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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 18915 South Carrolton Road CrrY/ZIP Ripon,95367 <br /> CROSS STREET Allen Road APN 245-380-310-000 PARCEL SIZE 2.0 acres <br /> OWNER NAME Alissa Bere2ay PHONE(209)403-6817 z <br /> OWNER ADDRESS 912 Mission Ridge Drive CrrY/STATE21P Manteca,CA 95337 <br /> CONTRACTOR AdvancedGeo,Inc. PHONE 800 511-9300 <br /> CONTRACTOR ADDRESS 837 North Shaw Road CITY/STATE/ZIP Stockton,CA 95215 <br /> LICENSE ❑='C-42 0=C-36 OTHER CA Professional GeOIOQWMBER 8574 EXPIRATION DATE I/31/21 <br /> grif,ii4l 10J-1-044 <br /> WATER TABLE DEPTH:60 ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ® PERC TEST #1 BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: ❑ NEW INSTALLATION ❑ REPAIR/ADDITION ❑ ENGINEER DESIGNED/ALTERNATIVE <br /> F': REPLACEMENT ❑ OUT-OF-SERVICE SEPTIC SYSTEM I I DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTICTANK TYPE/MFG CAPACITY gal #OFCOMPARTMENTS <br /> ❑ GREASETRAP TYPE/MFG CAPACITY gal #OFCOMPARTMENTS <br /> DISTANCE TO NEAREST: WELL it FOUNDATION ft PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP O PKGTX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> 0 LEACH LINES I LEACHING CHAMBERS #OF LINES LENGTH OF LINES It <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE _ft <br /> ❑ FILTER BED WIDTH It LENGTH it DEPTH it <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH It LENGTH If DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION It PROPERTY LINE _ ft <br /> ❑ SUMPS WIDTH it LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft <br /> O DISPOSAL PONDS WIDTH It LENGTH It DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE it <br /> (3 SEEPAGE PITS NUMBER WIDTH it DEPTH It <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTYLINE 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 1209)953-7697 <br /> SIGNED Brian Millman TITLE CA Professional Geologist No.8574 DATE 25 September 2020 <br /> EENT <br /> I VFb <br /> s 29 2020 <br /> AMEN.UNT' <br /> )EPARTMENT <br /> I�� l DEPART U �w <br /> Application Accepted !� Date o Area J9—I Employee ID# DA <br /> B <br /> Final Inspection By Date ✓ 01-0 ❑ SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 Ft: cn.-A PIVSump Soll Character: <br /> COMMENTS 5ItC{, t-o in rl`n'�Ctt +r-5-t- 5f+e✓ Noce-tw/ej!#z Kie-t 9:0 L11, <br /> PE Sc Received Check#/ Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO ash Remitted Service Re uest# <br /> Napa sa3 s /his <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />