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crryizip 5-77)C1C715 46.1 Is -23 r JOB ADDRESS ti igo C. . ADA A-VE • APN 2P0- 33 PARCEL SIZE Pr At • PHONE ((ISO) CV> •.) S32. CROSS STREET 5.16LE NI OWNER NAME C A 1.-v It..) -r-A-rf crryisTATEizip Lob I C 1.-04 0 CONTRACTOR ADDRESS 44 on 104.) • o A it SI • EXPIRATION DATE 14 ° LICENSE : C-42 DLO-36 OTHER C [Cr NUMBER tin y PERC TEST # 7- . REPAIR/ADDMON OUT-OF-SERVICE SEPTIC SYSTEM ENGINEER DESIGNED/ALTERNATIVE DESTRUCTION OTHER NUMBER OF EMPLOYEES: _ COMMERCIAL NUMBER OF BEDROOMS: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: RESIDENCE ft GEOGRAPHICAL INFORMATION: Coordinates X BUILDING PERMIT # LAND USE APPLICATION # WATER TABLE DEPTH: TYPE OF WORK: NEW INSTALLATION REPLACEMENT OWNER ADDRESS 2-932 cANJAL- DI. crrysTATEizip v-rbtdc-rixi CA 01 S-2.04 CONTRACTOR 1-‘VC oreetovutok)vsicikrrAL PHONE 310 031c ft LENGTH WELL ft FOUNDATION ft PROPERTY LINE ft DEPTH WELL ft FOUNDATION ft PROPERTY LINE ft DEPTH SEPTIC TANK GREASE TRAP LIFT STATION LI LEACH LINES FILTER BED DISTANCE TO NEAREST MOUNDED WIDTH DISTANCE TO NEAREST SUMPS WIDTH DISTANCE TO NEAREST DISPOSAL PONDS WIDTH DISTANCE TO NEAREST SEEPAGE PITS NUMBER DISTANCE TO NEAREST gal # OF COMPARTMENTS gal # OF COMPARTMENTS ft PROPERTY LINE ft # OF LINES LENGTH OF LINES ft ft FOUNDATION ft PROPERTY LINE ft ft DEPTH ft ft FOUNDATION ft PROPERTY LINE ft ft LENGTH ft DEPTH WELL ft FOUNDATION ft FOUNDATION ft PROPERTY LINE LEACHING CHAMBERS TYPE/MFG CAPACITY DISTANCE TO NEAREST: WELL ft FOUNDATION SIZE TYPE OF PUMP 0 PKG TX PLANT SAND OIL SEPARATOR (ENCLOSED SYSTEM) DISTANCE TO NEAREST WELL WIDTH ft LENGTH WELL WIDTH WELL ft LENGTH ft ft PROPERTY LINE DEPTH ft SAN I 4141 VEz) 1 2022 U/ r, m „:•• PUN , 1)/aA pt N. r 7-4,1&.Air TYPE/MFG CAPACITY Application Accepted By Final Inspection By Character of Soil to Depth of 3 R: COMMENTS - - - - - - - ONL Employee ID# Zt 0 SPE MIT - Approved by Pit/Sump Soil Character: 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 EXPIRES 1 YEAR FROM DATE ISSUED I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. SIGNED MINIMUM UR AD CE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 TITLE PILD 3 • CP 0- • DATE -31 -2.2.I 4.- 258 AC .1 VACANT LAW ‘c)' .329.82' \ t‘ _ II' L., i , Z .-.* 1 i g r4 is 11-1 NO0* 07'001/ ..5, SOO*06'0.9"E • • • • 330.01 330.00 iik 1 g •• 'T . 1 I 1 I s -- I," i ' I 20120' I 1 I I I . 11 I I I 1 1 1 g 1 1 r 1 1/14, 1 11: 1 1 1 1 1 1 1 1 , j +-H- PE Code SC INFO ...._ ReceivedClleci Iltn-1 Amount Remitted Date Permit/ Service Re9uest # Invoice # Permit ID# 4.-M 5 (---7.2 i,ey-, /q37 -..1) i 1 ) IV' i 9 Pk Z 4 V 3 0 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14/18