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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN CCLINTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZE'-ON 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 11065)N.Alpine Road CITY/ZIP Stockton, CA 35212 <br /> CROSS STREET EIg"it Mile Road APN 063-040-23 - PARCEL SIZE 1.5 =' <br /> i z <br /> OWNER NAME Whitlow/COrtopaSSI Farms. Inc. PHONE s <br /> OWNER ADDRESS 11292 N.Alpine Road CITY/STATE/ZIP Stockton CA 95212 <br /> CONTRACTOR _ / PHONE 1 <br /> CONTRACTOR ADDRESS 902 INDUSTRIAL WAY CITY/STATE/ZIP LODI CA 95240 <br /> LICENSE C-42 C-36 OTHER C-57 NUMBER 669004 EXPIRATION DATE 05-31-2021 <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y- <br /> 1)( 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 _ OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS__ <br /> ❑ GREAFS TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> CISTANCE'"O NEAREST: WELL_ ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPE OF PU;v?F_ ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <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 ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE_ ft <br /> ❑ SUMPS WIDTH ft LENGTH _ ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDAT:ON 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 ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> I HEREBY CFRTot-Y 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 /> MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTiONS-PLEASE CALL (209)953-7697 <br /> SIGNED TITLE STAFF SCIENTIST DATE 09-27-19 <br /> R•fa � k�M��•p ' ,I <br /> OAH- <br /> I'� I <br /> /^ r <br /> m <br /> pa' <br /> 19 <br /> NTY <br /> t - EN I O M NT L <br /> HE.ALrH PE DARTNIENT <br /> Eight Mile Road <br /> (0.68 miles south) <br /> P A R T M E ALTAJ S E h&L Y <br /> Application Accepted Date Area Employee ID# �. <br /> Final Inspection By Date illy SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 F . Pit/Sump Soil Character: <br /> COMMENTS C P,It <br /> PE SC Received Chec / Amount Date Pe,mIU Invoice# Permit ID# <br /> Code INFO Cash Remitted Service Re uest# <br /> Z ROD I qCF <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />