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"Now, `/ <br /> 6. <br /> L ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 3041E WEBER AVE-3A'FL-STORRTON CA 95202-(209)46$-M20 <br /> NON-REFUNDABLE PERMIT CALL f2091953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> I ...t-OCf k— L/.i <br /> I,m JOB AODREES / �� f �)J/L( f CRY21P Y <br /> CROSS STREET J ON,,/ SJJTPf /�!/' APN J- I,FU�I JJ PARCELSIZU^-ZL A-1 I <br /> OWNERNAME 1l Tn cdCL C� PHONE <br /> OWNERADDRESS CIWMTATVZIP <br /> CONTRACTOR ---,L" s 5f,G PRONE cL I <br /> 1 CONTMCTORADDRES4 C �. •�A.fS r CTTYISYAI VLIP c.% `. /:1 <br /> LLICENSE ❑C42 ❑C-36 OTHER NUMBER E PIRATION DATE <br /> WATER TABLE DEPTH: A GEOGRAPMICALINFORMATION: COBNinaMT X Y <br /> ❑ PERCTEST 1 BUILDINGPERMIT# LAND USE APPLICATION# <br /> L TYPE OP wORK: O New lNsI—L ... ❑ REPAIRIAMITTION O ENGINEER DRUGNED(ALTERNATIVE <br /> ❑ REPLACEMENT O DESTRULTION <br /> INSTALWTION WILL SERVE: ❑ RM.ENCE ❑ COMMERCIAL ❑ OTHE0. <br /> NUMBER OF LIVING UNITS: NUMBEROF BEDROOMS: NUMBER OF EMPLOYEES: <br /> L ❑ SEPTIC TANK TPEIMFG CAPACITY gal 0 OFCOMPARTMENTS <br /> ❑ GREASE TRAP TVPIUMFO CAPACITY pi 00FCOMPARTMENTS <br /> ❑ PKG TX PLANT D=ANCETONEAUbUr: WELL ft FWNDATKIN E PROPERTY UNE fl <br /> ❑ LIFT STATION SIyE TYPEOFPUMP ❑ SANDOILSEPARATOR(ENCLOEM <br /> SEDSYET ) <br /> L <br /> ❑ LEACH LINES ❑ LEACHING CHAMBERS XOFLINE9 LENGTH OF LINES ft <br /> DHTANCETONEARM WELL ft FOUNDATION ft PROPERTY LINE E <br /> 1 <br /> C3 FILTER FILTER BED Wl6 IENGTH ft DEPTH a <br /> L DIEFANCETONEAREET WELL ft FOUNDATION ft PROPERTY LINE R <br /> O MOUNDED Wlmx ft LENGTH ft DEPTH ft <br /> DISTANCETONEARM WELL ft FOUNDATION ft PROPERTY LINE It <br /> ❑ SDMPS WIDTH ft LENGTH ft DEPTH fi <br /> DIETANCETONFAREW WELL it FOUNDATION R PROPERTY LINE R <br /> L DISPOSAL PONDS WHITx ft LENGTH It DEPTH fi <br /> DISTANCETONEARM WELL ft FOUNDATION ft PROPERTY LME it <br /> ❑ SEEPAGE PITS NU... W.. ft DEPrH ft <br /> DISTANCETONEJIM WELL R FOUNDATION ft PROPERTY LME ft <br /> I HEREBY CERTIFY THAT I HAV EPREPARED THIS APPLICATION AND THE WOR.W ILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINANCE.STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINI UM S41H R OTICE REQUIRED FOR INSPECTIONS-PLEASE CA LL(209)953-7697 <br /> 1 SIGNED % TIME I", �T DATE <br /> {L J , <br /> L <br /> J A <br /> I % <br /> DEPARTMENT (' <br /> Application Accepted BY„% L'�P y�Z-'�' `� Dale G3 Z �^ Ana Employee IDX )/ /L, <br /> Ba <br /> Final lnrpeelian By Dal. ❑ SPECIAL PERMIT-Appmvd by <br /> Character of SMI h Depth of 3 Ph Pil/Sump Soil Charachr: <br /> COMMENTS <br /> L _ <br /> PE SC RaMwH tRiganJJ- A�•uvt PermlD <br /> CE (NPO B Cath R=8, Dnt Fic Vlrp acetX IomleeX Permit IDN <br /> j;C. X1277_. 14 c,SZi <br /> 43-024301 ONSRE WASTEWATER PERMIT <br />