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ONSITE WASTEWATER TREATMENT SYSTEM PERMiT <br />Scd JOAOIJ;t! COU4" F'MRORMENTAL HEALTH DEPARI HENT 1"66 E. I ;A2£LTIoN AvEtux • STOChION CA 95206 -(209) 461i•3420 <br />Jos ADDRESS <br />C rymp <br />L91141 •J x <br />CROS i STREET TT �li.Y•q�j ) AP i /_L� " _ Pai m sw <br />OWNER NAME (.A s , w*'1 �'�4. L.i e.s'}Y,x!'' � Y)a1 46-1 <br />L /#� t <br />OWNER ADDRESS ' I.L'Y G 4� '• rf IJ �._ CITY:'STATeibP <br />COWPACTOR--ti� S _._._._— PNCNe <br />CON'MCTOR ADDRESS <br />L;DENSE l]'C-4 IGC 36 OTHER _.__.____ <br />YSATER TA=LE DEPTH, fl CEDGRAFHICALiNFORMATIOT.'; Cooni3nafD+s X ______ Y_ <br />L) FERC TEST R E BUILDING PEFUT # �—__—�� _ LAND USE APPLICATION <br />TYPE OF WORK: tl NEW INSTALLATION ii FO PJADOi T7ON� ENGINEER DEStON£D IALTERIaATNE 1 <br />1 REPLACEMENT f'i OUT-OF-SERvKE SET''VIC SYS" Em _�_ DESTRUCTION <br />INS T.4LLA ilON OLL SMIE:^ ! licaalotwe F1 COAiLE=AL OTHER <br />NULmm of LtvIiNG UmTs: _ NIJKBER OF BEDROOMS: NUMBER OE Elt'PLO\7:ES: JI <br />11-11r,TANK � T wPE a G CAPACITY ��� _. S£3 <br />La CREASF. TRAP TYPF..&FCCAPFGTY gal SOFC0MP,ARTk4FNTS,�__ 1{ <br />DISTANCBTO NEAREST_ 41"r.LL//j�/��..(( <br />`.C�Z-- R ;'tTl3'.90J.TN3R _ ... P, PROP..iiTY LINE I() r ±! <br />V Ui-T87ATION SIZE TYPE OF PUMP O PKSTXPLA-W LT SAND OIL SEPARA'TOR.(ENCLOSED SYSTEW <br />DA <br />LEACH UWM <br />i:3 LEACHING CHAMBERS _ #OF LINES <br />� L> fd373ipFtLdE, �� <br />h <br />!� <br />y. <br />OrsTAmcf To NEARCST Z•.^::.L, !! Fot;?'DATION <br />F PROKRTY LINO <br />L.I <br />FIL'f ER BED <br />%DTH __ fi UiNOTH _...__. <br />.._fi OE:PTH <br />Dt TAw.ETO NEAREST WELL R FOUNW-iON <br />A PROPkAiYLINE <br />h <br />U <br />1,CsI.18:tTED <br />Ww m, _ It LiN-3TH <br />IT <br />Disumca Tc NEAREST 'Vs'E1k.,,,,,,,_,,,, tt rot,,mDAiiu-N <br />_.._.....__.....f PROPERTY LINE ._............_ .� <br />Z <br />cUPRPB <br />wtDTN ft LcNGTH <br />St O TH <br />_ _._ _ <br />DISTA=- TO NEAREST %WLt q F)UNDATK)N _,_,,,,,_ <br />ft -" PROPERTYUNC <br />G <br />DISPOSAL PONDS ydlDxta_„-__­ It LENGTH <br />_'•* DEPTH <br />� <br />DISTANCE TO NEAREST Auu_ ft i`ouw;TION <br />M PRpPERTY uut-, <br />seE"AM PITS <br />:,u:,sTri YYM)TN <br />, <br />n e:=' -T+ _?.$—_��� ------ <br />'� <br />`,,.. <br />DYgT•Ai Tq NEAREST +h'i.li. F+ FbU:v'iU.T�JN <br />'f' (t . r203"?1iY LtNV� <br />I riERE CERTIFY THAT I HAVE OPE PA4D THIS APPLICATION AND THE LMORK WILL t3E DOW IN ACCORDANCE VffH SAN JOAQUIN COUNTY ORDINA4CES. <br />h. STATE LAWS AND RULES AND REGULATIONS OF SAN J^..AAQUIN COUNTY. <br />DA <br />Application Accapkod By _ DatD-� Area -i ETTrpioyea <br />Final lrspoCinin BY��.%t!i.'_.�� .1� �� :.__ SPECIAL P Mit -Approved by -- <br />Charac9er of soil to Depth of 3 £1: _ _ PiLSmp SDil Character: <br />COMMENTS <br />a2-:-5 ONSITE WASTF'XA.TER TRIM Nr SYSTEM FEPM r <br />����� �.����%iirl%� t�.�il�.._t�Li Tyr, <br />•�f <br />Application Accapkod By _ DatD-� Area -i ETTrpioyea <br />Final lrspoCinin BY��.%t!i.'_.�� .1� �� :.__ SPECIAL P Mit -Approved by -- <br />Charac9er of soil to Depth of 3 £1: _ _ PiLSmp SDil Character: <br />COMMENTS <br />a2-:-5 ONSITE WASTF'XA.TER TRIM Nr SYSTEM FEPM r <br />