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I . 16 <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1668 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 468-3420 <br />NOWHEFUNDABLE PERMIT GALL (ZU-4) 993-/f79/ FOR INSPECTIONS tXPIHtS I T tAH t-HOM UAI t I55UhI <br />Joa ADDRESS 10800 E West Ripon Road CITY/ZIP Ripon, 95366 <br />CROSS STREET Austin Road APN 257-240-620-000 PARCEL SIZE 2.090 Acres <br />OWNER NAME Marsha 8 Jerry Jenkins PHONE 209-630-5358 <br />OWNER ADDRESS (209) 230-3314 <br />CONTRACTOR AdvancedGeo,Inc. <br />CONTRACTOR ADDRESS 837 North Shaw Road <br />CITY/STATE/ZIP Stockton, CA, 95215 <br />PHONE(800)511 9300 <br />CRY/STATE/ZIP Stockton, CA. 95215 <br />Supervised by CA Pro. fpF,�_ss__•, <br />LICENSE C-42 C-36 OTHER GEO NUMBER_°`^''-(; H_ EXPIRATION DATEJanuary 2023 <br />WATER TABLE DEPTH: <br />50-60 feet it GEOGRAPHICAL INFORMATION: Coordinates X Y <br />A PERC TEST #1 <br />BUILDING PERMIT # <br />It FOUNDATION <br />LAND USE APPLICATION # <br />TYPE OF WORK: <br />NEW INSTALLATION <br />REPAIR/ADDITION <br />ENGINEER DESIGNED /ALTERNATIVE <br />It FOUNDATION <br />REPLACEMENT <br />OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION <br />INSTALLATION WILL SERVE: _I RESIDENCE <br />1 COMMERCIAL <br />I OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK <br />TYPE/MFG _ <br />CAPACITY <br />gal # OF COMPARTMENTS <br />❑ GREASE TRAP <br />TYPE/MFG _ <br />CAPACITY <br />gal # OF COMPARTMENTS <br />DEPTH _ _ It <br />DISTANCE To NEAREST: WELL _ _ <br />It FOUNDATION <br />ft PROPERTY LINE fl <br />❑ LIFT STATION <br />SIZE TYPE OF PUMP <br />O PKG TX PLANT <br />O SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />0 LEACH LINES LEACHING CHAMBERS <br />#OF LINES <br />LENGTH OF LINES it <br />DISTANCE TO NEAREST WELL <br />It FOUNDATION <br />It PROPERTY LINE ft <br />❑ FILTER BED WIDTH it LENGTH <br />It <br />DEPTH ft <br />DISTANCE TO NEAREST WELL <br />It FOUNDATION <br />It PROPERTY LINE It <br />❑ MOUNDED WIDTH it LENGTH <br />It <br />DEPTH It <br />DISTANCE TO NEAREST WELL <br />If FOUNDATION <br />it PROPERTY LINE fl <br />❑ SUMPS WIDTH It LENGTH <br />It <br />DEPTH fl <br />DISTANCE TO NEAREST WELL <br />it FOUNDATION <br />it PROPERTY LINE _ ft <br />❑ DISPOSAL PONDS WIDTH It LENGTH <br />_ _fl <br />DEPTH _ _ It <br />DISTANCE TO NEAREST WELL <br />it FOUNDATION <br />it PROPERTY LINE ft <br />❑ SEEPAGE PITS NUMBER WIDTH <br />it DEPTH it <br />DISTANCE To NEAREST WELL <br />it FOUNDATION <br />it PROPERTY LINE it <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 REGULATIONS OF SAN JOAQUIN COUNTY. <br />MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED <br />FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />SIGNED <br />TITLE Staff Geologist <br />DATE 03/14/2022 <br />Z�_I�DEPARTMENT US aONLY <br />Application Accepted ByDate 3j/7/&7&2 Area� �f Employee ID#__)®//— <br />Final Inspection By _ _ _ _ _ _ Date ❑ SPECIAL PERMIT - Approved by <br />Character of Soil to Depth of 3 Ft: PIUSump Soil Character: <br />COMMENTS <br />PE I SC Received I Check#/ AmountPermit/ <br />Date. _ _ .. Invoice # I PermitlD# <br />W,70a 1 sJ3 I'hN l 1'71l-l1�,� '-,F�11iX%U(`1 I I I <br />42-01 / / f�Yf 70/ / VJ / bl J3 <br />4!14'18 �E/% <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />D <br />20�2 <br />OUNTY <br />MFNT <br />