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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 1901 N.Patterson Avenue CITYIZIP Stockton,CA 95215 ti CROSS STREET East Fremont Street APN 089-091-08 PARCEL SIZE 0.228 acres e d OWNER NAME Jose Gutierrez PHONE 209 271-7598 OWNER ADDRESS 2345 E.Acacia Street CITYISTATE2lP Stockton,CA 95205 CONTRACTOR AdvancedGeo,Inc. PHONE 800 511-9300 CONTRACTOR ADDRESS 837 North Shaw Road CITYISTATE2IP Stockton,CA 95215 I LICENSE 0-C-42 [_!_.C.36 OTHER C-57 NUMBER 1063765 EXPIRATION DATE 02/28/2022 WATER TABLE DEPTH: 70-80 R GEOGRAPHICAL INFORMATION: Coordinates X Y { PERC TEST 9_L BUILDING PERMIT# LAND USE APPLICATION# I TYPE OF WORK: _ NEW INSTALLATION _ REPAIRIADDITION _ ENGINEER DESIGNED/ALTERNATIVE REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: C RESIDENCE El COMMERCIAL LI OTHER i NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: I ❑ SEPTIC TANK TYPEIMFG CAPACITY gal #OF COMPARTMENTS I ❑ GREASE TRAP TYPEIMFG CAPACITY gal #OF COMPARTMENTS DISTANCE TO NEAREST: WELL ft FOUNDATION fl PROPERTY LINE it ❑ LIFTSTATION SIZE TYPE OF PUMP (3 PKGTXPLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) s ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES R I DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY UNE ft ❑ FILTER BED WIDTH R LENGTH R DEPTH R DISTANCE To NEAREST WELL ft FOUNDATION fl PROPERTYLINE R i ❑ MOUNDED WIDTH R LENGTH R DEPTH R DISTANCE TO NEAREST WELL ft FOUNOATION ft PROPERTYLINE It ! ❑ SUMPS WIDTH R LENGTH R DEPTH Ie NT ; DISTANCE To NEAREST WELL R FOUNDATION R PROPERTY LINE_ �p ❑ DISPOSAL PONDS WIDTH R LENGTH R DEPTH It ,VFX DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTYLINE c I I ❑ SEEPAGE PITS NDMBfRWIDTH R DEPTH A DISTANCE TO NEAREST WELL R FOUNDATION fl PROPERTY LINE SAA R ` I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDIN •Q t STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. 0/,y O SIGNED MINIMUMR ADVANCE NOTICE REQUIRED FORT SPE TIONS-PLEASE CALLeologistDATE05/08/2020 FACT h 0 PARTM�NT Y ProNT ! r I ! i f t I f I t f !'s t _ 3 t 697 t / DEPARTMENTVSE ONLY Application AcceptedB — L—� Date 1 LO Alva y �� Employee 10#—JILLte �I— Final Inspection By Date L? SPECIAL PERMIT-Approved by I Character of Solt to De th of'%Ft: 1 Pit! ump Soil Character: COMMENTS POO 1 "HcTil a�f!' 11Cj ra I ' - hie Pj_q4e>S1o•74 g<Cie FIne L,,r Y6lP. Skl'h- Vjn jrr !t t PE SC Received Check#! Amount Permit/ Invoice# Permit ID# Code INFO Date ash Remitted Service Re uest# i �„2 3 315 7 1 Z 1 { 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4114118 `�� •" ��t/W i q�