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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAOUIN 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 17835 North Tretheway Road Crry21p Lockeford 95237 <br /> =i <br /> CROSS STREET Locke Road APN 051-150-070-000 PARCEL SIZE 3.25 acres <br /> c <br /> OWNER NAME Brady and Judith Horton PHONE(209)712-2099 <br /> V. <br /> OWNER ADDRESS 17835 North Tretheway Road CIT//STATE/ZIP Lockeford CA 95237 <br /> CONTRACTOR AdvancedGeo,Inc. PHONE 800 511-9300 <br /> CONTRACTOR ADDRESS 837 North Shaw Road CITY/STATE/ZIP Stockton,CA 95215 <br /> CA Professional Geo Brian Millman 1/31/21 <br /> LICENSE El--C-42 0-C-36 OTHER NUMBER 8574 EXPIRATION DATE <br /> WATER TABLE DEPTH: 110-120 it GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> 9 PERC TEST #1 BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: ❑ NEW INSTALLATION C REPAIR/ADDITION C ENGINEER DESIGNED/ALTERNATIVE <br /> F1 REPLACEMENT ❑ OUT-OF-SERVICE SEPTIC SYSTEM G 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 /> ❑ GREASETRAP TYPE/MFG CAPACITY gal #OFCOMPARTMENTS <br /> DISTANCETO NEAREST: WELL it FOUNDATION it PROPERTY LINE It <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES I LEACHING CHAMBERS #OF LINES LENGTH OF LINES it <br /> DISTANCE TO NEAREST WELL ft FOUNDATfON ft PROPERTY LINE_ _it <br /> ❑ FILTER BED WIDTH it LENGTH it DEPTH it <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE it <br /> ❑ MOUNDED WIDTH it LENGTH it DEPTH _it <br /> DISTANCE TO NEAREST WELL R FOUNDATION it PROPERTY LINE _ It <br /> ❑ SUMPS WIDTH it LENGTH it DEPTH it <br /> DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTYLINE_ _it <br /> ❑ DISPOSAL PONDS WIDTH it LENGTH it DEPTH it <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE it <br /> ❑ SEEPAGE PITS NUMBER WIDTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTYLINE it <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAOUIN COUNTY ORDINANCES. <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAOUIN COUNTY. <br /> MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL/209 953-7697 <br /> SIGNED_ a Brian Millman TITLE CA Professional Geologist No.8574 DATE 01 October 2020 <br /> N1E�� <br /> EIVED <br /> 0 6 2020 <br /> QUIN COUNTY <br /> ONMENTAL <br /> DEPARTMENT <br /> DEPARTMENT USE QNLV <br /> Application Accepted By G �/� Date A," Area _ Employee ID# <br /> Final Inspection By Date ( ❑ SPECIAL PERMIT-Approved by <br /> Character of Soil to Dept PIVSump Soil Character: <br /> COMMENTS <br /> PE SC Received ountD t Permit/ Invoice# Permit ID# <br /> Code INFO B s emitted Service Re uest# <br /> aaa sa3 11 rsa <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />