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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1869E.HAMILTON AVENUE-STOCRTON CA 95MS-(209)498-3420 <br /> NON-REFUNDABLE PERMIT CALL(209)953.7697FORINSPEC77ONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> Joe ADOREss_12023 E- BRANDT ROAD cmV21P I OCKEFORD CA 951237 <br /> CROSS STREET_LOCKE ROAD MN 051-320-08 PenoEL sm 2.32AcREs <br /> s <br /> OWNER NAME LARRY WOODS PNONE209-603-0794 <br /> OWNER ADDRESS 9834 FERNWOOD AVENUE CITYMIATIMP STOCKTON. CA 95212 <br /> C❑NTRACTOR_TERRACON CONSULTANTS INWINE 209-367-3701 <br /> CONTRACTORAD❑REan 902 INDUSTRIAL WAY Cm/STATERIP LODI, CA 95240 <br /> LICENSE 0LIC-42 3'_IC-39 OMER C57 NUMBER669004 EFNMTB,D.. 5/31/2017 <br /> WATER TABLE DEPTH: 0 GEOGRAPHKALINFORMATION: COOrdlnetas X Y <br /> PERC TEST s_i I BUILDING PERMIT s LAND USE APPLICATION <br /> TYPE OF WORK: NEw MSTALLuirox -. REPAIRIAoneem LI ExONEERD SroxaD IALTERxATWE <br /> REPLACEMENT LI OUT-0FSEANCESEPTCSYSTEM U OESTIUCTNM <br /> INSTALLATION WILL SERVE: ❑ RE ExCE ❑ COMMERCIAL ❑ OTHER <br /> NUNI OF LMNG UNITS' NWBER OF BEDROOMS: NOMBER OF EMKOYEES: <br /> ❑ SEPTICTANK TYPE/WG CAPACITY OBI NOFCOMPARTMEMS <br /> (3 GREASETRAP TYPFJMFG CAPACITY gal Por COMPARTMENTS <br /> DISTANCE To NEAREST: WELL R FOUNDATION R PROPEMYLINE 8 <br /> ❑ LIFTSTATION SIZE TYPE OF PUMP D PRO TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> O LEACH LINES rl LEACHING CHAMBERS soFLNES LENGTHOFLNEa R <br /> DISTANCETONEAREST WELL-- R FMMOATpN R MosturrvuNE R <br /> ❑ FILTER BED Wpm R LENGTH R DEPTH R <br /> DISTANCETONEAREST WELL R FORNICATION A HIOPERTYLNE R <br /> U MOUNDED WON R LENGTH R DEPTH R <br /> DISTANCE TO NEAREST -I R FOINDATOM R PROPERTYIBNE R <br /> ❑ SUMPS WEnH R LENGTH R DEPTH R <br /> DISTANCE TO NEAREST WELL R FOUNDATION R PROPERTY LINE R <br /> ❑ DISPOSALPONDS WDTM R LENoN R DEPTH R <br /> DISTANCETONEAREST WELL R FOUNDATION It PRq¢RYLIME R <br /> ❑ SEEPAGE PITS NIMSFA WDTx R DEPTH R <br /> DISTANCE TO NEAREST WELLR Pot nma KHN R PROPERTY LINE R <br /> I HEREBY CERTFYTHAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE N ACCORDANCE WON SAM JOAQUIN COUNTYOROINANCES, <br /> STATE LAWS ANO RULES AND REUUTAMNS OF SAN JOAOUN COUNTY. <br /> MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INS" EASE CALL(209)953 7597 <br /> SIGNED TITLE STAFF SCIENTIST <br /> DATE_0101-2017 _ <br /> •—_�• APPROXIMATE SINE <br /> -_,,,�T' PFRWNTXRI TEST ' I <br /> LDGT❑N TIIIHPN <br /> TE EII18TNo <br /> __— LFAC161ELp ,Mr _-�_ <br /> .e 41V <br /> FLj' EJMir <br /> 2 Q�� P 0 <br /> C7 .- -- �i 7 O , <br /> 1TOpsM MAD = <br /> MTi <br /> D SPAR TAIEd <br /> Applicetloe Accepted Elk Area Employee <br /> Final Inspection By Data ❑ SPECIAL PERMIT-Approved by <br /> Cherecler o/Soll to Daptll oI3 Ft: PNBUmp Sell Clunder. <br /> COMMENTS <br /> PE SC I Reeel"d I CheclW Amount ParmN InvDlr�/ PmmNIDs <br /> Data <br /> Code INFO By Cash RanHWd SarYlNa oats <br /> +— <br /> 42-01 <br /> 7A12 N <br /> 4DUONSITE WASTEWATER TRTLT SYSTEM PERMIT <br />