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Crrv/ZiR I . 2 9 0 ao PARCEL SIZE ,5 PHONE Z OCr --Y5Z-z54•4> :SS311GliV 311S INSTALLATION WILL SERVE: ". RESIDENCE NUMBER OF LIVING UNITS: I COMMERCIAL NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: I OTHER 1413 TYPE/MFG TYPE/MFG ft # OF COMPARTMENTS # OF COMPARTMENTS PROPERTY LINE X. SEPTIC TANK LI GREASE TRAP LIFT STATION DISTANCE TO NEAREST: WELL SIZE TYPE OF PUMP PKG TX PLANT El SAND OIL SEPARATOR (ENCLOSED SYSTEM) PERC TEST # TYPE OF WORK: REPAIR/ADDITION OUT-OF-SERVICE SEPTIC SYSTEM BUILDING PERMIT # NEW INSTALLATION REPLACEMENT LAND USE APPLICATION # ENGINEER DESIGNED /ALTERNATIVE DESTRUCTION CAPACITY CAPACITY ft FOUNDATION gal gal ft 42-01 4/14/18 ITIZJ ONSITE WASTEWATER TRTMNT SYSTEM PERMIT PE Code SC INFO Received By Check#/ ./0 Cash Amount Remitted Date Permit/ leryjce Request # Invoice # Permit ID# 14? 10 i5 AV VISIIi 3) 1-21-il 5t< cQ,61 5 UR ADVANCE NOTICE REQUIRED FOR INSPEWIONS - PLEASE CALL (209)953-7697 TITLE 144 DATE / I z — Z SIGNED MINIMUM 6c4- DEPARTMENT USE ON Application Accepted Date 1-/Area ?Employee ID# Final Inspection By fiv1-''Vfl /al Date 1/ 20/1.11.1 SPECIAL PERMIT - Approved by Character of Soil to Depth of 3 Ft: r Pi Sump Soil Character: COMMENTS 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 I SPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED JOB ADDRESS CROSS STREET APN OWNER NAME OWNER ADDRESS CITY/STATE/ZIP ciain Liv-I IL CONTRACTOR e_ e,f2ou0 PHONE 9 /6 —366 -1// .5 e CONTRACTOR ADDRESS PO iSnic CITY/STATE/ZIP 404 t4--6?-00 L4 LICENSE C-42 C-36 OTHER A ; NUMBER it:00e) EXPIRATION DATE g <5 I 4- WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X # OF LINES / LENGTH OF LINES 4 7 ft ft FOUNDATION ft PROPERTY LINE ft ft DEPTH ft ft FOUNDATION ft PROPERTY LINE ft ft DEPTH ft ft FOUNDATION ft PROPERTY LINE ft ft DEPTH ft ft FOUNDATION ft PROPERTY LINE ft ft DEPTH ft ft PROPERTY LINE ft V 34, ft DEPTH .7-- 1/45 1 ft WELL zoo ft FOUNDATION / a n ft PROPERTY LINE 2-0 ft 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. .../54. LEACH LINES FILTER BED El MOUNDED SUMPS DISPOSAL PONDS „Pt( SEEPAGE PITS DISTANCE TO NEAREST WIDTH DISTANCE TO NEAREST WIDTH DISTANCE TO NEAREST WIDTH DISTANCE TO NEAREST WIDTH DISTANCE TO NEAREST NUMBER I DISTANCE TO NEAREST LEACHING CHAMBERS WELL ft FOUNDATI e V WIDTH WELL ft LENGTH WELL ft LENGTH WELL ft LENGTH WELL ft LENGTH