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1� <br /> ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL(209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 20121 E Walnut Drive CITY/ZIP Linden,95236 Z' <br /> .j <br /> r� <br /> CROSS STREET N Wall Road APN 091-310-240 PARCEL SIZE 35.58 J' <br /> v <br /> v <br /> OWNER NAME Leland Metzler PHONE 209-986-9320 <br /> v. <br /> OWNER ADDRESS 6747 N Wall Road CITY/STATE/ZIP Linden,CA 95236 <br /> CONTRACTOR Petralogix Engineering, Incorporated PHONE 209-770-0731 (Cell) <br /> CONTRACTOR ADDRESS 26675 Bruella Road CITY/STATE/ZIP Galt,CA 95362 <br /> LICENSE C42 ❑❑C-36 OTHER PG NUMBER 8657 PG EXPIRATION DATE N/A <br /> WATER TABLE DEPTH: +100 feet ft GEOGRAPHICAL INFORMATION: Coordinates X-121.0693326 y 38.0371431 <br /> X PERC TEST # 1 BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: RESIDENCE COMMERCIAL OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> 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 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 <br /> SIGNED J Yin-� TITLE Project Geologist DATE <br /> *S E C E <br /> ;0A/I.. <br /> J <br /> O <br /> A � <br /> DEPARTMENT USE ONLY , <br /> Application Accepted Ay _ i L Date Area y C C Employee ID# DII <br /> Final Inspection By — Date SA L—!/—VW SPECIAL PERMIT-Approved by <br /> Character of Soil tg, epth of Ft: Pit/Sump So Character- <br /> COMMENTS i'�Cc-) 4� loll , 3 1��� �ytCl� <br /> PE SC Received Check#/ Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO B Cash Remitted Service Request# <br /> �aaa S_12 <br /> 4 I '�(lv/�—I I r�(� /� ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/24//24/12 <br />