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r <br /> . ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 11793 Micke Grove Rd Cm/Zip Lodi 95240 v7 <br /> H <br /> CROSS STREET Armstrong Rd AP 053100-02 PARCEL SDS 208.53 acres <br /> d <br /> OWNER NAME Eduardo Ramirez PHONE(209)468-3582 <br /> OWNER ADDRESS 44 N.San Joaquin Sl,Ste 590 CrrY/STATE/ZIP Stockton,CA 95202 <br /> CONTRACTOR T&S Intermodal Maintenance,Inc dba T&S West PHONE 805-215-8694 <br /> CONTRACTOR ADDRESS 6066 Austin Rd,Stockton,CA 95215 CmISTATE/Zr Stockton,CA 95215 <br /> LICENSE C-42 C-36 OTHER B-General Building NUMBER 939001 EXPIRATION DATE 10/31/2019 <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> PERC TEST # BUILDING PERMIT#1801268 LAND USE APPLICATION# <br /> TYPE OF WORK: /,r NEW INSTALLATION y REPAIR/ADDI110N A ENGINEER DESIGNED/ALTERNATIVE <br /> -dyer <br /> OUT-OF-SERVICE TEM DESTRUCTION <br /> INSTALLATION WILL, ERVE: RESIDENCE u COMMERCIAL OTHER <br /> NUMBER OF LIVING UNITS: -CIL NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: T <br /> SEPTIC TANK TYPE/MFG EVj s hV^ I CAPACITY /(000 gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL ft FOUNDATION R PROPERTY LINE it <br /> ❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT 0 SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> SIN <br /> E$ LEACHING CHAMBERS #OF LINES LENGTH OF LINES `i It <br /> I DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE ft <br /> ❑ FILTER BED WIDTH ft LENGTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH <br /> DISTANCE TO NEAREST WELL It FOUNDATION It PROPERTY LINE It <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH <br /> DISTANCE TO NEAREST WELLIt FOUNDATION ft PROPERTY LINE , ^® <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTHEtyll/In_'ft/ <br /> DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE IR <br /> LJ SEEPAGE PITS Nurnor.a WIDTH ft DEPTH <br /> DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE ft Vr_`�,^���'I�'�'tj <br /> IFREBY CERTIFY THAT I HAVE PREPARED THIS APPUCATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, t'' C- <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 <br /> SIGNED TITLE DATE <br /> AN 4Attc) <br /> C(ea+Adw�' <br /> E°`'4 c <br /> k�l f(j nk <br /> C 11 <br /> dAk v U Iddid-7,ij <br /> 0 6 i •-.� � I c <br /> DEPARTMENT SE <br /> Application Accepted By Date Area Employee ID# <br /> Final Inspection By �'�►' Date SPECT ERM <br /> IT-Approved by <br /> Character of Soil to Depth ofll Ft: Pit/SUM <br /> P <br /> Soil Character: <br /> COMMENTS <br /> i <br /> IPE SC Received Check#/ Amount Permit/ <br /> Code INFO EICash emitted Date Service Request# Invoice# Permit ID# <br /> 51 -f2� <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />