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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA95205-(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 1352 BALDWIN LANE CITY/ZIP STOCKTON Ln <br /> H <br /> m <br /> CROSS STREET EAST FREMONT STREET/HIGHWAY 26 APN 101-130-74 PARCEL SIZE 15.59 0 <br /> 0 <br /> OWNER NAME AARON PARADISO PHONE N <br /> OWNER ADDRESS 1282 BALDWIN LANE CITY/STATEIZIP STOCKTON CA 95215 <br /> CONTRACTOR TERRACON CONSULTANTS INC PHONE 209-269-8586 <br /> CONTRACTOR ADDRESS 902 INDUSTRIAL WAY CITY/STATE/ZIP LODI,CA 95240 <br /> ron <br /> LICENSE C C-42 El C-36 fiOTHER r'q`�ONUMBEF_7d I EXPIRATION DAT- ��DI <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> TC/ PERC TEST #3 BUILDING PERMIT# LAND USE APPLICATION# <br /> F <br /> TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED 1ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE -1 COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPEIMFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL It FOUNDATION ft PROPERTY LINE It <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SUMPS WIDTH It LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE _ It <br /> ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH <br /> DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE /.0 I ` <br /> 1 HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDII8pI1C.�$ `rte 18 ?0?� <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. -'��F VV'1O <br /> MINIM A WOODUM 48 S <br /> ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL D(A209)09-15-2020 E TND MF/VooNj�. <br /> SIGNED opullys a wooas.ra..,, TITLE STAFF SCIENTIST <br /> ��s-�a,Tira °I q R rM60 <br /> tl 1 <br /> it <br /> �I <br /> I o <br /> it O — <br /> II O <br /> 0 <br /> I Il W <br /> f O <br /> o0 <br /> i O <br /> o <br /> 0 <br /> IO X-- <br /> i' o <br /> — <br /> •wcwr <br /> DEPARTMENTUSF ONLY <br /> Application Accepted B 1 Date Q / J O Area T % Employee ID#� <br /> Final Inspection By Date_ / p_ ❑ SPECIAL PERMIT-Approved by <br /> Character of Sail to epth of 3 Ft: ! PI Sump Soil Character: <br /> COMMENTS a O ')Jkl K01-6-- <br /> A 1 7�- W6 w <br /> PE SC Received Check#/ Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO B rash Remitted Service Request# <br /> vim <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4i14118 <br />