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1 <br /> ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAOUIN COUNTY ENVIRONMENTAL HPALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205•(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES'I YEAR FROM DATE ISSUED <br /> JoB AODRESs <br /> 26D5 South MaWlhur OrI- CITYIZIP Tran'95377 <br /> CROSS STREET P <br /> Val Iw APN 246-14-023 PARCELSIZE o <br /> X <br /> OWNER NAME Volptca Tmcy Apartments LLC PHONE 209.649.1299 <br /> OWNER ADDRESS 2494 San Hill rOaa A100 CRYISTATEMP <br /> CONTRACTOR <br /> W.C.MalDnay,tnc. PHONE 209-244.7080 <br /> CONTRACTOR ADDRESS PO Box 30326 CITY/STATE/ZIP Slockton Ca 95213 <br /> LIOENse 01C-42 ❑-IC-30 OTHER C-21.A NUMBER 716243 EXPIRATION DATE 1/31122 <br /> WATER TABLE DEPTH: it GEOGRAPHICAL INFORMATION; Coordinates X Y <br /> C PERCTEST # BUILDING PE RM IT LAND USEAPPLICATION# <br /> TYPE OF WORK: L, NEW INSTALLATION U REPAIR/ADDITIDN ENGINEER DESIGNED IAL;rERNATNE <br /> D REPLACEMENT D OUT-OF-SERVICE SEPTIC SYSTEM IX DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMERCIAL :J OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EIAPLOYEES; <br /> ❑ SEPTICTANK TYPE/MFG CAPACITY gat #OF COMPARTMENTS <br /> ❑ GREASETRAP TYPE/MFG CAPACITY pal n OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL R FOUNDATION R PROPERTY LINE R <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP ❑ PKGTXPLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES - LEACHING CHAMBERS #OF LINES LENGTH OF LINES R <br /> DISTANCE TO NEAREST WELL it FOUNDATION R PROPERTY LINE it <br /> ❑ FILTER BED WIDTH A LENGTH it DEPTH 1t <br /> DISTANCE TO NEAREST WELL It FOUNDATION 1t PROPERIYUNE /t <br /> ❑ MOUNDED WIDTH it LENGTH 1t DEPTH it <br /> DISTANCE To NEAREST V1CLL It FOUNDATION R PROPERTYUNE it <br /> ❑ SUMPS WIDTH it LENGTH 1t DEPTH R <br /> DISTANCE TO NEAREST WELLfl FOUNDATION 1t PRO?ERTY LINE It <br /> ❑ DISPOSAL PONDS WIDTH 1t LENGTH It DEPTH it <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY UNE R <br /> ❑ SEEPAGE PITS NumBER WIDTH It DEPTH 1t <br /> DISTANCETONEAREST WELL ft FOUNDATION R PROPERTYLINE R <br /> 1 HEREBY CERTIFY THAT I HAVE PREPAREDAPPLICATION <br /> E WORK ILL B D NEN ALCOR ANCE. ITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LA RULES AND <br /> f/NIM N R ADVANCE NQ_r1rF PFOHIRFE1 Fn— PEC lONS-PLF CAL 09)953-7697 / <br /> SIGNED <br /> TITLE Safety Director DATE — <br /> 1 <br /> S e e a t t a c h e d m a p <br /> F�MFNT <br /> E�AFD <br /> R 1 0 ?021 <br /> Q�/N C <br /> A pq R T7"4 t <br /> DEP AR T IH E NT I SE ONLY f� <br /> Appllcatlon Accepted By, L Area ea S /..0 y Employee ID# D gill <br /> Final Inspection Byy Date El SPECIAL PERMIT•Approved by <br /> Character of Soil to Depth of 3 Fl: IUSu P Soil Character: <br /> COVMENTS rte`— <br /> r <br /> �I'" uc�'�IFI�n i� �IicIQ�Q3l� a'1: <br /> PE SC Received Check#I Amount Date Permit' <br /> Invoice# Permit ID» <br /> Code INFO Cas Remitted <br /> Service Re ostk <br /> Od 07y <br /> 4210118 l Li/ / � —' C V ONSTFE WASTEWATER TRTMNT SYSTEM PERMIT <br />