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ONSITE WASTEWATER TREATMENT SYSTEM PER-MIT <br /> SAN JOAQLIN COUNTY ENVIRONMENT A LHE A LTH DEPARI.MEVT 3114E WERFR AvI, -3"Fl.-ST(N-K'I'OS CA 95202 - (209)46&3420 <br /> NON-REFUNDABLE PERMIT /... CALL(2")953-7697 FOR INSPECTIONS FXPIRES 1 YEAR FROM <br /> DATE ISSUED <br /> Joa ADDRESS Z.O Al //-EyU r � -`- I ITY?LIP� '9�1 4'.3„L2 <br /> CROSSSTR Vr S..0jT7L�c�crQ�[ll/t D_ APN � Q' -Z��.- P+R( Sfic � � <br /> 0 <br /> OWNER NAME PHONE.10�2&9 607 -P•[l`��1 v <br /> OWNERADORFS.S .4 S 4.a ova_ _ CITVISTATEJLIP_ <br /> r <br /> CONTRA(TOR PHOVF. <br /> 'l CONTRACTORADDRESS _ 01 /STAIFI-l.IP._„ _ <br /> LICENSF ❑C-42 ❑C-36 OTHER NNIBER E%PIRA LION DATE —� <br /> WATER TABLE DFPTFI: ItCEOGRAPHICAI.IVFOKMATIOV_Coordinates X V_ G <br /> 7 PER(TEST N_ BUILDING PERMIT# [,AND USE APPLICATION <br /> TYPE OF WORK: `❑, NEW INSTAI.LATtON RFPAIRIADDITION ElENGINECR DESIGNED/ALTERNATIVE <br /> 7^ REPLACEMENT DESTRLCTION <br /> INSTALLATION"WILL.SERVE: RESIDENCE U COMMERCIAL , OTHER <br /> NUMBEROF LIVING UNITS:_ BKyy+ _ NIL MBER OF HEDROOMS: NUMBER OF EMPLOYEES: -$' <br /> SEPTICTAN'K Tvpls'M ra _ CApAclry ZZZ d 6 g.l N OF COMPARTMENTS <br /> Q GREASE TRAP TYPL'MFG_ CAPACITY_ ___ gal a OF COMPARTMENTS <br /> O PKC TX PLANT DISTANCETO NEAREST: Wril. II FOLNDAT(ON 4- ft PROPERTY LIN[— R <br /> ❑ LIFT STATION SIZE I'M OF PUMP ❑ SAND OIL SEPARATOR(£NcLoSED SYM.vI) <br /> i <br /> (� 1.}:ACH '_ '� l /p]��/� ���4 'i Or LINES LENGTH OF LINES �R <br /> /U��//` �� �/f /'ELL a Il FOUNDMIO\ _It PROPERTY LINNF. ft <br /> ❑ FILTER �jj l✓�S� T�Y n ft LENo1H _ h DEPTH R <br /> IV 'ELL FOLINDITION _R PROPERTY LINE ft <br /> � s, a,/ --- <br /> ❑ MOUND ,- /,/} l � / ft I.C'IGTH_. _n DEPTH ft <br /> /H,ew!/ ��/jp %ELL___ft FOUNDAIION n PROPERTY LINE R <br /> ❑ SUMPS "_ ��y H Lr Ncmi __ft DEPI"H ft <br /> <CXJJ /C•�/Y'�,%n ` �rl.i._ 7t FOL.YD.AiiON_ n PROPF RTV LINE _1t <br /> ❑ DISPOS. f ft LENurH_ —R DEPTH <br /> DISTANCE I'DNEARESI WELL 11 FOUNDATION JD -Ir _ II PROPERTY LINE. <br /> }( SEEPAGE PITS NLIMaFRWTDTH ft DEPTH <br /> DISTANCE TO NEAREST WELL / _1: ',OLIVDATION _ R I•R(WERIY I INE _ � n <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND-i HE WORK WILL BE DONE.IV ACCORDANCE WITHSAN JOAQUIN COUNTY <br /> ORDINANCES,STATE LAWS AND RLLES AND REGLI.A'FIOVS OF SAN JOAQUIN COUNTY. <br /> MINIMUM 24 HOAR ADVANCE\OTICI.REQUIRED FOR INSPECTIONS-PI.F..ASH CALL(2Q9)953-7697, <br /> SIGNED/ - Y_ - TI TI.F._ I�Ltr Y���� DATE "¢- 4 <br /> i <br /> I Lj I A LJ q COU . <br /> IS N tE TA <br /> C J <br /> Ll <br /> DEPARTMEN���TyyyU E O .Y / <br /> Application Accep(ed By� Date- _ Arc. _ Employce 10# <br /> Final Inspect n By Dare Z, ❑ SPECIAL PERMIT-.4ppmved by <br /> Character of`foil to Depth of 3 Ft:_ _ PiUSump Soil Character: <br /> COMMENTS pCm/ <br /> O�l Lot L . as— <br /> An _ <br /> Jcx f E(/Zrc2�a4cls) r�fs(.}aLyJ�s�i�3i 9udn,/s it.,& { S.7 <br /> /'E SC Received Amuanl Permit/ <br /> Code INFO By Ca. <br /> h Remitted Date Invalce N Permit IDIN� <br /> Riogoo 333-1 <br /> 4r( z9E(E���er�3�• J� Pam!�c slew y S:s veam <br /> ONSITF WASTE ATER PERMI <br /> Iz�z.•zooT iv 8E'i2�',er.L�, �rs57in-b s 7 4a .c3rF.�i�r»'_7 <br />