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s � a <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 14749 A-wA w%e,+- QCsN N(tWJC DC.2JNfr CITYIZIP Lodi,95240 <br /> CROSS STREET Highway 12 APN 055-150-260-000 PARCEL SIZE 4.45 acres <br /> c <br /> OWNER NAME BAPH3 Inc. PHONE 209-200-7258 x <br /> OWNER ADDRESS PO BOX 2695 CITY/STATE/ZIP Lodi,California 95240 <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 NUMBBrian Millman 1/31/21 <br /> LICENSE C-42 C-C-36 OTHER ER 8574 EXPIRATION DATE <br /> WATER TABLE DEPTH: 15-20 it GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> 2Z1C PERC TEST #t BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION i- REPAIR/ADDITION C ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM I 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 /> O GREASE TRAP TYPE/MFG _ CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL ft FOUNDATION it PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES l LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTYLINE it <br /> ❑ FILTER BED WIDTH it LENGTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION it PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH ft LENGTH It DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE ft <br /> Cl SUMPS WIDTH it LENGTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION it PROPERTY LINE ft <br /> ❑ DISPOSAL PONDS WIDTH it LENGTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION it PROPERTY LINE ft <br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, <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_ Brian Millman TITLE CA Professional Geologist No.8574 DATE 11 November 2020 <br /> rLo <br /> O pMR��HT y <br /> T <br /> DEPARTMENTUS ONLY <br /> Application Accepted By<=�— a/ Date 11 /.7 O_a Area 11 Employee 1134 DA <br /> Final Inspection By Date k'UrL,:,❑ SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: <br /> COMMENTS Q i-A-L- 'LVb.t%-- : %�.. L1. mow.',NL_h <br /> PE SC Received Check#/ Amount Date PermiU Invoice# Permit ID# <br /> Code INFO BY Cash Remitted Service Reauest# <br /> a Sa 3 <br /> 4 11 / Y ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/t4//14/18 <br />