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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAOUIN COUNTY ENVIRONMENTAL HEALTH D9PAjtTVfNT 11"S E. HAZELTON AVENUE - STOCXTON CA 96205 -(209) 468-3420 <br />JOB AWAM crryfzp <br />CRMSTA99T <br />APN.,�5 PARCEL Sqa- A71 <br />OWNER NAME PHONE <br />OWNER ADoftss ILL, -oryarATear <br />CONTRACTOR pom <br />CON(TRACTC CITYISTATIMP <br />ucaNsm: CAP Doc -m OTHER Expmnok <br />WATER TAW A 0"; 0 — 6-0 It GeoGRAp"tcAL x y <br />D PeRCreST k BUILDING PO WIT #'!W- jcft).!Jf_QXAND usE Appuwiou # <br />Type OF WAX--- 'S, P45W lwai"I" R&AWAODMON 7, Mim 59ZZ TALm%ATm <br />REPLAC911111INT _ 0 OUT -OF -.SERVICE SEPTIC'SYSTEM D"TRUcTION <br />INSTALLATION WILL SERVE: ReMoCs D COMMERCIAL OTHER <br />NUMEOR OF LIVING UMTS; NVMWA of sawtooms: ta Nu"" OF evpwym,� <br />SEPTIC TANK T',,Peft&G CAPACITY gal <br />13 GREASE TRAP TYPVMFG CAPACITY 931 # OF COWARTMMTS— <br />OWANCE TO NEAREST: WELL __��� ft FOUNDATION /4ft PROPERTY LINE 54 ft <br />13 LIFT surioilii SIZE — TYPE Or PUMP_ 0 PKG TX PLANT 0 SAM OIL SEPARATOR JENCL&M SYSTEW <br />0- LEACH LINES <br />'. ' LEACHING CHANISEM <br /># of: Lms LENGTH OF Lwn W, ft <br />DISTANCE TO NEA AST <br />mu 2,00, <br />FOUNDATION PROPfRryUNE ft <br />Ci FILTER BED <br />WIDTH - <br />It LENGTH <br />It DEPTH <br />DwAnct To N*Ap"T <br />WELL— <br />It FOL#40ATION _ft PROPERTY LINE It <br />❑ MOUNOM <br />WoTm <br />ft LENGTH <br />it DEPTH It <br />DISTANCE TO NEAREST <br />A*LL_ <br />It FOUNOATJON It PROpawry Lm— It <br />Cl SUMPS <br />WKffm - <br />ft LENGTH <br />ft OEM ft <br />OtSTAWX TO NCARM <br />WELL <br />ft FOUNOATION _ft PROPERTY LINE <br />(3 DISPOSAL PONDS wiDTN - <br />ft LENGTH <br />It DEPTH <br />OYSTAHCE TO NEARM <br />AELL <br />IT F0.14ATlON —ft PROPERTY uhm ft <br />At- SEEPAGE PITS <br />NUMB" <br />VIADT" <br />ft DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />ft p*JNQApON 10 It PROI;6TY L*& It <br />i HEREBY CMFY THAT I HAVE PREPARED THIS APPUCATWH AND THE 010ft PALL BE DONE 01 ACCORDANCE WITH SM JOAOLM COUNTY ORDMAWft <br />STATE LAWS AND WAS AND REGOLATUM OF SAN JQAQRN =N7TY <br />m <br />42-01 owsm msmomwl"m $MFM PEFUT <br />4M4M <br />