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.4' <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 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 11325 W.Larch Rd. CITY/ZIP Tracy,CA <br /> CROSS STREET Corral Hollow APN 212-180-23 PARCEL SIZE . �6 p <br /> 0 <br /> OWNER NAME Kumar,Ajay PHONE 510-938-3070 <br /> m <br /> OWNER ADDRESS 420 Acoma Way CITY/STATEIZIP Fremont,CA 94539 <br /> CONTRACTOR Mike's Backhoe Service PHONE 209-456-2865 <br /> CONTRACTOR ADDRESS P.O.Box 650 CITY/STATE/ZIP Manteca,CA 95336 <br /> LICENSE ❑❑C-42 ❑❑C-36 OTHERA NUMBER 608554 EXPIRATION DATE 2020 <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ❑ PERC TEST # BUILDING PERMIT#1905259 LAND USE APPLICATION# <br /> TYPE OF WORK: NEw INSTALLATION ❑ REPAIRIADDITION 7 ENGINEER DESIGNED/ALTERNATIVE <br /> F1 REPLACEMENT Fl OUT-OF-SERVICE SEPTIC SYSTEM -1 DESTRUCTION <br /> INSTALLATION WILL SERVE: RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS:1 NUMBER OF BEDROOMS:3 NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG P&L concrete CAPACITY 1600 gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: VVELL1001 It FOUNDATION 5 ft PROPERTY LINE 25 It <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES i i LEACHING CHAMBERS #OF LINES 3 LENGTH OF LINES 100' ft <br /> DISTANCE TO NEAREST WELL 100 It FOUNDATION 10' ft PROPERTY LINE.'0ft <br /> ❑ FILTER BED WIDTH It LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE <br /> ❑ MOUNDED WIDTH ft LENGTH It DEPTH <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE CEl VEP <br /> ❑ SUMPS WIDTH It LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL It FOUNDATION R PROPERTY LINE 06^ 26 <br /> L1DISPOSAL PONDS WIDTH It LENGTH ft DEPTH <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE OAA. JL <br /> � <br /> ❑ SEEPAGE PITS NUMBER WIDTH It DEPTHf�Af VIN COUNTY <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE HEe I v ONMENTAL <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, '1 <br /> "r-AKTMENT <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 Mike Fuller TITLE Contractor DATE 4/3/2020 <br /> S e el JAIt I t a c h e d <br /> II DEPARTMENT USE ONLY <br /> Application Accepted GC3Ys� i�W4C'�h Date ZaV0 Area S Employee ID# DA <br /> Final Inspection By 111LA. Date ❑ SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 Ft: Pit/ ump Soil Character: <br /> COMMENTS /1JEwW SFR. rP/ Z No wells n6giffUol 0;'t jy) wt,In;mum 506'Gk d- the <br /> orVos(d repi4c sWfF�couytNK feg;oj). <br /> PE SC Received Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO Remitted Service Request# <br /> 9,111 117 S8 <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />