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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 />NON-KEFUNDABLE PERMIT GALL ZUY 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUEI <br />JOB ADDRESS 8200 ST RT 99 E. FRONTAGE ROAD CITY/ZIP STOCKTON CA <br />CROSS STREET E. FOPPIANO LANE APN 085-310-10 PARCEL SIZE 2.18 <br />OWNER NAME TULEBERG WAREHOUSE C/O JOE BAGLIETTO <br />OWNER ADDRESS 301 S. AURORA STREET <br />CONTRACTOR TERRACON CONSULTANTS (NEIL O. ANDERSON & ASSOCIATES) <br />CONTRACTOR ADDRESS 902 INDUSTRIAL WAY <br />LICENSE Fl C-42 r C-36 OTHER C-57 NUMBER 669004 <br />NGOC LE, ST. LUKE CHURCH 2OO-712-8888 <br />CITY/STATE/ZIP STOCKTON CA 95203 <br />PHONE 209-367-3701 <br />CITY/STATE/ZIP LODI, CA 95240 <br />EXPIRATION DATE 5/31/19 <br />WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br />PERC TEST # 1 BUILDING PERMIT # LAND USE APPLICATION # <br />TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED /ALTERNATIVE <br />REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION <br />INSTALLATION WILL SERVE: Fl RESIDENCE ❑ COMMERCIAL n OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK <br />TYPE/MFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />❑ GREASE TRAP <br />TYPF/MFG <br />CAPACITY <br />gal #OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ LIFT STATION <br />SIZE TYPE OF PUMP <br />❑ PKG TX PLANT <br />❑ <br />SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ LEACH LINES <br />LEACHING CHAMBERS <br /># OF LINES <br />LENGTH OF LINES <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ FILTER BED <br />WIDTH <br />ft <br />LENGTH <br />ft <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ MOUNDED <br />WIDTH <br />ft <br />LENGTH <br />ft <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ SUMPS <br />WIDTH <br />ft <br />LENGTH <br />It <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ DISPOSAL PONDS <br />WIDTH <br />ft <br />LENGTH <br />ft <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ SEEPAGE PITS <br />NUMBER <br />WIDTH <br />ft DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />ft <br />1 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 <br />Final Inspection By <br />Date <br />Date <br />_ Area <br />_ 0 <br />Character of Soil o Depth of 3 Ft: Pit/Sump Soil Ch <br />COMMENTS I Lr M�.-&019 <br />PERMIT - Approved by <br />K. <br />PE SC Received hec Amount Permit/E EIVED <br />Code INFO ash Remitted D ,jite Service Re ues #/ - Invoice # Permit ID <br />/ � 7 <br />19 2018 <br />42-01 ONSITE WASTEWATER TRTMNT SYS�/�,�I�RU)N COUNTY <br />4/14/18 ' ""'�RiVTR'ONMENTAL <br />HEALTH DEPARTMENT <br />