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Iiti- tL.�3 <br /> ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)46"20 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JoeADOREss 7500 W. Linne Road c,TYrz,P Tracy 95304 a <br /> CROSS STREET Chrisman Road APN 25332018 PARCELSIZE 12.5 acres c <br /> 0 <br /> OWNER NAME Jefferson School PHONE 209-835-3053 <br /> OWNER ADDRESS 7500 W. Linne Road CITYISTATEIZIP Tracy CA 95304 <br /> CONTRACTOR TBD PHONE_ ( � �� <br /> CONTRACTOR ADDRESS • a CITYISTATEJZIP \J ; <br /> Q tie <br /> LICENSE ._ C-42 .._"C-36 OTHER NUMBER EXPIRATION DATE <br /> WATER TABLE DEPTH: >50' ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: X NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> X REPLACEMENT Xi OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: RESIDENCE X COMMERCIAL I.._ OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES:750 Students <br /> SEPTIC TANK TYPE/MFG Jensen Precast-3X.IP2500 CAPACITY_ 7500 _ gal #OF COMPARTMENDTSacuy <br /> 2 <br /> DC GREASETRAP TYPEIMFG Jensen Precast-JV i%i✓EE cAPAc,TY_ s'' _ gal #OFCOMPARTMENTS 2 <br /> DISTANCE TO NEAREST: WELL 375 ft FOUNDATION •J It PROPERTY LINE 175 ft <br /> 1>{?tA•Y" � '� LIFTSTATION SIZE Ai✓! "r'j1TYPE OF PUMP.i:�4\ A:L D PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> .LL CC __........._................_..........._.....__._._._____Y....-....._........._._............._........._...._..__...._................................_......_..... ......_ .. ..:� .......__ _............ ....yr_. .. <br /> (� LEACH LINES I I LEACHING CHAMBERS #OF LINES 1 LENGTH OF LINES 100 It <br /> DISTANCE TO NEAREST WELL 505 it FOUNDATION ft PROPERTY LINE 75 It <br /> ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH It <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SUMPS WIDTH ft LENGTH it DEPTH ft <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH it LENGTH It DEPTH ft <br /> DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE It <br /> (� SEEPAGE PITS NUMBER 16 WIDTH 5 ft DEPTH 25 it <br /> DISTANCE TO NEAREST WELL 505 it FOUNDATION 115 ft PROPERTY LINE 70 ft <br /> I HEREBY RTIFY THAT H EO THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN AGUIN COUNTY ORDINANCES, <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> UR ADVANCE NOTICE REQUIRED FOR 1N CT ONS-PLEA9'E CALL 209 953-7 97 <br /> SIGNEDATE <br /> i I I <br /> AX <br /> DI 111 <br /> 7 .-HA empire <br /> 1 <br /> 1 <br /> t <br /> 1 <br /> I <br /> I �4 <br /> y{ �/ PA T EN E LY _ <br /> Application Accepted I PLA- Date C Area d Employee ID#L�C;s v.5 <br /> d <br /> Final Inspection By ty, _ Date�, „�; SPECIAL P MIT-Approved by <br /> Character of Soil toth of 3 Ft: tlSump Soil Character: <br /> g Jp /,COMMENTS % <br /> T'I/10 v 'iy"�} <br /> - ! .,w Sw- ros 'r r;' T— `• PE SC Received C Amount Dam Permitl Invoice# P <br /> Code INFO Cash Re ittod Service R uest#y <br /> C 1 <br /> {2.Qy y i+7 04SRE WASTEJJA R TRTMN STEM PERMfT - <br /> 4124112 <br />