Laserfiche WebLink
V D <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STocKToN CA 95205 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT ALL (209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />/11 s•-.) <br />APN 2-7? 6 cr <br />SEPTIC TANK <br />GREASE TRAP <br />TYPE/MFG <br />TYPE/MFG <br />CAPACITY <br />CAPACITY <br />DISTANCE TO NEAREST: WELL ft FOUNDATION <br />LIFT STATION SIZE TYPE OF PUMP U PKG TX PLANT <br />ft <br />gal # OF COMPARTMENTS <br />gal # OF COMPARTMENTS <br />ft PROPERTY LINE <br />44 NEN". <br />qk" <br />sAA'JoA <br />Al Celt/El; 14 2021 <br />eh twifovv-iN'y <br />PA AL. <br />"qtAlr <br /> fie( <br />Area 14/4 Employee ID# A6 <br />JOB ADDRESS / 7 6 o o <br />CROSS STREET g-1 kA1 Y /42 0 <br />OWNER NAME <br />e CITY/ZIP <br />OWNER ADDRESS a4--,/.9 Age (---,/,__CITY/STATE/ZIP <br />CONTRACTOR /1°/e5gt i'' C,'f-, (:- S-e...,., c,--- PHONE <br />c CONTRACTOR ADDRESS ./ 4-Ke / <br />LICENSE EI 0 C-42 0 DC-36 OTHER A NUMBER <br />0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />z_ <br />Character: Sul /11A. <br />E SPECIAL PERMIT - Approved by Pit <br />COMMENTS F64) Lie cl + erIT dies 40 re/1100. <br />DEPARTMENT USE ONLY / <br />Date iilp-i a i <br />Date i A7fr," <br />mp oi <br />PE <br />Code <br />SC <br />INFO <br />Received <br />By <br />Check Amount <br />Remitted Date Permit/ <br />aervice Request # Invoice # Permit ID# <br />11a 13 »S- ZZ— /6-6(3c +3°C) LIIIIIISI CM3SGI <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />Application Accepted B <br />Final Inspection By <br />Character of Soil to Depth of 3 Ft: <br />42-01 <br />4/14/18 <br />WATER TABLE DEPTH: <br /> C, D -70 <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />PERC TEST # <br />TYPE OF WORK: 0 NEW INSTALLATION REPAiR/AoDiTioN [1 ENGINEER DESIGNED /ALTERNATIVE <br />Fl REPLACEMENT <br /> OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br />PARCEL SIZE <br />PHONE <br />C <br />/ :SS3NUUV 31IS CITY/STATE/ZIP <br />EXPIRATION DATE /// ct -2 <br /> <br />INSTALLATION WILL SERVE: RESIDENCE <br /> <br />NUMBER OF LIVING UNITS: <br />0 COMMERCIAL <br /> <br />E OTHER <br />NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />BUILDING PERMIT # <br /> <br />LAND USE APPLICATION #