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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1666 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 10880 N.Highway 99 Frontage Rd. CITY/ZIP Stockton v <br /> CROSS STREET 8 Mile Rd. APN 086-070-46 PARCEL SIZE 1.05 acres o <br /> 0 <br /> OWNER NAME ase PHONE <br /> ChStockton LP 310-689-7600 <br /> OWNER ADDRESS 6444 San Fernando Rd.#3944 CITYISTATE/ZIP Glendale,Ca 91121 <br /> CONTRACTOR MHK Construction PHONE 209-883-9221 <br /> CONTRACTOR ADDRESS PO Box 928 CITY/STATE/ZIP Denair,Ca 95316 <br /> LICENSE ❑. C-42 ❑ .C-36 OTHER A NUMBER 662027 EXPIRATION DATE 092021 <br /> WATER TABLE DEPTH: 371 ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ❑ PERC TEST # BUILDING PERMIT# 2002981 LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION X REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT _ OUT-OF-SERVICE SEPTIC SYSTEM - DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE N COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES! <br /> ❑ SEPTIC TANK TYPE/MFG EXISTING CAPACITY 4800 gal #OFCOMPARTMENTS 2 <br /> ❑ GREASETRAP TYPE/MFG EXISTING CAPACITY 1500 gal #OFCOMPARTMENTS 3 <br /> DISTANCE TO NEAREST: WELL 100, ft FOUNDATION 100' ft PROPERTY LINE 100, it <br /> O LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT 0 SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> LEACH LINES LEACHING CHAMBERS #OF LINES 4 LENGTH OF LINES 50 it <br /> DISTANCE To NEAREST WELL-rm PLicitit FOUNDATION 100, it PROPERTY LINE 10, it <br /> ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTYLINE it <br /> ❑ MOUNDED WIDTH It LENGTH ft DEPTH ft <br /> DISTANCE To NEAREST WELL ft FOUNDATION it PROPERTY LINE ft <br /> ❑ SUMPS WIDTH It LENGTH It DEPTH it <br /> DISTANCE To NEAREST WELL it FOUNDATION it PROPERTY LINE it <br /> ❑ DISPOSAL PONDS WIDTH It LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELLit FOUNDATION ft PROPERTY LINE ft <br /> SEEPAGE PITS NUMBER 4 WIDTH M 1 1 4 ft DEPTH 25 it <br /> DISTANCE TO NEAREST WELL '+ee' K)bk FOUNDATION 100' ft PROPERTY LINE 10, ft <br /> 1 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 f209) <br /> SIGNED TITLE ARCHITECT DATE 4-13-2021 <br /> q yM <br /> UPI <br /> D <br /> v ,2021 <br /> N <br /> pqR-� <br /> Nr <br /> TF— <br /> DEPARTMENTUS ONLY <br /> Application Accepted B Date Area qlqel Employee ID# DA <br /> Final Inspection By Data ❑ SPECIAL PERMIT-Approved by <br /> Character Of Soil to D pth of 3 Ft: I PK/Sump Soil Character: _ <br /> COMMENTS ft n r � 41VOr :� eiha Tr ' <br /> rnt 0 Pe V IaIJS jres fnvy&A ' O&COi -w7 <br /> PE SC Received Check#/ ount Date Permit/ Invoice# Permit ID# <br /> Code INFO Cash Remitted Service Request# <br /> 42A1 73'7 f O / ONSITE WASTEWATER TRTMNT SYSTEM PERM <br /> IT4114/18 <br />