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46--F-2- <br /> d ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQM COONTY ENVIRONMENTAL HEALTH DEPARTMENT 300E WE%RAVE-3iO FL-STOCKTON CA 95202.(209)4683I20 <br /> NON-REFUNDABLE PERMIT r / CALL(209)9534697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOBADDREBS ��AZJdL F Ln AAS Ac(r Crrvmp I IP,LIC4 <br /> • CROSS SDIEET _ll✓AIC /� APN (43-2.J0-Ql PARCEL SM C <br /> OWNERNAME 1 PHONE boa/1—t�n�41-I <br /> OWNERADDRESS G b 1 CM/STATL/ZIP <br /> CANIRACTOR PRONE <br /> CONTRACMRADDRESS CITY/STATIUZIP <br /> LICENSE 0C-42 ❑C-36 MER NUMBER E%MRATION DATE <br /> WATERTABLEDRPTH: ft GEOGMPHICALINFORMATION: C"NAIIRleJ % Y <br /> ❑ PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: 1 NEWINSTALLATION ❑ REPAIR/ADDITION ❑ ENGINEERDESIGNED/ALTERNATIVE <br /> O REPLACEMENT ❑ DEETRDrnon <br /> INSTALLATION WILL SERVE: -Z RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OPLIVING UNOB: NUMBEROFSEDROGMS: NUMBEROFEMPLOYEES: <br /> ® SEPTICTANK TYPF/MPO �.1 (— (ov ,c+e CAPACITY -E' Sal #OFCOMPARTMENTS z <br /> ❑ GREASE TRAP TYPEIMFG CAPAC SOI #OF COMPARTMENTS <br /> (3 PXG TX PLANT DISTANCEMNEARFST: WELL ft FOUNDATION It PROPERTY LINE ft <br /> ❑ LIFT STATION SDE TWEOF PUMP ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> LEACH LINES ❑ LEACHING CHAMBERS #OF LINES_-lL LENGTH OF LINES YU fl 1 <br /> DISTANCETONEARFST WELL Sb+ ft FOUNDATION ft PROPERTY LME It <br /> ❑ FILTER BED Wlan ft LENGTH ft DEPTH ft <br /> DISTANCEMNEAREST WELL R FOUNDATION ft PROPERTY LME fl N <br /> ❑ MOUNDED WIDTH It LENGTH H DEPTH fl m <br /> DIEPANCE M NEAREST WELL It FOUNDATION ft PROPERTY LINE ft <br /> ❑ SUMPS WmTH fl LENGTH ft DEPTH <br /> DISTANCEMNEAMST WELL ft FOUNDATION ft PROPERTY LINE H C <br /> ❑ DISPOSAL PONDS WDHE ft LENGTH It DEPTH fl <br /> DISTANCETONMRJ= WELL ft FOUNDATKIN ft PROPERTY LINE D N <br /> • td SEEPAGE PITS NuMBER__4 7 WDrrx 3 fl DEPTH 2,.5 ft ICM <br /> DHDFANCEMNMIUUiT WELL 07J fl PWNDATION ft PROPERTY LINE ft <br /> I HEREBY CERTIFY THAT I HAVE PREPARED TKIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINANCES,SPATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIM UM#4 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-769. �Q <br /> SIGNS DATEDb 6 <br /> O 1 <br /> W y� <br /> V Z M <br /> Z Z Qa <br /> Z � n <br /> S <br /> 6o g EOO o 1 <br /> zoo$ m <br /> °a PAYMEr <br /> HRECEIVI <br /> u <br /> FEB - 7 : <br /> ® SANJOAONME <br /> EHOMB <br /> HEALTH DEY?AF <br /> Z D?'I s e4 38'ta i i. <br /> ApplkatloR Atvepted ( D.Oe ,,CJJ7 <br /> FIDEI ImpatloN Dake ❑ SPECIAL PERMIT-Appnved by <br /> CWeRRlerof Soillo pt of3PC ! // PIUSoRIp SDtI CM1anater. <br /> COMMENTS T o F J2E Go!!+J A-AO 77 011 77J Sx S7T 6-fa <br /> C10 � 3 lv S<A02, <br /> • .SATS 7-70.LA- r>r hTAJ N6a..l S�J°'Pc SY�si`EM •FU.L DAJE /,,Ed�aoM A-�IO.TxuN • <br /> S ,Cry/i3c�i � <br /> PE SC Reeelved M1xIdN Aunuot PermlU IDnke# Permit lDq <br /> Code InF B ee ReMRed Dete 6erWSe Re unt# - <br /> 4i.0 117 9b2— 'FSo w 96 goo liT7S <br /> ONSITE WASTEWATER PERMIT <br /> 122VJp03 <br />