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r ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUI14 COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INS EcrtDNS EXPIRES 1 YEAR FROM DATE ISSUED JOB ADDRESS 14900 West Schulte �'�` CITY/Zlp Tracy 95377 M CROSS STREET Lammers Road APN 209-240-340 PARCEL SIZE ' a OWNER NAME LBA Development Company XIX,LP PHONE (949)833-0400 ° x OWNER ADDRESS 3347 Mk*velson Drive,Ste,200 CITY/STATEILP Irvine,CA 92612 CONTRACTOR Millie and Severson GC PHONE 562-493-3811 CONTRACTOR ADDRESS 3601 Serpentine Drive (;rr lSTATE(LIP Los Alamitos,LA 90720 LICENSE C)C-42 ❑IC-36 OTHER A NUMBER 99031 EXPIRATION DATE 7/31=18 WATER TABLE DEPTH; ' ft GEOGRAPHICAL INFORMATION: Coordinates X 37'43'10.5'N Y 121°29'34.3"W ❑ PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# TYPE OF WORK: NEW INSTALLATION 0 REPAjR1ADDrnON ENGINEER DESIGNED ALTERNATIVE ❑ REPLACEMENT ❑ OUT-0F-SERVICE SEPTIC SYSTEM ❑ DESTRUCTION INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMERCIAL ❑ OTHER NUMBER OF Lwo UNrrs: NUMBER OF BEDROOMS: NUMBER of"PLOYEES: ❑✓ SEPTIC TANK TYPE/MFG Battery Septic,tank/Jensen Precast CAPACITY 5,000 gal #OF COMPARTMENTS 2 ❑ G REASE TRAP TYPE/MFO CAPACITY gal #OF COMPARTMENTS DISTANCE To NEAREST: WELL 646 ft FOUNDATION 136 ft PROPERTY ZINE 41 ft ❑ LIFT STATION SIZE TYPE OF PUMP ❑ 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 V❑ FILTERBED WIDTH 48.5 R LENGTH 82.5 it DEPTH 42" ft DISTANCE To NEAREST WELL 560 ft FOUNDATION 140 It PROPERTY LINE 5 ft ❑ MOUNDED WIDTH ft LENGTH it DEPTH ft DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ SUMPS WIDTH ft LENom ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE ft ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft DISTANCE To NEAREST WELL ft FOUNDATION It PROPERTY LINE it I HEREBY CERTIFY THAT I HAVE PREPAR S APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, 8 E LAWS AND RULES TIONS OF SAN JOAQUIN COUNTY. MU fOU DYAN CE !p IRED FOR INSPECTIONS-PLEASE CALL 209 953-7$97 SIGN jr— TITLER DATE — 7-! r 1 M . Application Accepted By Date Area ( Employee ID# Final inspection By ' '„rY'^ Date i v f Z I D SPECIAL PERMIT-Approved by Character of Soif to pt Ft: i Pit/Sump Soil Character; COMMENTS �H 19 �/� �/L i '/'K 7' iii (• ^' G�6 -�^ > r i/ltC `1 Ti /T c� l��4i l -te PE SC Received Che" Amount Date Permit! Invoice# Permit ID# Code INFO B Cash Remitted Service Request# 42-01 ONSRE WASTEWATER TRTMNT SYSTEM PERMIT 424112