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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 122 West Harney Lane CITY/ZIP Lodi,95242 LA y CROSS STREET North Extension RoadAPN 058-060-460 PARCEL SIZE 27.01 acres C OWNER NAME I Hsin Orchids PHONE(209)602-6569 OWNER ADDRESS 122 West Harney Lane CITY/STATE/ZIP Lodi,CA 95242 CONTRACTOR Baez Geotechnical Group PHONE (209)632-3779 CONTRACTOR ADDRESS 2060 Colorado Avenue,Suite 8 CITY/STATE/ZIP Turlock,CA 95382 LICENSE 11 C-42 07C-36 OTHER GE 2339/CE 43010 NUMBER EXPIRATION DATE 3/31/2022 WATER TABLE DEPTH: 45 ft GEOGRAPHICAL INFORMATION: Coordinates X 38.099161 fir-121.316882 ix PERC TEST #J- BUILDING PERMIT# LAND USE APPLICATION# TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE ., REPLACEMENT - OUT-OF-SERVICE SEPTIC SYSTEM _ DESTRUCTION INSTALLATION WILL SERVE: ❑ RESIDENCE LX COMMERCIAL-AgricultUre OTHER NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES:Up to 50 SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft ❑ LIFTSTATION SIZE TYPE OF PUMP O PKGTXPLANT ❑ 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 ft DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL R FOUNDATION ft PROPERTY LINE ft ❑ SUMPS WIDTH ft LENGTH It DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft ❑ SEEPAGE PITS NUMBER WIDTH It DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft I HEREBY CERTIFY THAT I 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 O V N E NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 7 SIGNED TITLE Project Engineer DATE 7/20/2020 EENr QED 282020 1EN LINTY PA R QL MENTI DEPARTMENT US ONLY Application Accepted. _y�— Date d 7 J Area C��f Employee ID# U Final Inspection By\( ) Date f^ ( Ldp G SPECIAL PERMIT-APProved by Character of Soil to Depth of 3 Ft: O Pi;lp Soil Character: COMMENTS R'fC 97I1y \'l. . �� --n'-n/'- L(V, PE SC Received Check#/ Amount fte Permit/ Invoice# Permit ID# Code INFO ash Remitted Service Re ue # 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14/18