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ti ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED JOB ADDRESS 7125 Sedan Ave CITYIZIP Mantexa/95337 CROSS STREET I immn Ave APN 226-10-018 PARCEL SIZE 137 Acres 6 0 OWNER NAME Mike I horton PHONE OWNER ADDRESS 7125 Sedan Ave CITY/STATE/ZIP Manteca/CA/95337 CONTRACTOR CIL CAL Inc PHONE (209)543-1799 CONTRACTOR ADDRESS 4230 Kiernan Ave Ste 150 CITYISTATE/ZIP Modesto/CA/95357 LICENSE C42 C-36 OTHER NUMBER EXPIRATION DATE WATER TABLE DEPTH: 24 ft GEOGRAPHICAL INFORMATION: Coordinates X 37.77578069 Latitude y 121.2205588 Longitude V— PERC TEST #z BUILDING PERMIT# LAND USE APPLICATION# TYPE OF WORK: NEW INSTALLATION REPAIRIADOITION ENGINEER DESIGNED/ALTERNATIVE REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: K RESIDENCE COMMERCIAL OTHER NUMBER OF LIVING UNITS: 1 NUMBER OF BEDROOMS.3 NUMBER OF EMPLOYEES: ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS ❑ GREASETRAP TYPE/MFG CAPACITY gal #OFCOMPARTMENTS DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ FILTER BED WIDTH ft LENGTH it DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ SUMPS WIDTH ft LENGTH 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 It FOUNDATION It PROPERTY LINE ft ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE it I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 SIGNED � dL/Z TITLE Staff Geologist DATE 2/10/2020 S e,I e I JAJt t al c I h I e I d F !i A NT DEPARTMENTUSEON Y Application Accepted B Date ~'Area <. . / et.---kE451-yee ID# ,.- Final Inspection By Date ,W 140 SPEPIAL PERMIT-Approved by Character of Soil to Depth of Ft: Pit/Sump Soil Character. COMMF.,r>;J S TU VA 0- yr CQ 3 vim' m-� PE SC Received Check#I Amount PermiU Code INFO B Cash Remitted Date Service Request# Invoice# Permit ID# ZzZ7,04, z 4 �I�,in ( � I'�(� NSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14/18/14/18