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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAOUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HA2ELTON AVENUE - STOCKTON CA 95205 - (209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL (209) 953-7697FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />JOB ADDRESS 10330 East Eight Mile Road CITY/`ZIP Stockton. 95212 <br />CROSS STREET Highway 88 APN 089-020-230 PARCEL SIZE 0,460 Acres <br />OWNER NAME LUIS Ramirez PHONE 209-230-3314 <br />OWNER ADDRESS (209) 230-3314 CITY/STATEIZIP Stockton, CA, 95215 <br />CONTRACTOR Ad` anoedGeo, Inc. PHONE (800) 511-9300 <br />CONTRACTOR ADDRESS 837 North Shaw Road CITY/STATE/ZIP Stockton, CA, 95215 <br />Supervised by CA Pro. g r - , <br />LICENSE C42 C-36 OTHER GEO NUMBER w EXPIRATION DATE January 2023 <br />DEPARTMENT USE.ONLY c 1 Employee ID# r F �,„k <br />Application Accepted By _ G Date _ Area q <br />Final Inspection By _ Date SPECIAL PERMIT - Approved by <br />Character of Soil to Depth of 3 kt: ItlSump Soil Character: <br />COMMENTS __ �._jzLi i . 1 -w <br />ai. ncamv6 ash ea a,nesnn, =IQDat I Invoice # Permit ID# <br />NFO <br />31r Service Re4 #_ <br />51x3 !sem <br />42-01z.�� 1/YYY��' f.�/�f 7 UNSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14x18 <br />50.60 (eel <br />' T <br />WATER TABLE DEPTH: <br />it GEOGRAPHICAL INFORMATION: Coordinates X <br />Y <br />PERC TEST If <br />BUILDING PERMIT # <br />LAND USE APPLICATION # <br />-. <br />TYPE OF WORK: <br />NEw INSTALLATION <br />REPAIRIADOmON <br />ENGINEER DESIGNED /ALTERNATIVE <br />REPLACEMENT <br />OUT -OF -SERVICE SEPTIC SYSTEM <br />DESTRUCTION <br />INSTALLATION WILL SERVE: RESIDENCE <br />COMMERCIAL <br />OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES: <br />❑ <br />SEPTIC TANK <br />TYPE/MFG _ _ _ <br />CAPACITY _ _ <br />gal # OF COMPARTMENTS______.__ <br />❑ <br />GREASETRAP <br />TYPE/MFG ____ <br />CAPACITY _ _- <br />gal NOFCOMPARTMENTS <br />DISTANCE TO NEAREST: WELL <br />It FOUNDATION <br />it PROPERTY LINE Il <br />❑ <br />LIFT STATION <br />SIZE TYPE OF PUMP <br />O PKG TX PLANT O SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ <br />LEACH LINES <br />LEACHING CHAMBERS <br />#OF LINES <br />LENGTH OF LINES It <br />DISTANCE TO NEAREST WELL <br />It FOUNDATION <br />it PROPERTY LINE it <br />❑ <br />FILTER BED <br />WIDTH It LENGTH <br />It <br />DEPTH It <br />DISTANCE TO NEAREST WELL <br />It FOUNDATION <br />It PROPERTY LINE It <br />❑ <br />MOUNDED <br />WIDTH If LENGTH <br />It <br />DEPTH Il <br />DISTANCE TO NEAREST WELL <br />K FOUNDATION <br />It PROPERTY LINE ft <br />❑ <br />SUMPS <br />WIDTH K LENGTH <br />It <br />DEPTH It <br />DISTANCE TO NEAREST WELL <br />It FOUNDATION <br />It PROPERTY LINE it <br />❑ <br />DISPOSAL PONDS WIDTH It LENGTH <br />R <br />DEPTH it <br />DISTANCE TO NEAREST WELL <br />It FOUNDATION <br />h PROPERTY UNE It <br />❑ <br />SEEPAGE PITS <br />NUMBER WIDTH <br />It <br />DEPTH It <br />DISTANCE TO NEAREST WELL <br />ft FOUNDATION <br />It PROPERTY LINE It <br />I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAOUIN COUNTY ORDINANCES, <br />STATE LAWS AND RULES AND REGULATIONS OF SAN JOAOUIN COUNTY. <br />MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />tYom <br />rI <br />TITLE Staff Geologist <br />DATE 01/2512022 <br />DEPARTMENT USE.ONLY c 1 Employee ID# r F �,„k <br />Application Accepted By _ G Date _ Area q <br />Final Inspection By _ Date SPECIAL PERMIT - Approved by <br />Character of Soil to Depth of 3 kt: ItlSump Soil Character: <br />COMMENTS __ �._jzLi i . 1 -w <br />ai. ncamv6 ash ea a,nesnn, =IQDat I Invoice # Permit ID# <br />NFO <br />31r Service Re4 #_ <br />51x3 !sem <br />42-01z.�� 1/YYY��' f.�/�f 7 UNSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14x18 <br />