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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOACtUIH COUNTY ENVR[ONMENTAL HEALTH OEPARTMEXT 1868 E HAZELTON AVENUE-STOCKTON CA 95205-(209)458.3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR ImspEcTioms EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 20797 E.Frazier Rd. CRYlLIP Linden 952M <br /> CROSS STREE-r Clementsa <br /> APN 066.190-12 •-- PARCELSuE 10-0 Ac. <br /> OWNER NAME Randy Marston <br /> PHONE(204)321.6327 ° <br /> OWNER ADDRESS 17170 E.Frond St- CrrWSTATEfhP Cnden.CA 45236 <br /> CONTRACTOR L1ve Oak GeOEnAronmardal PHONE(209)389-WS <br /> CONTRACTOR ADDRESS 407 W Oak St CmISTATErLIp L.odl,CA 95240 <br /> LrcENSE C I IC-42 ❑OCU ODER CEG NUMBER 2151 E1CPIRATION DATE 42=4 <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL E1IFORMATION; Coordinates X Y__ <br /> PERC TEST 0 1 BUILDING PERMIT# LAND USE APPLICAnON# <br /> TYPE OF WORJL- 7 N Ew INSTALLATION f] REPAVt1ADOITION G ENGINFC6 DE&GiEOJALTERNATIVE <br /> Cl REPLACEMEH7 l7LJT-O"ERVri!SEPTIC SYSTEM ❑ DEsTRUCTION <br /> INSTALLATION WILL SERVE; ❑ ResIDEHCE ❑ COMMERCIAL ❑ OAR <br /> NUMBER OF LNTNG UNIT'$: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTICTANK TYPFJMFG C,4pACTTY gal #OFCOMPARTmENTB <br /> Q GRFASETRAP TYPEIMFG CAPACrfY 931 #OFCOMPARTMETITS <br /> OISTANCE TO NEAREST. WELL R FotwmnON R PROPERTY LwE }[ <br /> ❑ LIFT STATI ON SIZE TYPE OF PUMP Q PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> Q LEACH LINES LEACHING CHAMBERS 0 OF UN ES LENGTH OF LINES�`R <br /> DISTANCE TO NEAREST WELL ft FOUNDATION R PROPERTYLINE ft <br /> ❑ FILTER BED Wtmi It LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WE R FOUNDATION ft PROPERTY UNE ft <br /> ❑ MOUNDED WmTH ft LENGTH ft DEPTH R <br /> DMANCE TO NEAREST WELL It FOUNDATION ft PROPERTY UNE ft <br /> ❑ SUMPS WIDTH f, itliOl1�I ft DEPTH ft <br /> OI STANCE TO NEAREST WELL ft FOUNDATION ft PROPERrYtJNE it <br /> ❑ DISPOSAL PONDS WIDTH fl LENGTH R DEPTH it <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTYUNE 1t <br /> ❑ SEEPAGE PITS NUMBER_ WUrH - DEPTH R <br /> OI STANCE TO NEAREST WELL ft FOUNDATION ft PROPERTYUNE ft <br /> I HEREBY CERTIFY THAT r RAVE PREPARED THIS APPUCATION AND THE WORK WILL BE DONE IN ACCORDANCE WTTH SAN JOALUIN COUNTY ORDINANCE$ <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIM M ADV E N TI ERE fRED F R fN PE 7f N -PLEASE CALL(2409),953-7697 <br /> SIGNED r-TLE Project Manager1n <br /> OnrE R= <br /> + ------ --$ I <br /> nPARTMENT <br /> Application Accepted sy Area f Employee ID#Fina! ctur of Soi By Q SPEC PERMIT•Approved by �■�_ <br /> Character of Soil to Depth of S p[: <br /> COMMENTS P WSump Sell Chsractor: Itiw(1]� <br /> f4 iv <br /> �A`�� <br /> PE SC Rrcehred Eh Amount pew <br /> Cade INFO omitted Dom' Ice R uest R Invoice! Permit 10# <br /> ;2� <br /> �ir <br /> 411101IQ <br /> 4 18 ONSITE WASTEWATER TRTMNT SYSTEM PERMrT <br />