newton Rd. Ow/STATE/ZIP Stockton CA 95205 <br />LICENSE 1 (3-42 A, B, C16 C-36 OTHER NUMBER 680607 EXPIRATION DATE 11 /3°/21