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JOB ADDRESS 27665 Kennefick Rd CITY/Zip Galt 95632 <br />CROSS STREET Liberty APN 5-210-3 PARCEL SIZE 6 ac <br />OWNER NAME Fred Rhodes PHONE 916-826-4949 <br />OWNER ADDRESS 27487 Kennefick Rd CITY/STATE/LP Galt, CA 95632 <br />CONTRACTOR Fred Rhodes Construction HONE <br />CONTRACTOR ADDRESS 27487 Kennefick Rd CITY/STATE/ZIP Galt CA 95632 <br />LICENSE I I C-42 I I C-36 OTHER A NUMBER 732636 F _XPIRATION DATE 4/30/2023 <br />cke Q- k <br /> 6.44, <br />EPARTMENT USE NLY <br />Employee ID# 1' <br />Date 6y <br /> 2 2..o I <br /> Area --- <br />2 SPECIAL PERMIT - Approved by <br />Date q Z L\1 el el Ci.k. 0 <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95206 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />WATER TABLE DEPTH: <br /> <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br /> <br />BUILDING PERMIT* Bps-2 (1) ?LAND USE APPLICATION # PERC TEST # <br /> <br />TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED /ALTERNATIVE <br />REPLACEMENT <br /> OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> <br />INSTALLATION WILL SERVE: )4FIESIDENCE COMMERCIAL I OTHER <br /> <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> <br />--iii<SEPTIC TANK TYPE/MFG Poi- I— CAPACITY 1 0?') gal # OF COMPARTMENTS <br />ID GREASE TRAP TYPE/MFG <br />CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL <br /> ft FOUNDATION ft PROPERTY LINE ft <br />ID LIFT STATION SIZE TYPE OF PUMP <br /> <br />PKG TX PLANT CI SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br /> <br />NI LEACH LINES LEACHING CHAMBERS # OF LINES 2 LENGTH OF LINES 56 ft <br />DISTANCE TO NEAREST WELL 152 ft FOUNDATION 10 ft PROPERTY LINE 20 ft <br />ID FILTER BED WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />LI MOUNDED WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />0 SUMPS WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />LI DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br />....X........ SEEPAGE PITSNUMBER WIDTH i'..% <br />DISTANCE TO NEARE,5_ WELL <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ft FO NDATION ft PROPERTY LINE ft <br />ft DEPTH 2 5 ft <br />I HEREBY CERTIFY THAT I HAVE P RE PPLI • • TIO AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> TITLE — • DATE 7 - <br />NCE tr. TI • REQUIRED FOR IN TIONS - PLEASE CALL (209) 973-7697 <br />A LAW, ND ULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br />-a <br />MINIMY <br />SIGNED <br />Application Accepted B <br />Final Inspection By <br />Character of Soil to Depth o 3 F1: <br />COMMENTS /Vert/ Old/1144 kOrl ; <br /> <br />Pit/Sump sop Character: <br />,,s-iPrri(e Z 7 57 11.-q <br /> <br />PE <br />Code <br />SC <br />INFO <br />Received Check#0 Amount <br />Remitted Date Permit/ <br />Re uest # Invoice # Permit ID# <br />14'2 1 I III .5-1't L 1 2 <br />sZrvice <br />32. <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18