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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT f 4 SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 468-3420 NON-KEFUNDABL ERMIT GALL ZU91953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUE[ JOB ADDRESS 18690 tampede Rd. CITY/ZIP Clements q -n -a a CROSS STREET APN 019-33-004 PARCEL SIZE 10,100 Acres OWNER NAMEMr. andelMrs.Sanni 1&4ward) nPHOFJE OWNER ADDRESS I&A0 FA-�QcAp— " '/ 59g yZ G� CONTRACTOR Haley Contracting PHONE 209-463-2517 CONTRACTOR ADDRESS 4228 Newton Rd. CITY/STATE/ZIP Stockton CA 95205 LICENSE C-42 )( C-36 OTHER B,A,C16 NUMBER 580907 EXPIRATION DATE 11/30/2019 WATER TABLE DEPTH: I� tJO ft GEOGRAPHICAL INFORMATION: Coordinates X Y PERC TEST # BUILDING PERMIT # 18-00638 LAND USE APPLICATION # TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED /ALTERNATIVE REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: 7L RESIDENCE _ COMMERCIAL OTHER NUMBER OF LIVING UNITS: / _ NUMBER OF BEDROOMS: 4 NUMBER OF EMPLOYEES: SEPTIC TANK TYPE/MFG P&L Concrete CAPACITY 1600 gal # OF COMPARTMENTS 2 GREASE TRAP TYPE/MFG CAPACITY gal # OF COMPARTMENTS DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) I HEREBY CERTIFY THAT I HAVE PREPARF�Q THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, S ATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. SIGNED Secretary DATE 7/23/2018 �ZIE,PA USE ONLY 'I / q Application Accepted By (LlDate if IZO 19 Area Employee ID# Vj Final Inspection By lkllyp Date 8 is//� SPECIAL PERMIT -Approved by Character of Soil to Depth of 3 Ft: Pit/Sump Soi Character: COMMENTS AIC WP B( CA S,-hc ut-(- CL%u t ;,Is -fq e I PE Sc Received Amount ate Permit/ Invoice # Permit ID# Code INFO Cas Remitted Service Request # 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14/18 LEACH LINES LEACHING CHAMBERS # OF LINES 3 LENGTH OF LINES 85 ft DISTANCE TO NEAREST WELL 160 ft FOUNDATION 20 ft PROPERTY LINE 150 ft ❑ FILTER BED WIDTH It LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ��_ gggrrr ��41 ❑ SUMPS DISTANCE TO NEAREST WIDTH WELL ft LENGTH ft FOUNDATION ft PROPERTY LINE DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE fty ❑ DISPOSAL PONDS WIDTH DISTANCE TO NEAREST ft LENGTH WELL ft DEPTH i 4tO ft PROP—TY LINE �Od�_. ft ^O ft FOUNDATION 3 1 l �- 25' HFn.lv v SEEPAGE PITS NUMBER WIDTH ft DEPTH /-RC�AU/1V DISTANCE TO NEAREST WELL 200 It FOUNDATION 20 ft PROPERTY LINE 150 y I HEREBY CERTIFY THAT I HAVE PREPARF�Q THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, S ATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. SIGNED Secretary DATE 7/23/2018 �ZIE,PA USE ONLY 'I / q Application Accepted By (LlDate if IZO 19 Area Employee ID# Vj Final Inspection By lkllyp Date 8 is//� SPECIAL PERMIT -Approved by Character of Soil to Depth of 3 Ft: Pit/Sump Soi Character: COMMENTS AIC WP B( CA S,-hc ut-(- CL%u t ;,Is -fq e I PE Sc Received Amount ate Permit/ Invoice # Permit ID# Code INFO Cas Remitted Service Request # 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14/18