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07y/zip Stockton, CA PHONE PARCEL SIZE I 3 7 APN Cpe -L 0°0 JOB ADDRESS 4620 Shippee rd CROSS STREET Gnek°W OWNER NAME R th SG 1,11 3 I) OWNER ADDRESS SC4 1,41t, CONTRACTOR Mike's Backhoe Service CONTRACTOR ADDRESS P.O. Box 650 LICENSE 0 0C-42 D=C-36 OTHER A CITY/STATE/ZIP PHONE 209-456-2865 CITY/STATE/ZIP Manteca, CA 95336 EXPIRATION DATE 2020 NUMBER 608554 ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE *STock"roN CA 95205 - (209)468-3420 NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED ft GEOGRAPHICAL INFORMATION: Coordinates X BUILDING PERMIT # Joalcuci LAND USE APPLICATION # o 0 OUT-OF-SERVICE SEPTIC SYSTEM DESIGNED /AkTERNAT1VE REPAIR/ADOMON DESTRUCTION fo TYPE OF WORK: INSTALLATION REPLACEMENT 1200 WATER TABLE DEPTH: PERC TEST # DISTANCE TO NEAREST: VVELL 1°°' CAPACITY 1200 gal # OF COMPARTMENTS 2 CAPACITY gal # OF COMPARTMENTS ft FOUNDATION 30' ft PROPERTY LINE 5°' ft VSEPTIC TANK GREASE TRAP Typomo P&L Concrete TYPE/MFG -e- RE AUG PAYMENT EIVED Z 2020 ct,cot Application Accepted B '--,/ ZL DEPARTMEN Date 4- TIUS ONLY a aoao Final Inspection By Date 5/ /002.4 0 SPECIAL PERMIT -Approved by Character of Soil to Depth of 3 Ft: Pi Sump Soil Character: (900.?(93, T" J1 Area Employee ID# SAN JOAO1 IN COUNTY YVIRDis MENTAL EA,,LTAI DEPARTMENT 1.) Keui fif C E S OV)Y1 5 lervi CO 9/10W — INSTALLATION WILL SERVE: 0 RESIDENCE 0 COMMERCIAL 0 OTHER NUMBER OF LIVING UNITS: 1 NUMBER OF BEDROOMS: 3 NUMBER OF EMPLOYEES: LENGTH OF LINES 66' ft ft PROPERTY LINE 10' ft ft DEPTH ft ft PROPERTY LINE ft ft DEPTH ft ft PROPERTY LINE ft ft DEPTH ft DISTANCE TO NEAREST WELL /'SEEPAGE PITS NUMBER 3 WIDTH 36" DISTANCE TO NEAREST WELL 150' LIFT STATION SIZE TYPE OF PUMP U PKG TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) P/..f..EACH LINES LEACHING CHAMBERS # OF LINES 3 DISTANCE TO NEAREST WELL 100. ft FOUNDATION CI FILTER BED WIDTH ft LENGTH DISTANCE TO NEAREST WELL ft FOUNDATION MOUNDED WIDTH ft LENGTH DISTANCE TO NEAREST WELL ft FOUNDATION SUMPS WIDTH ft LENGTH DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft ft FOUNDATION ft PROPERTY UNE ft ft DEPTH 26' ft ft FOUNDATION 7° ft PROPERTY LINE 1°' ft HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 SIGNED Mike Fuller TITLE Contractor DATE 8/12/2020 PE Code SC INFO Received %I Icie9)/1 a sh Amount LI Date Remitted Permit/ Service Re uest # Invoice # Permit ID# 9)10 /IS-- m thrce00 430 0 'VI-P3Z OOVL qS 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14/18