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r i ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1568 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 NON-REFUNDABLE PERMIT CALL(209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED JOB ADDRESS 20500 Holly Drive CITy21P Tracy,CA CROSS STREET Northwest corner of Arbor Ave and W.Sugar Road APN 212-160-20 PARCEL SIZE 110-acres c 0 OWNER NAME Mr.Paul Schneider,Siegfried PHONE 209-942-0214 OWNER ADDRESS 3428 Brookside Road Cm/STATE/ZIP Stockton,CA 95219 CONTRACTOR Construction Testing Services PHONE 916-419-4747 CONTRACTOR ADDRESS 4400 Yankee Hill Drive CITY/STATE21P Rocklin,CA 95677 LICENSE ❑7C-42 ❑7C-36 OTHER Business Lie.,Rocklin,CA NUMBER 014215 EXPIRATION DATE 06/30/2022 WATER TABLE DEPTH: 8 ft GEOGRAPHICAL INFORMATION: Coordinates X 37.769810 y-121.421112 Z PERC TEST #P1 through P4 BUILDING PERMIT# LAND USE APPLICATION# TYPE OF WORK: X NEW INSTALLATION ❑ REPAIR/ADDITION C ENGINEER DESIGNED/ALTERNATIVE ❑ REPLACEMENT Fl OUT-OF-SERVICE SEPTIC SYSTEM ❑ DESTRUCTION INSTALLATION WILL SERVE: ❑ RESIDENCE N COMMERCIAL ❑ OTHER NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES:TBD ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OFCOMPARTMENTS ❑ GREASETRAP TYPE/MFG CAPACITY gal #OFCOMPARTMENTS DISTANCE TO NEAREST: WELL ft FOUNDATION N PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) la LEACH LINES _1 LEACHING CHAMBERS TBD #OF LINES TBD LENGTH OF LINES TBD ft DISTANCE TO NEAREST WELL>500' ft FOUNDATION>10' ft PROPERTY LINE>95' it ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft 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 ft LENGTH ft DEPTH it DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE It ❑ SEEPAGE PITS NUMBER WIDTH it 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. MINIMUM 48 HOUR ADVANeEVOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 209 953-7697 SIGNED Mike Turner,PG,CEG TITLE Project Geologist DATE 9/30/2021 S e e A t a c h e d s i t e p l a n f o r l o c a t i o n s ANT EO SAA 6 ?�21 I � �C0�NTY MFNT DEPARTMENT USE.ONLY Application AcceptedDate D ) Area 7 Employee ID# Final inspection By--H 1 Data i ❑ SPECIAL PERMIT-Approved by Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: COMMENTS PE se Received Check#/ Amount at Perm iU Invoice# PermitID# Code INFO sh Remi Se Ice Re u st# 4dad sa3 �� 42-01 ( /3 Z ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14/18