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E PERC TEST # 1 BUILDING PERMIT # <br /> <br />LAND USE APPLICATION # <br /> PA yh„ <br />RECpivi N r vE-D <br /> mA o 4 20 <br />21 Njn <br /> cON couNT TH EpmENTAL AR TioNT <br />41. <br />4 <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 26201 Thornton Road Ty/z, Thornton, CA 95686 <br />CROSS STREET W Walnut Grove Road ApN 001-190-660-000 PARCEL SIZE 0.811 acres 0 <br />OWNER NAME Anigiothuetics LLC PHONE (916) 686-7300 <br />6041 Grant Avenue CM/STATE/ZIP Carmichael, CA 95608 OWNER ADDRESS <br />PHONE 800 511-9300 CONTRACTOR AdvancedGeo, Inc. <br />CITY/STATE/ZIP Stockton, CA 95215 CONTRACTOR ADDRESS 837 North Shaw Road <br />LICENSE 00C-42 0=C-36 OTHER CA Professional Geo Brian Millman <br />EXPIRATION DATE 1/31/23 NUMBER 8574 <br />WATER TABLE DEPTH: 15-20 ft GEOGRAPHICAL INFORMATION: Coordinates X <br />TYPE OF WORK: <br />NEW INSTALLATION O REPAIR/ADDITION C ENGINEER DESIGNED /ALTERNATIVE <br />REPLACEMENT I1 OUT-OF-SERVICE SEPTIC SYSTEM <br /> I DESTRUCTION <br /> <br />INSTALLATION WILL SERVE: <br />0 RESIDENCE 0 COMMERCIAL <br /> <br />0 OTHER <br /> <br />NUMBER OF LIVING UNITS: <br /> <br />NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />CI SEPTIC TANK <br /> <br />TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />GREASE TRAP <br />TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL <br /> ft FOUNDATION ft PROPERTY LINE ft <br />LIFT STATION SIZE TYPE OF PUMP PKG TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />LEACH LINES I LEACHING CHAMBERS # OF LINES <br /> LENGTH OF LINES ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION <br /> ft PROPERTY LINE ft <br />CI FILTER BED WIDTH ft LENGTH <br /> ft <br /> <br />DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />CI MOUNDED WIDTH tt LENGTH <br /> ft DEPTH ft <br />DISTANCE TO NEAREST WELL <br /> <br />ft FOUNDATION ft PROPERTY LINE ft <br />CI SUMPS WIDTH ft LENGTH <br /> ft DEPTH It <br />DISTANCE TO NEAREST WELL ft FOUNDATION <br /> <br />ft PROPERTY LINE ft <br />DISPOSAL PONDS WIDTH ft LENGTH <br /> ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />SEEPAGE PITS NUMBER WIDTH <br /> ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION <br /> ft 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 />A <br /> A <br />SIGNED Brian Millman TITLE CA Professional Geologis No. 8574 DATE 05 March 2021 <br />DEPARTMENT US E ONLY <br />Application Accepte .S., 2 By ."--)Z 1- 1..- Date / Area q/15 Employee ID# A,111 <br />Final Inspection B Date J/ ('k (1...MA El SP IAL PERMIT - Approved by <br />Character of Soil to Depth of 3 Ft: PIVSump Soll Character: <br />COMMENTS •Q ...Q.—(..... q..AsecG...... 1—. 1/4 3 <br />PE <br />Code <br />SC <br />INFO <br />Received <br />.1911 <br />Check#/ <br />pash <br />Amount <br />Remitted t Permit/ <br />Service Request # Invoice # Permit ID# <br />s w /— 40- is.50 is-.2 9114 4 qounfict. <br />42-01 <br />4/14/18 ed 123323 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT