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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> I!ry SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 6GO E MAIN STREET-STOCKTON CA 95202-(209)468-3420 <br /> 41r NON-REFUNDABLE PERMIT CALL 209 953.7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> I Joe AGGRESS 7.;,1)5//,30 .A�r43; /Ia.F. L 3 cm2P] <br /> CROSS STREET IiPl/JLfs� 0^/i <br /> yn APN Qb ^Zi11 ^�. —PARCEL SIZE <br /> WNT v�p <br /> OER NAME r IU 0^I PHONE y49- <br /> OWNER ADDRESS CmISTATEMP GG <br /> CONTRACTOR �4e L Ji-_ Gi.L/ Jg�C PHONE 4G9-ro77 / 993-9.65 <br /> CONTRACTORADORESS _ 7C� P����IX/�-��/_b[[lP CITYISTATEOP Z....t% <br /> LICENSE O842 QC-36 OTHER NUMBER 41S59Y9_EX'PIRATION DATE O7-31-1 Z ^` <br /> WATERTABLEDEPM: R GEOGRAPHICAL INFORMATION: Coordinates X Y V ' <br /> q PERC TEST Y BUILDING PERM IT# LAND USE APPLICATION# <br /> PEO <br /> E OF WORK: ❑ NEW INSTALLATION REPAIR/AOgTMN ❑ ENGINEER DEBIGNlOIALIERNATNE <br /> ❑ REPLACEMENT ❑ OUT-OFSERWCESEPTMSYSTEM ❑ DESTRUCTION <br /> INSTALLATION WILL SERVE: PL RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> �y NUMBER OF WING UNITS: NUMBER OF BEDROOMS' ^Y NUMBER of EMPLOYEES' <br /> Y-SEPTIC TANK TYPE/MFG�,1(/ CAPACITY_ /6440 991 #OFCOMPARTMENTS <br /> ❑ GREASE TRAP TYPF/MFG CAPACITY ` gal YOFCOMPARTMENTS a <br /> DISTANCE TO NEAREST: WELL R FOUNDATION ft PROPERTY LINE ft ' <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP ❑ PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> CFL LEACH LINES ❑ LEACHING CHAMBERS YOF LINES LENGTH OF LINEA rIOT ft <br /> DISTANCETONEAREET WELL "SJ+ ft FWNDATION 510 R PROPERTY LINE d 1 ft ' <br /> ❑ FILTER BED WIDTH ft LENGTH R DEPTH ft <br /> DISTANCE TO NEAREST WELL R FOUNOATMN R PROPERTY UNE R <br /> ❑ MOUNDED WIOTN ft LENGTH R OEM If <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE It <br /> O SUMPS WroTH ft LENGTH R DEPTH ft <br /> DISTANCETONEAREST WELL ft FOUNDATION R PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIorH R LENGTH ft OEM R <br /> DISTANCE TO NEAREST WELL ft FOINDATION ft PROPERTY LNI ft ' <br /> SEEPAGE PITS NUMBER 3 WIDTH _9 ft DEM -,;9 ft <br /> DISTANCETONEAREST WELL IP ft FOUNDATION /AD ft PROPERTY LINE aS ft <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM 24 OUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 209 953-7697 <br /> SIGNED TITLE DATE G�lw <br /> i/ry <br /> Si <br /> y <br /> SP JO OU C VN <br /> D T DE a .E <br /> E P A R T IN EN T JV S Fq O N kL q/J <br /> Application Acca axg4mDara20AR:e Employee IDI <br /> Final ImPectionB Date O SPECIAL PERMIT-ApproveGDy <br /> Character of S-'ill <br /> epm of 3 Ft: PIU umP Sall Character: <br /> COMMENTS . <br /> 1 <br /> PE SC RaCehnW C Amount - Data P Reg InvalceY PamNt IDY <br /> Co1N INFO Ramllted SON]" uestY <br /> 4241 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> mine ' <br /> � 1 <br /> R <br />