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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />• SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 468-3420 <br />NON-KEFUNDABLE PERMIT t.ALL (LUN) VDJ-/OJ/ I -VH INSYtGIIVNS CxrIKtS I I tAK rKVM LPAI r IACIut <br />JOB ADDRESS 476 N Patton Avenue Cm/ZIP Stockton, 95215 <br />CROSS STREET Ada Avenue APN 103-130-15 PARCEL SIZE 2.20 <br />OWNER NAME Paul Armanino PHONE <br />OWNER ADDRESS Same as above <br />CONTRACTOR Petralogix Engineering PHONE 209-770-0731 <br />CONTRACTOR ADDRESS 26675 Bruella Road CITY/STATE/ZIP Galt. CA 95632 <br />LICENSE ❑LIC -42 ❑IIC36 OTHER PG NUMBER 8657 EXPIRATION DATE 4/30/2023 <br />a-6 n%T raTammer <br />WATER TABLE DEPTH: <br />ft GEOGRAPHICAL INFORMATION: Coordinates X -121" 10.126'W Y 37" 58.474' <br />lA PERC TEST # <br />1 BUILDING PERMIT # <br />Data 9V2ZZ2 <br />LAND USE APPLICATION # <br />TYPE OF WORK: <br />I1 NEW INSTALLATION I I <br />REPAWADDITION <br />ENGINEER DESIGNED /ALTERNATIVE <br />It FOUNDATION <br />I.I REPLACEMENT I I <br />OUT -OF -SERVICE SEPTIC <br />SYSTEM I I DESTRUCTION <br />INSTALLATION WILL SERVE: 1 l RESIDENCE <br />I I COMMERCIAL <br />❑ OTHER <br />NUMBER OF LIVING 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 />❑ MOUNDED <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 />❑ LEACH LINES <br />LEACHING CHAMBERS <br />USE ONLY <br />L Area / / f –/ Employee ID# <br /># OF LINES <br />Data 9V2ZZ2 <br />LENGTH OF LINES It <br />Date <br />DISTANCE TO NEAREST <br />WELL <br />Character of Soil to Dep1h of 3 Ft: <br />COMMENTS <br />It FOUNDATION <br />Pit/Sump Soil C ratter: <br />—a�P <br />ft PROPERTY LINE it <br />❑ FILTER BED <br />WIDTH <br />ft <br />LENGTH <br />ft <br />DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE It <br />❑ MOUNDED <br />WIDTH <br />ft <br />LENGTH <br />ft <br />DEPTH It <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />It PROPERTY LINE It <br />❑ SUMPS <br />WIDTH <br />It <br />LENGTH <br />ft <br />DEPTH It <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ DISPOSAL PONDS WIDTH <br />It <br />LENGTH <br />ft <br />DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ SEEPAGE PITS <br />NUMBER <br />WIDTH <br />It DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION <br />ft PROPERTY LINE It <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 />Application Accepted By AF2, <br />DEPARTMENT <br />USE ONLY <br />L Area / / f –/ Employee ID# <br />AA <br />Data 9V2ZZ2 <br />Final Inspection By <br />Date <br />s ❑ SPECIAL PERMIT - Approved by <br />Character of Soil to Dep1h of 3 Ft: <br />COMMENTS <br />Pit/Sump Soil C ratter: <br />—a�P <br />O <br />% <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/24/12 <br />Q( /1001jN <br />FoM'C T fin' <br />.,Iy,4r <br />