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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 .(209) 468.3420 NON-KEFUNDABLE PERMIT (:ALL JOB ADDRESS 8408 N. Beecher Road /J EAPIKLU -I TLAK rKUM LJAIC I*bUtl Stockton/95215 CROSS STREET Comstock Road APN 089-150-20 PARCEL SIZE 40.3+/- Acres OWNER NAME Frank Stonebarger PHONE 209-401-6790 OWNER ADDRESS 8408 N. Beecher Road Cm/STATE21P Stockton/CA/95215 CONTRACTOR Dillon 8 Murphy PHONE 209-334-6613 CONTRACTOR ADDRESS P.O. Box 2180 CITY/STATE/ZAP LodVCA/95240 LICENSE ❑_C-42 ❑ C-36 OTHER NUMBER EXPIRATION WATER TABLE DEPTH: It GEOGRAPHICAL INFORMATION: Coordinates X Y * PERC TEST 1 BUILDING PERMIT # LAND USE APPLICATION #PA 1800m TYPE OF WORK: NEW INSTALLATION REPAIR/ADOMON ENGINEER DESIGNED /ALTERNATIVE ft PROPERTY LINE ft REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM _ DESTRUCTION INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMERCIAL ❑ OTHER NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: ❑ SEPTIC TANK TYPEIMFG CAPACITY gal # OF COMPARTMENTS ❑ GREASE TRAP TYPE/MFG CAPACITY gal # OF COMPARTMENTS ft DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT ❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) ❑ LEACH LINES LEACHING CHAMBERS # OF LINES LENGTH OF LINES ft DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE ft ❑ FILTER BED WIDTH It LENGTH ft DEPTH It DISTANCE TO NEAREST WELL It FOUNDATION It PROPERTY LINE ft ❑ MOUNDED WIDTH It LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft ❑ SUMPS WIDTH It LENGTH It DEPTH It DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE It ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH It DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE It ❑ SEEPAGE PITS NUMBER WIDTH It DEPTH R DISTANCE TO NEAREST WELL It FOUNDATION it PROPERTY LINE It I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPUCAT10N AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. 48 UM ADVANCE NOTICE REQUIRED INSPECTIONSUM FOR PLEASE CALL (2M 951-ZOI SIGNED TITLE Party Chief DATE 6 =Z "I ECMENr E/VED P 1 1 2018 AQU11V C ou ?0)VjwS/V. Ivry DE ART JAL L RENT Application Accepted By Final Inspection By Character of Soil to Dep TMENT UfEONLY GTL Date 1 Area D� Employee ID# Date ❑ SPECIAL PERMIT - Approved by Soil PE SC Received Check#/ Amount Parm iU Code INFO B Cash Re 'tied Dam Service Re uest # Invoice # Permit ID# z� s �3 -11-t l`1 22 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4114/18