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/Z -i11 -2o2/ ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 468.3420 NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS tXPIRES T TEAK I-KUM UAI t IJJUtU JOB ADDRESS 19597 E Mehrten Road CITY/ZIP Clements, Ca `7 l CROSS STREET Mackville Road APN 023-020-28 PARCEL SIZE 6.97 OWNER NAMEJennlfer Redmond PHONE 415-505-7418 OWNER ADDRESS 180 Lower Terrace CITY/STATE/ZIP San Francisco, Ca 94114 CONTRACTOR Del Smith Design Build PHONE 209-743-1194 CONTRACTOR ADDRESS 180 Lower Terrace CITY/STATEIZIP San Francisco, Ca 94114 LICENSE C-42 ._ C-36 OTHER B-1 NUMBER 923616 EXPIRATION DATE 10-31-2022 WATER IAe LL ULF I H: .._... ___.- PERC TEST # BUILDING PERMIT # LAND USE APPLICATION # TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED /ALTERNATIVE REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: 1 RESIDENCE _ COMMEF NUMBER OF BEDROOMS:B OTHER NUMBER OF EMPLOYEES: SIGNED Del G Smith I Z 7� — Ho,,�sz— F6 utjOA Z GJ Application Accepted JG+ / Final Inspection By ' Character of Soil to 0 'Sol Character IViciti,S COMMENTSAC Wn Emits}I�1. 1► INFO 42-01 4/14118 • :I MINE=— 1 DEPARTMENT US ONLY 7/11 Date i � /JA' Area 77 � Employee l Dar Date v!i Z ❑ SPECIAL PE MIT .Approved by PiHS mp goil Character: I t -k 4051ir ti . eS vncL�, y+7 1 n1_,tre > D.• 3 t°it�si'�1'1 11 %r,00.a 304 Date J- 13�oz� 3q � a -1n0 1�nes-I.sovb 64epth,I: qch II`res Permit! Invoice # Permit IN cir ,f°v ed Pe I/ :e Re uest # sa t 1 p,0n cis Ffms- aN l�nChCslsf 'ro"` VMder jo yrLY ONSITE WASTEWATER TRTMNT SYSTEM PERMIT C(Z)061?e; 'r No dee p er i hart 4Z P� ,es okep- SEPTIC TANK TYPEIMFG CAPACITY _ gal # OF COMPARTMENTS �❑ GREASE TRAP TYPEIMFG CAPACITY gal # OF COMPARTMENTS DISTANCE To NEAREST: WELL* ft FOUNDATION ft PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) e, /�/ +ll( LEACH LINES LEACHING CHAMBERS OF LINES � LENGTH OF �NV ft �el V \ DISTANCE TO NEAREST WELL '150' ft FOUNDATION +30' ft PROPERTY LINE S� 1t ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft PAYMENT DISTANCE TO NEAREST WELLft FOUNDATION ft PROPERTY LINE ft L3 MOUNDED WIDTH ft LENGTH ft DEPTH ft b ��I�� DISTANC/E TO NEAREST WELL ft FOUNDATION ft PRO RTYLINE ft 1w, SUMPS WIDTH,': ft LENGT ft DEPTH ft I L 2021 DISTANCE TO NEAREST WELL +200 ft FOUNDATION 80 ft PROPERTY LINES ftlf ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH 'AN JOAQUIN COUNTY, DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ftENVIRONMENTAL ❑ SEEPAGE PITS NUMBER WIDTH It DEPTH M LTH DEPARTMENT, DISTANCE TO NEAREST WELLft FOUNDATION ft PROPERTY LINE ft 1 HEREBY CERTIFY THAT I HAVE PREPARED THIS APPIJ ON AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, -- -- -- - .. !!/ ll /1^ - ^ .TL/.JAJE,,LAWS D RUL AND REGULATIONS OF SAN JOAQUIN COUNTY. cno rA,cO=f TInIUQ - PI Fd CF Cdl I /?1791 953-7697 SIGNED Del G Smith I Z 7� — Ho,,�sz— F6 utjOA Z GJ Application Accepted JG+ / Final Inspection By ' Character of Soil to 0 'Sol Character IViciti,S COMMENTSAC Wn Emits}I�1. 1► INFO 42-01 4/14118 • :I MINE=— 1 DEPARTMENT US ONLY 7/11 Date i � /JA' Area 77 � Employee l Dar Date v!i Z ❑ SPECIAL PE MIT .Approved by PiHS mp goil Character: I t -k 4051ir ti . eS vncL�, y+7 1 n1_,tre > D.• 3 t°it�si'�1'1 11 %r,00.a 304 Date J- 13�oz� 3q � a -1n0 1�nes-I.sovb 64epth,I: qch II`res Permit! Invoice # Permit IN cir ,f°v ed Pe I/ :e Re uest # sa t 1 p,0n cis Ffms- aN l�nChCslsf 'ro"` VMder jo yrLY ONSITE WASTEWATER TRTMNT SYSTEM PERMIT C(Z)061?e; 'r No dee p er i hart 4Z P� ,es okep-