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- ? 11 P <br /> ONSITE WASTEWATERTREATMENTSYSTElVT PERMIT <br /> SAN JUAOUIn CUUrerr ENVIRONMENTAL HEALTH DEPAaTMENT 304 E WEBER Ayr.-3-Fl.-S'TOCKTON CA 93202 -(209)468.342Oil 1 r• w <br /> NON REFUNDABLE PE IT C .I, 2119 -3-7697 FOR INSP£CTEONS <br /> EXPIR 1 YEAR FAOM BATF ISSUED <br /> JUN AAIIRhSb ,(� <br /> CROSS 5E'NCt;r .0-+C1~: APN Q '� �(/_ <br /> PAA.EL LE A <br /> OWNER NAME I � /? �i p <br /> /��'1 /PHONE —!J 7/ <br /> OWNCR ADORFC4 �. LJ(/ /V2 - �r " � , 9}' <br /> Cr1rl5rnrElZIP f� �[/ w / 1/�� •• <br /> CONTRACTOR "l�I�+LJ ��L -. 571V •� <br /> PHonE _ <br /> CONTRACTOR ADORE,CT CITY+STATFJZIP <br /> w <br /> LICENSE C-42 O C-35 DTHER A'uIHITEA ERPIKATIUN DATE ` <br /> WATER TARI.I:Dix].11!:: fl GEOGRAPHICAL INFORMATION: Coordlea[es X y <br /> ❑ PERC TEST # Li BUILDING PERMIT# LAND USE APPLICATION R <br /> TYPE OF WORK; O NEW INSTALLATIONt CIREPAIRlADumoN ❑ - <br /> ENGINEERDESICNEDIALTERNATIVP <br /> [ REPLACEMENTi 0 DESTRUCTION <br /> INSTALLATION WILL SERVP; RESIDENCE ❑ COMMERCIALS OTHER�- <br /> NUMBER OeLIVINCUNrIS: ��,,A���j NumueRofBEUKOOMs: NuMemoFEMPLoym; l� <br /> SEPT[CTANK TyeuwG 460 f✓ �/— CAPACITY <br /> gaI #UT CUMf'AaiMENI'S <br /> ❑ CREASETRAP TYPERv11G CAPACITY_ <br /> Nal #CF CY)MPARTMEh"I$ <br /> ❑ PKC TX PLANT DISTANCE FO NEARLST: WELL ryft 1"UVNDATION S <br /> I ft PROPERTY LINT: �•� 1i <br /> D LIFT STgT10N SezF. TYPE OFPvhP ❑ SAND OIL SEPARATOR(ENCLOSED SYIrrEM) <br /> ik LEACH LINES OLLEACHING CHAMBERS CT50�/-7P 0 OF LINFS /4.-� 9 <br /> � 4=0:2- LFNGTR OF UNRS �v O <br /> DISTANCE TO NFAAE$'T WELL-/ R RX;NUATNTN__ '�p tt PROPr:RTV Iw.. <br /> [7 EII.TFR RED WIUTN _ [ ft <br /> —,W _ ft LENG711 ,.M,�_-_„-• fl DtP�rl _ ft <br /> DISTANCE TO NEAREST WELL R FOUNC)A'CION fl PROPERTY LINE ft \Y\J <br /> ❑• MOUNDED W1D711 11 LENGTH R Depen fl 1 <br /> D[STANCF•TO NEAREST WELL !l FOUNDATION ft PROPERTY LINE <br /> D SUMPS WrDrH -.--.._. ft LVNGTI? ft DrPTH R <br /> f 1i! <br /> DIPrAN('.ETONFARESr WEI.1. K FOUNDATION fl PROVERTYLINr R <br /> fVC1 <br /> CI DISPOSAL PONDS WIDTH --'_ fl <br /> R LENGTH ft DEPTH R <br /> DUMANCE'TO NEIRVt WELL----_.__.ft FOUNDATION R PROPERTY LINT. <br /> fl <br /> ya` SEEPAGF.PIT5 NUMsra WEDnf !1 DtrrN - 1l <br /> DIS'TAN(;Y TD NEAREST WELL R FOIJN'DATIUN_,� - R PROPERTY UNr f; <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND-1WORK WIIJ,HE DONE[A ACC.UROANCIF WITH MAN JOAQUIN C.UUNTY <br /> ORDINANCES,STATE TAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> IINIMUM 14 HOU aI)YAI%C-NL7r £REQUIRED FOR INSPE r NS-PLEASE CAI.I.(309)953,7{,g7 <br /> SIGNF.O� <br /> •nTLk DATE <br /> v <br /> i <br /> i <br /> I <br /> PAYMENT G <br /> F�F�=�lVED <br /> .SUN 2 8 2007 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENT <br /> AL <br /> HEALTH DEPARTMENT <br /> lD PARTMT ,E DNI. <br /> Application Accep . ate Arco Emp3Dycc iTNly 4 <br /> Final I-pectin. 'pale w El SPECIAL PERMIT-Appmved 6y <br /> Character of Sell to p OF Ft: Pit/Sump Soil Character: <br /> COMMENTS/ •F r <br /> PE SC RecclYe CheekO7 Amount Dain Perm H! <br /> de <br /> CaINFO R Cath Remitted Service Rc at6rrI# I;iTE <br /> Permi!ID# <br /> azZZ12GO ;/J /)/J� [� WAN R;WATER PLAMI I Ii/ZSRUU3 'Cr(f(/ TvYwwVVV <br /> Ed wazs:ii zaez az u�r 'ON xdj woaa <br />