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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />I SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 468-3420 <br />NON-KEFUNDABLE PERMIT (:ALL ZUV) V0J-/0'J/ FOR INSPECTIONS t_XPIRES l TEAR FROM UATE ISSUEI <br />JOB ADDRESS 6011 East Pine Street CITY2IP LODI CA 95240 <br />CROSS STREET Guild Ave APN 049-120-65 PARCEL SIZE 16.82 <br />OWNER NAME All State Packers PHONE 209-369-3586 <br />OWNER ADDRESS 6155 East Pine Street / P.O. Box 350 CITY/STATE/ZIP LODI CA 95240 <br />CONTRACTOR HALEY CONTRACTING PHONE 209-463-2517 <br />CONTRACTOR ADDR,(E`SSS 4228 NEWTON ROAD CITY/STATE/ZIP STOCKTON CA 95205 <br />LICENSE ❑ C-42��G.36 OTHER A, B, C-36 NUMBER 580907 EXPIRATION DATE 11-31-2023 <br />WATER TABLE DEPTH: 50 ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br />1 PERC TEST # BUILDING PER LAND USE APPLICATION # <br />TYPE OF WORK: NEW INSTALLATION REPAIRIADDITION ENGINEER DESIGNED /ALTERNATIVE <br />REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION <br />n <br />a <br />C <br />yC <br />INSTALLATION WILL SERVE: ❑ RESIDENCE <br />0MMERCIAL <br />❑ OTHER <br />DISTANCE TO NEAREST <br />WELL City Water ft FOUNDATION 80 <br />ft PROPERTY LINE 10 <br />NUMBER OF LIVING UNITS: NUMBER OF BE <br />OOMs: <br />NUMBER OF EMPLOYEES: <br />DEPTH <br />ft <br />❑ <br />SEPTIC TANK TYPE/MFG EXISTING <br />CAPACITY <br />gal # OF COMPARTMENTS <br />❑ MOUNDED WIDTH <br />❑ <br />GREASE TRAP TYPE/MFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />WELL ft FOUNDATION <br />ft PROPERTY LINE <br />DISTANCE TO NEAREST: WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />DEPTH <br />❑ <br />LIFT STATION SIZE TYPE OF PUMP <br />❑ PKG TX PLANT <br />❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />ft <br />❑ DISPOSAL PONDS WIDTH <br />ft LENGTH It <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />❑ LEACH LINES LEACHING CHAMBERS Infiltrator EQ -36 # OF LINES 7 <br />LENGTH OF LINES 100 <br />ft <br />DISTANCE TO NEAREST <br />WELL City Water ft FOUNDATION 80 <br />ft PROPERTY LINE 10 <br />ft <br />❑ FILTER BED WIDTH <br />ft LENGTH ft <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL ft FOUNDATION <br />It PROPERTY LINE <br />ft <br />❑ MOUNDED WIDTH <br />It LENGTH ft <br />DEPTH <br />It <br />DISTANCE TO NEAREST <br />WELL ft FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ SUMPS WIDTH <br />ft LENGTH It <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL ft FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ DISPOSAL PONDS WIDTH <br />ft LENGTH It <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL it FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ SEEPAGE PITS NUMBER 7 <br />WIDTH 5-0- - (60") <br />ft DEPTH 25 Feet <br />ft <br />DISTANCE TO NEAREST <br />WELL City Water ft FOUNDATION 150 <br />ft PROPERTY LINE 10 <br />ft <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 />MINIAIIM AA 114nMR AnVANCF NnTICF RF[]I/IRFn FAR INSPFCTII)NS - PLFASF CALL /2091 953-7697 <br />SIGNED <br />to <br />TITLE PRESIDENT <br />DATE 11-24--220j21 <br />- - - - "� �- <br />��analpn 3 <br />IME NT <br />�o EIVED <br />NOV 2 4 2021 <br />sM JCAQUIN COUNTN <br />CtsIitaONMENTAL <br />I tEAIL"!' DEPARTMENT <br />D-ARTMENT USE ONLY-��+}'1`/�IJ� <br />Application Accepted Date Area �%�J� Employee ID# is �t/Y <br />Final Inspection By Date I 1 SPEEI FAL PERMIT - Approved by <br />Character of Soil to Depth of 3 Ft: PiVSump Soil Character: <br />COMMENTS DO /LUT � �- f7JA OA LZAfif <br />PE SC Received Check#/ Amount <br />ate Permit/ Invoice # Permit ID# <br />Code INFO Cash Remitted <br />Service Request # <br />2 I U 5 <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18 <br />