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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 15999 W.Corral Hollow Road CITY/ZIP Tracy,95377 <br /> CROSS STREET 580 Freeway APN 251-140-05 PARCEL SIZE 5753.40 ac D <br /> 0 <br /> 0 <br /> OWNER NAME Department of Energy,Lawrence Livermore National Lab-C/O Ada Chan(Site Rep) PHONE 925-422-1100 m <br /> OWNER ADDRESS 15999 W.Corral Hollow Road CITYISTATEIZIP Tracy,CA,95377 <br /> CONTRACTO PHONE 19 ' <br /> CONTRACTOR ADDRESS CITYISTATE/ZIP-L^H'ne ocoer" <br /> LICENSE C-42 I C-36 OTHER NUMBER 632667 EXPIRATION DATE 12/31/2019 <br /> WATER TABLE DEPTH: 100` ft GEOGRAPHICAL INFORMATION: Coordinates X -121,537373° y 37.667148' <br /> PERC TEST # 7 BUILDING PERMIT#NIA LAND USE APPLICATION#NIA <br /> TYPE OF WORK: NEW INSTALLATION REPAIRIADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: I RESIDENCE COMMERCIAL I OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES:20 <br /> SEPTIC TANK TYPE/MFG Precast Concrete CAPACITY 2,000 gal #OF COMPARTMENTS 2 <br /> ❑ GREASETRAP TYPE/MFG CAPACITY gal #OFCOMPARTMENTS <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 /> —^—LE-ACA LINES LEACHING CHAMItSFIRS 60 <br /> DISTANCE TO NEAREST WELL 500'+ ft FOUNDATION 150'+ ft PROPERTY LINE 4200'+ ft <br /> FILTER BED WIDTH ' —�If ft LENGTH t*n ft DEPTH ft <br /> �� <br /> DISTANCE TO NEAREST WELL 15='!(- ft FOUNDATION � ft PROPERTY LINE_ gQttJt ft <br /> ❑ MOUNDED WIDTH ft LENGTH It DEPTH ft <br /> DISTANCE To NEAREST WELL It FOUNDATION ft PROPERTYLINE ft <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH It <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH It 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 ft FOUNDATION ft 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 /> I M 48 HOADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 209 953-76A7 <br /> SIGNED TITLE '>4—C1%( <br /> J1 KtC DATE <br /> 0 6 ?419 <br /> NINCou <br /> T EPq� Ory�Y <br /> D ARTMENT U O <br /> Application Accepte4Deof <br /> Date Area Employee ID# � <br /> Final Inspection By Date >C�SIPE IAL PERMIT-Approved by <br /> Character of Soil to 3 Ft: it/Sump Soilh13 aracter: <br /> COMMENTS o <br /> r <br /> PE SC Received In Amount Perm <br /> iU <br /> Cod INFO B Cash a itted Date Service RAquest# Invoice# Permit ID# <br /> D 0 � <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />