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I 'S <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE-STOCKTON CA 95205 - (209) 468-3420 <br />I1UIv-ntrUNUNnLt rtKM1 I (.ALL (LUV) V0J-1081 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUE <br />JOB ADDRESS 4874 S. State RT 99 W. Frontage CITYI71p Stockton, CA 95206 <br />CROSS STREET Transworld Drive <br />OWNER NAME Oswaldo Ordaz <br />OWNER ADDRESS 1828 Stageline Circle <br />CONTRACTOR Dillon & Murphy, c/o Joe Murphy <br />CONTRACTOR ADDRESS PO Box2180 <br />LICENSE 11 -IC -42 ❑i,C-36 OTHER R.C.E. <br />APN 179-270-10 PARCEL SIZE 0.93 <br />PHONE 650-218-4215 <br />CITY/STATE/ZIP Rocklin, CA 95765 <br />PHONE 209-334-6613 <br />45277 <br />CITY/STATEIZIP Lodi, CA 95241 <br />9/30/22 <br />J <br />WATER IABLE DEPTH: <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />Y <br />X1 PERC TEST # <br />1 BUILDING PERMIT # <br />LAND USE APPLICATION # <br />TYPE OF WORK: <br />n NEW INSTALLATION P <br />REPAIR/ADDrnON <br />rl ENGINEER DESIGNED /ALTERNATIVE <br />WELL <br />CI REPLACEMENT ❑ <br />OUT -OF -SERVICE SEPTIC SYSTEM <br />❑ DESTRUCTION <br />INSTALLATION WILL <br />SERVE: ❑ RESIDENCE <br />❑ COMMERCIAL <br />❑ OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK <br />TYPEIMFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />❑ GREASE TRAP <br />TYPE/MFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />ft FOUNDATION <br />DISTANCE TO NEAREST: WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ LIFTSTATION <br />SIZE TYPE OF PUMP <br />❑ PKG TX PLANT ❑ <br />SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ <br />LEACH LINES <br />❑ LEACHING CHAMBERS <br />#OF LINES <br />LENGTH OF LINES ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ <br />FILTER BED <br />WIDTH <br />ft <br />LENGTH <br />ft <br />DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ <br />MOUNDED <br />WIDTH <br />ft <br />LENGTH <br />ft <br />DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ <br />SUMPS <br />WIDTH <br />ft <br />LENGTH <br />ft <br />DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ <br />DISPOSAL PONDS WIDTH <br />ft <br />LENGTH <br />ft <br />DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ <br />SEEPAGE PITS <br />NUMBER <br />WIDTH <br />ft DEPTH ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE 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 />DEPARTMENU EONLY <br />Application Accepted B Date Area 5 tot: oC ^ j,1j <br />LNEmployee ID#A <br />Final Inspection By �` L'IC�ii Date ❑ SPECIAL PERMIT -A roved b <br />` PP Y <br />Character of Soil to Depth of 3 Ft: Pit/Sump Soil,Cbaracter: <br />COMMENTS�^.T.=t C✓ r'�✓C7 %rUbrlei kriLK3 LIZ%6—((�C '1�D <br />PE SC Received hec Amount Date Permit/Invoice # Permit ID# <br />Code INFO B sh Remitted Service Re uest# <br />as sa3 qg 00 SqDx 4n <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18 <br />Project #20130 <br />