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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SA1I JOAOUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELroN AVENUE-STOCKTON CA 95205-(209)468-3420 <br /> NON-REFUNDABLE PERMIT 1,31 CALL 209 953-7697FORINSPECTI0NS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS /�11 CRYMP�-.J� <br /> ' ? 1 i ei <br /> CROSS STREET _ APN� 7 Z CID O`1 PARCEL SIZES I. 66 <br /> OWNERNAME SF. PHONE ��+� 12 O f <br /> OwNER AmpEss '1--� fop �ul�' Cnv/STA P Sc 0VV!' 39 - <br /> CONTRACTOR YC PPHONE <br /> CONTRACTORADDRESS 7_i/C /J.�ITY/STATERIP <br /> UcENSE ./x-42 _ C-36 OTHER NUMBER PIRATtON DATE <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X j Y <br /> .. PERC TEST 9 BUILDING PERMIT,# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION REPAIR/AoaTTON ENG EER DESIGNED/ALTERNATNE <br /> REPLACEMT OUTOrSERVICE SEPTIC SYSTEM DESTRUCTON <br /> INSTALLATION WILL SERVE: ('L RESIDENCE IJ COMMERCIAL _ OTHER <br /> NUMBER OF LIVING UNITS: J NUMBER OF BEDROOM$: -Y NUMBER OF ELIPLOYEEs. <br /> SEPTIC TANK TYPE/If6FG � CAPAC.TY �!�-Ci gal #:,F COMPARTMENTSy7_ <br /> L3 GREASE TRAP TYPE/MFG CAPACITY gai B OF CONPARTfi.LNTS <br /> DISTANCE TO NEAREST: VVELL IG" It FOUNDATION ft PROPErtTr LINE Sy f- It <br /> ❑ LIFT STATION SLM ___ TYPEOFPUMP _ _. ❑ PKGTXPLANT ❑ SAND OIL SEPARATOR MACLOSED SYSTEM <br /> I <br /> C�LEACH LINES LEACHING CHAMBERS / x OF LINES �L LENGTH OF UES C ft <br /> DISTANCE To NEAREST WIE _1[.[_�• ft FOUNDATION _ti PROPERTY LINE 7 R <br /> (3 FILTER BED WIDTH ft LENGTH ft DEPTH n <br /> DISTANCE TO NEA RES' WELL ft FOUNDATION ft PROPERTYUNE it <br /> ❑ MOUNDED WIDTH ft LEN37H ft DEPTH fl <br /> DISTANCETO NEAREST WELL IT FOUNDATION ft FROPERTYLINE ft <br /> ❑ SUMPS WIDTH ft LEN�,-H ft DEPTH It <br /> DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH. ft <br /> DISTANCE TO NEAREST WEUR FOUNDATION it PROPnERTYUNE it <br /> SEEPAGE PITS NUMBER WIDTH _A0, 11, It DEPTT+. ,>S It . <br /> DISTANCE To NEAREST WELL /j) ), fl FOUNDATION It PROPERTY LINE c�• fr <br /> L HERESY 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 /> MWIMUM 48 H R ADVANCE NOTICE REQUIREDINSPEC77ONS <br /> PLE4SE CALL(209).q53-76,97 <br /> SIGNED— - ----- TITLE lLil9 +�fL�� __.. _ DATE <br /> IIi II ' it ! II ! I <br /> I li i i <br /> I III I I I ! I I <br /> ! I ! ADI <br /> �Fo <br /> , °� II <br /> 0 <br /> 1 <br /> I I o <br /> ' I i ,! . ! I I I I I <br /> l I i I ! ! i ! ! I I NMS cOV <br /> I I I I I ! FpgFNtq�TY <br /> I I I I ( I RTjyFNT <br /> III 1 it I <br /> I � i it II <br /> DEPARTMENT ,TNLY A A <br /> Application Accepted �Lr� Date =I li)L� Area C/ EmpbMIDC_,P <br /> Final Inspection By Date L SPECIAL PERMIT-Approved ly <br /> Character of Soll to Depth of 3 Ft: Pit/Sump Soo ClTarscter: <br /> COMMENTS f�PC�G,ic Nit° fN1c�rlU �9C�VIQC 4�JrYlr u:! YJOi�'�2f%'► % � nG IbI <br /> PE Sc ROoeivad CheckF/ Amount Permit/ <br /> Code INFO Cash Remitted Date Service that# # I PtxTnftiD# <br /> a2-DIOH6rtE WASTEVV;.TEP,TRTT✓ifT SYSTEM PE4MIT <br /> M'14.'18 <br />