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JOB ADDRESS 8444 S El Dorado St. c irazip French Camp 95231 <br />143 17 c7o PHONE 510-309-2082 OWNER NAME System CTC <br />CONTRACTOR Acorn Onsite, Inc. PHONE 925-447-5200 <br />WATER TABLE DEPTH: TBD ft GEOGRAPHICAL INFORMATION: Coordinates X 37 87927 y -121.27560 <br />LAND USE APPLICATION # BUILDING PERMIT # <br /> <br />INSTALLATION WILL SERVE: 0 RESIDENCE COMMERCIAL <br /> <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />LI OTHER <br />DISTANCE TO NEAREST: WELL TBD ft FOUNDATION TBD ft PROPERTY LINE TBD <br />1:1 LIFT STATION SIZE TBD <br />TBD <br />TYPE OF PUMP TBD PKG TX PLANT CI SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />WELL TBD ft FOUNDATION TBD ft PROPERTY LINE TBD ft <br />ft LENGTH <br />DISTANCE TO NEAREST <br />WIDTH TBD TBD ft DEPTH TBD ft <br />DISTANCE TO NEAREST WELL TBD <br />LI SEEPAGE PITS NUMBER TBD WIDTH TBD <br />DISTANCE TO NEAREST WELL TBD ft FOUNDATION TBD <br />ft FOUNDATION TBD ft PROPERTY LINE TBD ft <br /> ft DEPTH TBD ft <br />ft FOUNDATION TBD ft PROPERTY LINE TBD ft <br /> ft DEPTH TBD ft <br />ft FOUNDATION ft PROPERTY LINE TBD ft TBD <br /> ft DEPTH TBD ft <br />ft FOUNDATION TBD ft PROPERTY LINE TBD ft <br /> <br />ft DEPTH TBD ft <br /> <br />ft PROPERTY LINE TBD <br /> <br />ft <br />DISTANCE TO NEAREST WELL TBD <br />TBD <br />TBD <br />WIDTH TBD ft LENGTH <br />DISTANCE TO NEAREST WELL TBD <br />WIDTH TBD ft LENGTH <br />TBD LI DISPOSAL PONDS WIDTH TBD ft LENGTH <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 />TYPE OF WORK: <br />Percolation test <br />NEW INSTALLATION <br />REPLACEMENT <br />REPAIR/ADDITION <br />OUT-OF-SERVICE SEPTIC SYSTEM <br />ENGINEER DESIGNED /ALTERNATIVE <br />DESTRUCTION <br />PERC TEST #1 :ssmiaav ails LEACHING CHAMBERS TBD # OF LINES TBD LENGTH OF LINES TBD ft <br />48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 MINI <br />A A I S <br />TO A <br />A ES <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 />111,4 <br />Quin./ <br />1 <br />oNA„,k-ouN <br />EP N7 A AR7 -4,7N <br />1. f•IS;4 <br />41.0 <br />A <br />TITLE Civil Engineer <br />A <br />DATE 5-19-20 21 <br />ST. <br />SIGNED <br />A TB <br />IN <br />Application Accepted B <br />Final Inspection By SIA-53 <br />Character of Soil to Depth of 3 Ft: <br />COMMENTS 7 .32_ ili4,-/z-4—( <br />Area Date <br />Date 0 SPECIAL PERMIT - Approved by <br />1/Ci‘ Employee ID# (P? 21 <br />// <br />Pit/Sump Soil Character: <br />DEPARTMENT U E ONLY <br />PE <br />Code <br />SC <br />INFO <br />Received <br />By <br />It;FIN>dt <br />as <br />Amount <br />Remitted ate Permit/ <br />Service Request # Invoice # Permit ID# <br />4;a a. s-d 3 a2f2._ /2.44 )--a <br />pl <br />19-1C gl SRODOW3 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 42-01 <br />4/14/18 <br />ft <br />LEACH LINES <br />FILTER BED <br />MOUNDED <br />SUMPS <br />SEPTIC TANK <br />GREASE TRAP TYPE/MFG TBD <br />TYPE/MFG TBD <br /> CAPACITY TBD gal # OF COMPARTMENTS TBD <br />DISTANCE TO NEAREST WELL TBD <br />CAPACITY TBD gal # OF COMPARTMENTS TBD <br />Hurd St 193 - 170 17 ,18 ,19 , & 20 0.34 acre CROSS STREET APN PARCEL SIZE <br />OWNER ADDRESS 1390 Creekside Dr #61 CirdSTATE/Zip Walnut Creek, CA 94596 <br />CONTRACTOR ADDRESS 2288 Buena Vista Avenue CITY/STATE/ZIP Livermore CA 94550 <br /> NUMBER 66172 EXPIRATION DATE 06/30/2022 <br />'IS fur f oft y C4 h--) <br />LICENSE LI L1C-42 01 C-36 OTHER Civil Engineer