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►. <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE -STOCKTON CA 95205 -(209) 468.3420 <br />IYUN-KtI-UNUAtSLt r t:KMI l <br />Joe ADDRESS 11000 North West Lane <br />t,ALL (LUV) VW -/OJ/ PUK IKSPtGIIUKS CAPIKtS 1 TtAK I•KUM UAIt ISSUtl <br />CITv/ZIP Lodi <br />CROSS STREET Eight Mile Road APN 059-080-29 PARCEL SIZE 25.83 -Acres <br />G" <br />OWNER NAME 1 L, S �Ini.,�y� 1 Ci VN I y �^T ✓ P PTP PHONE l <br />OWNERADDRESS PO aox )HOZ) CITY/STATE21P LOC/t) <br />CONTRACTOR Terracon Consultants / Aaron Mejorado PHONE 209-367-3701 <br />CONTRACTOR ADDRESS 902 Industrial Way CITY/STATE/ZIP LOdVCA/95240 <br />LICENSE L C-42 ❑ iC-36 OTHER PE <br />72446 4tiRATION DATE 06/30/2022 <br />WATER TABLE DEPTH: <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />Y <br />X PERC TEST # <br />F BUILDING PERMIT # <br />LAND USE APPLICATION # <br />TYPE OF WORK: <br />NEW INSTALLATION <br />REPAIR/ADDITION <br />ENGINEER DESIGNED IALTERNATIVE <br />ft DEPTH <br />REPLACEMENT <br />OUT-OFSERVICE SEPTIC SYSTEM <br />DESTRUCTION <br />INSTALLATION WILL SERVE: LI RESIDENCE <br />LI COMMERCIAL <br />J OTHER <br />NUMBER OF LIVING <br />UNITS: NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK <br />TYPE/MFG <br />CAPACITY <br />gal #OF COMPARTMENTS <br />❑ GREASE TRAP <br />TYPE/MFG <br />CAPACITY <br />gal #OF COMPARTMENTS <br />DISTANCE TO NEAREST <br />DISTANCE TO NEAREST: WELL <br />it FOUNDATION <br />It PROPERTY LINE It <br />❑ LIFT STATION <br />SIZE TYPE OF PUMP <br />❑ PKG TX PLANT ❑ <br />SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />0 <br />N <br />I <br />O LEACH LINES <br />- LEACHING CHAMBERS <br /># OF LINES LENGTH OF LINES <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION ft PROPERTYLINE <br />O FILTER BED <br />WIDTH <br />ft LENGTH <br />ft DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION ft PROPERTY LINE <br />O MOUNDED <br />WIDTH <br />ft LENGTH <br />ft DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION It PROPERTY LINE <br />0 SUMPS <br />WIDTH <br />It LENGTH <br />ft DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION ft PROPERTY LINE <br />O DISPOSAL PONDS WIDTH <br />It LENGTH <br />ft DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION ft PROPERTY LINE <br />O SEEPAGE PITS <br />NUMBER <br />WIDTH <br />ft DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />R FOUNDATION ft PROPERTY LINE <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 <br />AND RULES AND <br />REGULATIONS OF SAN JOAQUIN COUNTY. <br />MINIMUM <br />48 HOUR ADVANCE NOTICE <br />REQUIRED <br />FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />SIGNED IAL, i, T--,,-+ <br />�� 0-1±!nT—K <br />TITLE Staff Scientist / Consultant DATE 07-20-2021 <br />ft <br />ft <br />It <br />It <br />It <br />It <br />It <br />ft <br />ft <br />ft <br />ft <br />ft <br />DEPARTMENT <br />Application Accepted Bm Date 7 2 d) Area � � � Employee ID#D_ <br />Final Inspection By Date SPECIAL PERMIT - Approved by <br />Character of Soil to D?th S Pit��/rSi—p Soil 'Character: <br />rel -12 <br />l Aa� %G� <br />:ti9tAWL S 4I <br />Amount <br />42-01 7 � � - (,4 y( ^'� '"T— (� r�,,,.�/� ( �(.t� ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18 / <br />