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I <br /> 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 I YEAR FROM DATE ISSUED <br /> JOB ADDRESS 7623 South EI Dorado Street CITY/ZIp French Camp,95231 <br /> m <br /> CROSS STREET West Hospital Road ApN 193-160-380 PARCEL SIZE 1.02 0 <br /> OWNER NAME Maria Maciel PHONE 209 808-4933 <br /> OWNER ADDRESS 1771 Silvercreek Circle CITYISTATE/ZIP Stockton,CA,95207 <br /> CONTRACTOR AdvancedGeo,Inc.(AGI) PHONE(800)511-9300 <br /> CONTRACTOR ADDRESS 837 N Shaw Road CITY/STATE/ZIP Stockton,CA,95215 <br /> LICENSE I- C42 LI C-36 OTHER C-57/A-Haz NUMBER 680227 EXPIRATION DATE 11/30/20 <br /> WATER TABLE DEPTH: 25-30 ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> X PERC TEST # I 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: L RESIDENCE L COMMERCIAL LOTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES It <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ FILTER BED WIDTH ft LENGTH It DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH It LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL It FOUNDATION It PROPERTY LINE It <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION 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 It DEPTH ft <br /> DISTANCE TO NEAREST WELL It 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 /> MINIMUM 48 H01IR ADVANCE 110TICE REQUIRED FOR INSPECTIONSL 7 <br /> SIGNED ^ TITLE Senior Geologist DATE(33 <br /> All 7A <br /> r 11 <br /> 41 <br /> If I <br /> q <br /> E ,ARTMENT E <br /> Application Accep By to Area Employee ID# <br /> 1 r- <br /> Final Inspection By Date tf I.! SPECIAL PERMIT-Approved by <br /> Character of Soil Depth of 3 Ft: Pit/S mp Soil Character: <br /> COMMENTS I �� i I ti I 1A, <br /> PE SCReceived hec Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO B Remitted Service Request# <br /> 41 00 <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />