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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 9$205 - (209) 466-3420 NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED Joe ADDRESS 10330 East Eight Mlle Road CITvZP Stockton, 95212 CROSS STREET Highway 88 APN 089-020-230 PARCEL SIZE 0.460 A='e5 OWNER NAME Luis Ramirez PHONE 209-230-3314 OWNER ADDRESS (209) 230-3314 CITY/STATE/ZIP Stockton, CA, 95215 CONTRACTOR AdvancedGeo, Inc. PHONE (800) 511-9300 CONTRACTOR ADDRESS 837 North Shaw Road Crrr/STATE/ZIP Stockton, CA, 95215 Supervised by CA Pro.+ LICENSE U -.0-42 C-36 OTHER GEO NUMBER.;'.:_ EXPIRATION DATE January 2023 -y-� ❑ LEACH LINES LEACHING CHAMBERS 50.64 tact LENGTH OF LINES it DISTANCE TO NEAREST WELL WATER TABLE DEPTH: It GEOGRAPHICAL INFORMATION: Coordinates X Y PERC TEST # ' BUILDING PERMIT #- DEPTH it LAND USE APPLICATION # TYPE OF WORK: NEw INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED /ALTERNATIVE DEPTH It REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: RESIDENCE . COMMERCIAL OTHER - NUMBER OF UVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: ❑ SEPTIC TANK TYPE/MpG CAPACITY __- gal If OF COMPARTMENTS- ❑ GREASETRAP TYPEIM=c CAPACITY gal #OFCOMPARTMENTS ❑ SEEPAGE PITS NUMBER WIDTH__ DISTANCE TO NEAREST: WELL It FOUNDATION it PROPERTY LINE It ❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR (ENCLOSED SYSTEM) ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES it DISTANCE TO NEAREST WELL It FOUNDATION it PROPERTY LINE It ❑ FILTER BED WIDTH _ _ _. 11 LENGTH h DEPTH it DISTANCE TO NEAREST WELL It FOUNDATION N PROPERTY LINE ft ❑ MOUNDED WIDTH _ _-_,l LENGTH N DEPTH It DISTANCE To NEAREST WELL N FOUNDATION It PROPERTY LINE N ❑ SUMPS WIDTH _ It LENGTH N DEPTH It DISTANCE TO NEAREST WELL N FOUNDATION _ N PROPERTYLINE N ❑ DISPOSAL PONDS WIDTH _ _ _ Il LENGTH 11 DEPTH It DISTANCE To NEAREST WELL It FOUNDATION _ it PROPERTY LINE it ❑ SEEPAGE PITS NUMBER WIDTH__ ft DEPTH N DISTANCE TO NEAREST WELL II FOUNDATION it PROPERTY LINE It I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAOUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-769 7 SIGNED rl� TITLE Staff Geologist DATE 01/25/2022 DEPARTMENT USE ONLY ti„k G Application Accepted By �L �- Date j_ Area 9/q9 Employee ID#Fr Final Inspection By Date -.1 SPECIAL PERMIT - Approved by -----1111-- --- Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: COMMENTS Code— INFO B as" Reml I;aa 7s -a3 )S' 42-01 to 4!11/18 Invoice # I Permit ID# 140 NSITE WASTEWATER TRTMNT SYSTEM PERMIT T D 022 ITY NT