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L' , I ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 468-3420 NON-REFUMnARILE PERJM'IITCALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED JOB ADDRES' I / S �-/ u -T -i,r, CITY/ZIP Manteca, 95336 CROSS STREET Kimberly Drive APN 208 -20 -WC) 1 �^ PARCEL SIZE 1.00 acre OWNER NAME Ricardo Enriquez PHONE (209) 628-0986 OWNER ADDRESS 170 C Austin Road CITY/STATEiZIP Manteca, CA 95336 CONTRACTOR Jose Valdovinos Development PHONE (209) 628-0986 CONTRACTOR ADDRESS 733 Shadowbrook Lane CrrY/STATE/ZIP Manteca, CA 95336 LICENSE '�. I C-42 C-36 OTHER Bill Stevens NUMBER CE 43010 V / EXPIRATION DATE 3/31/2022 1/ WATER TABLE DEPTH: 25 ft GEOGRAPHICAL INFORMATION: Coordinates X 37.800729° Y -121.179541' PERC TEST # ' BUILDING PERMIT # Check#/ LAND USE APPLICATION # TYPE OF WORK: NEW INSTALLATION REPAIR/ADDMON ENGINEER DESIGNED /ALTERNATIVE WELL REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: C RESIDENCE I COMMERCIAL F' OTHER NUMBER OF LIVING UNITS: 1 NUMBER OF BEDROOM NUMBER OF EMPLOYEES: ❑ SEPTIC TANK TYPE/MFG CAPACITY gal # OF COMPARTMENTS ❑ GREASE TRAP TYPE/MFG CAPACITY gal # OF COMPARTMENTS It FOUNDATION DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT O SAND OIL SEPARATOR (ENCLOSED SYSTEM) ❑ LEACH LINES LEACHING CHAMBERS Check#/ # OF LINES Code LENGTH OF LINES ft ash DISTANCE TO NEAREST WELL s ? ft FOUNDATION Is"1IMT1, C ft PROPERTY LINE ft ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION It PROPERTY LINE ft ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ DISPOSAL PONDS WIDTH It LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. V. DEPARTMENT USE ONLY `I rC (' Application Acceptedt �� / - — Date J' Area q7 % t Employee ID# Final Inspection By /1/CJ)l�� Date SPECIAL PERMIT -Approved by Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: COMMENTS Prr P. CLA (on �n1 (� `( i"NTV, PE SC Received Check#/ Amount Da PertniU Invoice# Permit ID# Code INFO ash Remitted Service Re est # Jaa s ? Is"1IMT1, C I 42-01 18 7-T 2� 7� ONSITE WASTEWATER TRTMNT SYSTEM PERMIT E�M,�7 At E1 QED N 25 20 22 QU/N C E MEN00NTy ARTMENT