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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 1352 BALDWIN LANE CITY/ZIP STOCKTON ur <br /> 1 <br /> m <br /> CROSS STREET EAST FREMONT STREET/HIGHWAY 26 APN 101-130-74 PARCELSIZE 15.59 0 <br /> 0 <br /> OWNER NAME AARON PARADISO PHONE um <br /> OWNER ADDRESS 1282 BALDWIN LANE CITY/STATE/ZIP STOCKTON CA 95215 <br /> CONTRACTOR TERRACON CONSULTANTS INC PHONE 209-269-8586 <br /> CONTRACTOR ADDRESS 902 INDUSTRIAL WAY CITY/STATE/ZIP LODI,CA 95240 <br /> LICENSE ❑1 F C-42 :1C-3640THER ` ° t'10ONUMBEF 7d tq_&_EXPIRATION DAT- <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X T Y <br /> ,E' PERC TEST #3 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: RESIDENCE COMMERCIAL ] OTHER <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 it <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ FILTER BED WIDTH ft LENGTH ft DEPTH fl <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH ft LENGTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SUMPS WIDTH ft LENGTH ft DEPTH fl <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE fl <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH fy // <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft \`CC/�HT <br /> ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH f / C AOI <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE �k 1 C <br /> 1 HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDI"*# ` 8 4�o?O <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. ���r VV JO <br /> SIGNED MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL D(A2 09)09-535 2020 F Ty D/MFIAt CC) <br /> TAMARA WOODS TITLE STAFF SCIENTIST <br /> to fartTaf °Ii ""° RTM N <br /> c F <br /> _ T <br /> it <br /> 0 <br /> 0 o a- <br /> 10 <br /> io o i — X__ <br /> I � I <br /> ,I I <br /> / DEPARTMENT USjE ONLY <br /> Application Accepted By G�L/y Date Q O Area 7 �! Employee ID#� <br /> Final Inspection By Date ❑ SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: <br /> COMMENTS <br /> PE SC Received Check#/ Amount Parm 1V <br /> Code INFO ash Remitted Dat Service Re ue t# Invoice# Permit ID# <br /> 6 <br /> Llaaa sa 3 lliS S;(--- <br /> 42-01 <br /> (-42-01 <br /> 4114118 r� ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> /\,),�1��, '(1 / <br />