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ON ITE WASTEWATER TREATMENT SYSTEM PERMIT <br />» SAN J•)Aji,N COUNT, MVIF40M thTAk Hk ALIN UI 1'0IiTMINi <br /> i N6tl E nuke.Doh Av(.hul-S rocs roN CA aJ206•(20S)16S-yt20 <br /> NON-REFUNDABI ERMt CALL(209)953-7597F0A1NsPperlONs <br /> JosAvoak _ E%NIKES 1 YEAR FROM DATE ISSUED <br /> -- <br /> st 1�N'�Sl ROIVG 1�D ----� <br /> ! pp �� ` I <br /> CROl3 S7NEEl — (G C. Iz J--Z.___.. APN._ Q�6 - 110--4 ~ <br /> --- ._ 1 PARCEL SIZE !d•���• <br /> OWNER NAPE-__„ S N_t L_L.Q/y (ID MID- 1 L. [.Dwl -_ i�Zb k__49 <br /> wgNE1� G ' A <br /> OWNER AOONku ... i ,N.� 'a qJ Q.I . CITYISTAIUZIP _ ST�C�.'�'71�Erb �9 <br /> Cow?Haiycw LI ` _1rt:Utn�✓I1QpA1m�N�h. 1 <br /> _. PHUNe _.ItCY•0��1 <br /> CONTRACTORAWREss `Fo'1 W, U_AL Sf, CRYrBIArE/ZIP_ I.OD I CA 95140 <br /> i - <br /> LMCENSE ❑iCat .;: C46 OITIER eG _ 7151_ ..__.E%PMATIONDATE `f-30-y4 <br /> WAITLR TYLE DvtN:.+ R GWORAPHICAL(WORMATION: CooranBMs X r <br /> PERC TEST <br /> — PERMR r LAND USE APPUCATIGN If <br /> TVPWOFWORK: G NEW INSTALLATION <br /> RkPAiq/ADOITiOpr .._.ENGNE TNNATNE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM 1. DESTRUCTION <br /> INSTALLATION WILL SERVE: ,j REatou" - _.-- <br /> --- <br /> ❑ CawERCNAL (:; OTHER <br /> (_ NUMekR OF LIVING UMTS. NUIEBEII OF OEtN10gp:---__---- NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPtAVG _ CAPACITY go /OF COMPARTMENT& <br /> U GREASE TRAP TYPE/WG CAPACrTY_- -- 0 S OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL R FOUNDATION __ It PROPER"LINE R <br /> O LIFT STA T10N SIZE _...____TYPE Of PUMP U PKG TX PLANT U SAND OIL SEPARATOR(IMMAM SYSTM <br /> •OF Lv+Es_-- LENGTH OF LINES--_ <br /> 13 LEACH LINES LEACHING CHAMBERS_ R <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY UNE R <br /> ❑ FILTER BED WIDTH __It LEN6Tr R DEPTH_ R <br /> DISTANCE TO NEAREST WELL R POUNDATION----ft PROPERTY LWE R <br /> ❑ MOUNDED WIDTH __It 'L;UIGTH R DEPTH_ R <br /> DISTANCE TO NEAREST WELL R FOUNDATION__ R PROPERTI LINE R <br /> ❑ SUMPS WIDTH R LENGM— R DEPTH <br /> DISTANCE TO NEAREST WELL <br /> U DISPOSAL PONDS WIDTH R FOUNDATION R PROPERTY UNE }( <br /> _ R LENGTH -. R DEPTH_ R <br /> DISTANCE TO NEAREST WELL__ R FOUNDATION R PROPERTY UNE R <br /> __.. <br /> � SEEPAGE PITS NLrNaEI1 ___ WIDTH ......._.-_ti DEPTH__---- R <br /> DISTANCE TO NEAREST WELL R FOUNDATION ...__ R PROPERTY LINE_ R <br /> . -ERE&Y CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WOW(WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES. <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAOUIN COUNTY. <br /> MININUM 0�&ffl AQW&Q nCERE=RED FOR INSPECTI I PLEASE CALL 1209)953-7697 <br /> SIGNED <br /> - -- ----------- --- TITLE .O/R of• m aK . <br /> DATE 1 -I 3" <br /> R {qm Ir <br /> 1& <br /> c x "IN' <br /> G <br /> < o -�- �c•rq� <br /> oto" e <br /> i >-- <br /> --- _ �; O I: "r; T. S•c-Its• <br /> _ { <br /> ALT M F N <br /> AppliCauon ACCeptetl By G—�Z L L T <br /> Oato_S /`i JArad _�l�—C(___ tmP+oy, <br /> Char Inspection Daft SPECIAL PERMIT Approved Dy — <br /> Charade,of Soil to Depth of 3 R: _ PRISUmp Soil CharacMr: _ .. .M/)�_� <br /> COMMENTS _ ,I <br /> PIE so Kealy" hoe Amount <br /> Date <br /> Parmtl/ InvdaB I Per <br /> Code MEFO B ..-... _._�� I(Y R W t <br /> 4:j—;jj ga3 i3Ig.Z L42-01 <br /> — -- <br /> Q114M9 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />