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Otis["f E��'_+ --EWATER TREATMENT SY\. M PERMIT <br /> SAN JOAQt IN(OI N"IN F.%%IRON%I I.NI U.HLA,,..,,sEPARTMF.N-r 304 E WF.RF:R E-3-FI.-STO(-RTON CA 95202 - (209)568-3421) <br /> NON-REFUNDABLE PERMIT CALL(209)953-7697 FOR INSPE(I10"s EXPIRES I YEAR FROM DATE ISSUED <br /> _gs377 <br /> rJOR:\DOR1.Ss ZE IAC v t"i4 C4 CITY/'LIP1u FlL—ypOSSSTREF'l v ✓NIL l^Cn APN L.S 3 — f�C?-Z� PARCEL SIZE. -` , - C. .fl7MPHONE <br /> CITY/STATE/ZIP TC 1C [sNF R AUDRF.SS � )?U I r M( T <br /> PHONE <br /> CONTRACTOR <br /> CONTRACTOR ADDRESS_ O - f rN I t l�;C,Y CITN'/STA'TE/ZIP'-r C- <br /> LtCEN.SE ❑C-42 D C-30 OTHER NL MRFR EXPIRATION Unit:_ ---, <br /> WATER TABLE DEPTH:_I �-��� R GLOGRAPHICALINFORMATION: Coordinates X \ <br /> ❑ PERU TEST I$ __ ----- BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF\\ORK: .J NI N+INNI\I I NT'ION LJ REPAIR/ADDITION JENGIN EER DESIGNEE)/ALTERNATIVE <br /> :.l R1 VI +AFVI NI 'C7 DESrRt'rnON <br /> INSTALLATION WILL SERVE: 'd RESIDENCE ❑ COMMERCIAL) — ❑ OTHER_ _ <br /> NUMBER OF LIVING UNITS: � - 3 NUMBER OF BEDROOMS: NUMBER OF E.MPIAYEES: <br /> Q SEPTICTANK TYPE/MFG j _._ C.APACRY /'+ L l gal #OF COMPARTMENTS 2� <br /> ❑ GREASE TRAP TYPE'MFO CAPACITY gal #OF COMPARTMENTS <br /> ❑ PKG TX PLANT DISTANCLTONEARLW: WELL aGII.w+^ ft FOUNDATION ft PROPERTY LINE___ ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ SAND OIL SEPARATOR(EN(LOSLD SYSTFNI) <br /> LEACH LINES ❑ LEACHING CHAMBERS #OF LINES LENGTH OF LINES TD R N <br /> DISTANCE To NEAREST WELT._ If FOUNDATION R PROPERTY LINE ft <br /> ❑ FILTER BED WIDTH fl LENGTH _fl DEPTH �ft <br /> DISTANCE.TO NEAREST WELL. ft FOUNDATION ft PROPERTY LINE R <br /> ❑ MOUNDED WIDTH R LENGTH R DEPTH R <br /> �,..! DISTANCE To N,lEAREST WELL_ R FOUNDATION ft PROPERTY LINE ft Ley <br /> qq SUMPS WIDTH T ft LENGTH 1-2– _R DEPTH IF If <br /> v"J <br /> I\ DISTANCF:TO NF+RF:cr WFI.L_ J[U FOUNDATION ft PROPERTY LINE fl <br /> ❑ DISPOSAL PONDS NAmm _ ft LFNoI T; ft DEPTH ft <br /> DISI-A%(FTo N1 NRt.ST WELL ft FOUNDATION R PROPERTY LINE R <br /> ❑ SEEPACE PITS NI+us N WWTH ft DEPTH R n <br /> DIsr NNr I TO NI.ARFST WELL_ R FOUNDATION ft PROPFKrY LINE ft <br /> I TIF Ht N1(.I.KIII'N 111+1 IHUt.YRI.PARED IIIINNPPIT(.1r1()N,AND IIIF NIFRKN+11.LHF.ImN1INXT(ORDANCE WITH SAN JOAQUIN COUNTY <br /> ORDINNN(H.SI N11 I NNIS ANDRILFS:NNDRFI.I 1 tIIONNul IN'I FN(JI IN('0(%TY. <br /> MINI\11141 24 H: i)UIIi - _ 951-)h97 r• <br /> C.'iED ` /� � 7111 F. /J.'�t='✓,'� DATE <br /> SI11 2LI�S <br /> v <br /> e <br /> J CjC ii <br /> P <br /> 0 <br /> c\, <br /> klA <br /> � N <br /> T)IPNRTNIF:1.1 'N F.(INL1 <br /> Application Necepted Hr _ .+\D1C- Date /I Z- LLQ" Area <br /> Final Inspection ON _ Sa'�C. e�C��`-`J Dale ❑ SPECIAL PERMIT- <br /> Character of Soft to Depth of 3 Ft: _ Pit/Sump ti I('haracter <br /> COMMENTS 01-,3 LuT .1 i. r ra< t :c c �=�(Lt <br /> -- <br /> -- - <br /> Z(("i'z IC 2a to7 <br /> PE SC Recei+'ed Ch"LAl',rd) nnulunl Permil/ <br /> Code INFO By (-ash Re'umed Date Ser+ice Request# tD`Oicc>: PerrnillU# <br /> tJ 2,to 11 S <br /> I. ' <br /> �L��� - r <br /> 42412401 w•� T'"Ne_ (� (S,.•e (IG- c GQ,[.�r,.,oL�S[.0 1 ',SITE WASTEWATER PFRNIII <br /> 12222003 <br />