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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 />rI1UN-r%tr UINUAt5Lt rCKMI I <br />JOB ADDRESS 4600 A.rrpo Road <br />CROSSSTREET Hig"'y99 <br />OWNER NAME Lodi Unified Scnoa District <br />OWNER ADDRESS 1305E Vine Street <br />CONTRACTOR WWF Contractors Corp <br />CONTRACTOR ADDRESS 9823 Old Winery Piave Suite 20 <br />CITY/ZIP 95220 <br />APN 01731001 <br />CITY/STATE/ZIP Ladi <br />PHONE 916-853-0514 <br />PARCEL SIZE 9acres <br />209-331-7223 <br />CITY/STATE/ZIP Sacramento, CA 95827 <br />LICENSE ❑-C42 X -C-36 OTHER NUMBER 418113 EXPIRATION DATE 6/30/2023 <br />3 <br />WATER TABLE DEPTH: 60 ft GEOGRAPHICAL INFORMATION: Coordinates X 38.173620 Y -121.261607 <br />❑ PERC TEST # BUILDING PERMIT # LAND USE APPLICATION # <br />TYPE OF WORK: NEW INSTALLATION _ REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE <br />X REPLACEMENT _ OUT -OF -SERVICE SEPTIC SYSTEM _ DESTRUCTION <br />INSTALLATION WILL SERVE: ❑ RESIDENCE G COMMERCIAL X OTHER 5°1' <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: 3 <br />❑ SEPTIC TANK TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />M GREASE TRAP TYPE/MFG Jensen Precast Model JP 1000 EPE-G CAPACITY 1000 gal # OF COMPARTMENTS 2 <br />DISTANCE TO NEAREST: WELL 200 It FOUNDATION 15 ft PROPERTY LINE 50 ft <br />❑ LIFTSTATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ LEACH LINES F LEACHING CHAMBERS <br /># OF LINES <br />LENGTH OF LINES ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ FILTER BED WIDTH <br />ft LENGTH <br />It DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ MOUNDED WIDTH <br />It LENGTH <br />ft DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ SUMPS WIDTH <br />ft LENGTH <br />ft DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ DISPOSAL PONDS WIDTH <br />ft LENGTH <br />ft DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ SEEPAGE PITS NUMBER <br />WIDTH <br />ft DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />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 <br />REGULATIONS OF SAN JOAQUIN <br />COUNTY. <br />MINIMUM 48 HOUR ADVANCE NOTICE <br />REQUIRED <br />FOR INSPECTIONS <br />- PLEASE CALL (209) 953-7697 <br />SIGNED S+epkwi -- e try <br />TITLE Aroh¢ect <br />DATE 11122021 <br />ECm,�� <br />NT <br />I <br />AFD <br />iv 04 2421 <br />QU/N C <br />ONMpARtMFNTY <br />PARTMENT S NLY / %/� <br />Application Accepted B DateW... <br />Area Employee ID# (J— — <br />Final Inspection By Date❑ SPECIAL PERMIT -Approved by <br />Character of Soil to D th t: 4Character: <br />COMMENTS V t (/ <br />- ttv 2 2/ <br />PE SC Received Check#/ Amount Date Permit' Invoice # Permit ID# <br />Code INFO B sh Remitted Service Request <br />S 11 2 ow "ITM <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14!18 <br />