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'i <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 1177 North Stokes Avenue Clry/ZIP Stockton,95215 <br /> CROSS STREET East Fremont Street APN 143-280-01 PARCEL SIZE 3.01 Acres b <br /> e <br /> OWNER NAME Stockton Terminal Eastern RR Co. PHONE 510 835-7251 <br /> OWNER ADDRESS 1177 North Stokes Avenue CITY/STATE/ZIP Stockton,CA,95215 <br /> CONTRACTOR Advanced GeoEnvironmental,Inc(AGE) PHONE(800)511-9300 <br /> CONTRACTOR ADDRESS 837 North Shaw Road CITYISTATE/ZIP Stockton,CA,95215 <br /> LICENSE ❑-.C-42 ❑_C-36 OTHERC-57/A-Haz NUMBER 680227 EXPIRATION DATE II/30/19 <br /> WATER TABLE DEPTH: �D� ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> PERC TEST #1 BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: _ NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMERCIAL Ll OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPEIMFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE To NEAREST: WELL it FOUNDATION ft PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES C LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY UNE ft <br /> ❑ FILTERBED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY UNE it <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION It PROPERTY UNE ft <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION it PROPERTY LINE ft <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> 1 ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 209 953-7697 <br /> SIGNED zn TITLE Senoir Geologist DATE 5/30/19 <br /> IVNT <br /> ED <br /> s 2019 <br /> SUN <br /> NTAL N <br /> TMENT <br /> "DEPARTMENT USE NLY <br /> Application Accepted By Date Area mployee ID# <br /> Final Inspection By //f bite ❑ SPE AL PERMIT-Approved by <br /> Character of Soil to Depth of 3 Ft: Pit/Sump Soil Ch rade. <br /> COMMENTS <br /> �e t-(,ala ko to yke. t_n�o\-S (I-l. d m ivt /i✓C <br /> PE SC Received Che Amount Date Permit, Invoice# Permit ID# <br /> Code INFO B Remitted ervice ue t# <br /> ?iZ <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14118 <br />