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ONSITE WASTEWATERTREATMENT 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 20745 Elliott RoadCITY/Zip Lockeford,95237 <br /> CROSS STREET Highway 88 APN zv/� I PARCEL SIZE 21.74 acres <br /> PHONE <br /> Leonard Peterson,L.A.Delta Investments,Inc. 209-400-5595 <br /> OWNER NAME r <br /> OWNER ADDRESS P.O.Box 1040 CITY/STATE/ZIP Lockeford.CA 95237 <br /> O <br /> CONTRACTOR Leonard Peterson,Inc— --__— — — PHONE 209-400-5595 <br /> Ln <br /> CONTRACTOR ADDRESS 19 Hammond,Ste 510 CITY/STATE/ZIP Irvine,CA 92618 m <br /> O <br /> LICENSE C-42 C-36 OTHER B NUMBER 931072 EXPIRATION DATE 4/30/2021 "+ <br /> Q <br /> I I <br /> WATER TABLE DEPTH:0� It 0--_It GEOGRAPHIC/LL INFORMATION: Coordinates X_— Y <br /> n <br /> PERC TEST # SR0078904 BUILDING PERMIT# LAND USE APPLICATION#_ ""' --__ <br /> TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE O <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION Q" <br /> INSTALLATION WILL SERVE: RESIDENCE x COMMERCIAL OTHER D <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: (n <br /> N <br /> I1 SEPTIC TANK TYPE/MFG Pre-Cast Concrete/Jensen Precast CAPACITY 2000 gal #OF COMPARTMENTS 2 -- Uj <br /> — V <br /> ❑ GREASE TRAP TYPEiMFG — — CAPACITY — gal #OF COMPARTMENTS_—_ <br /> DISTANCE TO NEAREST: WELL4f-���! ft FOUNDATION_ 4 — ft PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> LEACH LINES LEACHING CHAMBERS #OF LINES 3 LENGTH OF LINES 50 ft <br /> DISTANCE TO NEAREST WELL 130 ft FOUNDATION 300 ft PROPERTY LINE 72 ft <br /> ❑ FILTER BED WIDTH _— ft LENGTH _— tiv DEPTH_--_-----_ ft <br /> DISTANCE TO NEAREST WELL R FOU"t ► * rr�....����IIIENT PROPERTY LINE-----_ R <br /> NT <br /> ❑ MOUNDED WIDTH _ -- ft LENGTH _—EEN ��ut"VEPTH_--_-----_ ft <br /> DISTANCE TO NEAREST WELL ft ft PROPERTY LINE ft <br /> ❑ SUMPS WIDTH —_ ft LENGTH — —_ft DEPTH— -- —_ ft <br /> DISTANCE TO NEAREST WELL---- R FOUNDATION _R PROPERTY LINE �/��/ \ <br /> r R <br /> Z1 DISPOSAL PONDS WIDTH ft LENGTHft DEPTH_-_ �T��f��`/•�\.� �_ ft <br /> DISTANCE TO NEAREST WELL_ ft FOUNDATION —ft PROPERTY LINE ®®' °i- ft <br /> ® SEEPAGE PITS NUMBER 3 WIDTH 4ft DEPTH 25__ •yw� T� I _ ft <br /> DISTANCE TO NEAREST WELL 188 ft FOUNDATION 265 R PROPERTY LINE V& ' -+ ft <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIf Tjd dl <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. tN Iv R NNMENTAL ly <br /> HEALTH DEPARTMENT <br /> MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS- PLEASE CALL (209)953-7697 <br /> SIGNED TITLE DATE <br /> Nlop <br /> -777 r <br /> Ne c.. 1 �. . ._ <br /> ( <br /> is <br /> T w- <br /> --'- <br /> I <br /> \1 <br /> J. <br /> D ARTMENTiUSE ONLY <br /> Application Accepted B _ Date Area Employee ID# <br /> Final Inspection By --- _ DateSPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3I�Ft: — —_ Pit/Sump Soil haracter. _ <br /> COMMENTS r"Gn L,4" UM WA 60 1A, . 0+4,r- 4WO <br /> If49--�` = it <br /> PE SC Rec ived Check#/ Amount D e/ Permit/ Invoice# Permit ID# <br /> Code INFO ash Re fittedService Request# <br /> SR � a(� l <br /> 4201 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />