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a hi 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 />JO, ADDRESS 2605 South MacArthur Dove <br />CITY/ZIP Tracy 95377 <br />CROSS STREET ValP.° <br /> Ap N 246-14-023 <br />PARCEL SIZE P <br />OWNER NAME Valpico Tracy Apartmenls LLC <br /> <br />Vodpitc <br />PHONE 209-649-1299 <br />OWNER ADDRESS 2494 San Hill road 9100 <br />CITY/STATE/ZIP Merriste-15-337 /41-4.14.,Q P.4‘4- <br />CONTRACTOR W.C. Maloney, Inc. PHONE 209-244-7090 <br />C PO Box 30326 CONTRACTOR ADDRESS CITY/STATE/ZIP Stockton Ca 95213 <br />LICENSE — C-42 --' C-36 OTHER C-21, A NUMBER 718243 EXPIRATION DATE 1131122 <br />WATER TABLE DEPTH: <br />PERC TEST # <br />II GEOGRAPHICAL INFORMATION: Coordinates X <br />BUILDING PERMIT # <br /> <br />LAND USE APPLICATION # <br />TYPE OF WORK: NEW INSTALLATION _ REPAIR/ADDITION _ ENGINEER DESIGNED /ALTERNATIVE <br />REPLACEMENT <br />OUT-OF-SERVICE SEPTIC SYSTEM <br /> <br />X DESTRUCTION S.F. <br /> <br />INSTALLATION WILL SERVE: <br /> 7 RESIDENCE _T. COMMERCIAL <br />OTHER <br /> <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: LIES SEPTIC TANK <br /> <br />TYPE/MFG <br /> <br />CAPACITY gal # OF COMPARTMENTS <br />GREASE TRAP <br /> <br />TYPE/MFG <br /> <br />CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL <br /> II FOUNDATION ft PROPERTY LINE ft <br />LIFT STATION <br /> <br />SIZE TYPE OF PUMP CI PKG TX PLANT <br /> <br />0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />LEACH LINES LEACHING CHAMBERS <br />OF LINES LENGTH OF LINES <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br />FILTER BED WIDTH ft LENGTH <br /> <br />ft DEPTH <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br />MOUNDED WIDTH 11 LENGTH <br /> ft DEPTH <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br />SUMPS WIDTH ft LENGTH ft DEPTH <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br />DISPOSAL PONDS WIDTH ft LENGTH ft <br />DEPTH <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br /> It <br />SEEPAGE PITS NUMBER WIDTH ft DEPTH It <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE <br /> II <br />.14 AI 1 2 <br />2021 MINIM R ADVANC,FM) r,F RFOUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />SIGNED TITLE Safety Director DATE 1/11/21 <br />SA N jo4 <br /> N//R8Li/N CouN <br />P4 R 74;71.A./ <br />!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 />rn a <br />DEPARTMENT USE ONLY <br /> Date I. Employee ID# <br />Date /1_1 74 I SPECIAL PERMIT -Approved by <br /> Pit/Sum Soil Character: <br />PE <br />Code <br />SC <br />INFO <br />Received Check#/ <br />Cash , , <br />Amount <br />Remitted Date v-, <br />Permit/ <br />Service Request # Invoice # Permit ID# <br />9 .444 i 071' d 6edir 4' I .5-, , , , a COis i)ell . 11 I <br />42-01 <br />4/14/18 //7a3W57 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />Application Accepted By <br />Final Inspection By <br />Character of Soil to Depth of 3 Ft: <br />COMMENTS