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PERC TEST # 1 BUILDING PERMIT # <br /> <br />LAND USE APPLICATION # <br />42-01 <br />4/14/18 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />Application Accepted B <br />Final Inspection By Date 1 <br />lific/Su Character of Soil to • p of 3 Ft: <br />COMMENTS r -a-k_ I v 3 0 en;SA <br />Area i /61 Ci Employee ID# As. <br />0 SPECIAL PERMIT - Approved by <br />erecter: <br />PE <br />Code <br />SC <br />INFO <br />Received <br />B <br />Check#/ <br />Cash <br />Amount <br />Remitted Date 1,s <br />PermiU <br />Service Request # Invoice # Permit ID# <br />i-la? S? 3 17/5,-- ,446-a. KO , --';' <br />1 <br />s • 1.4, Wqg <br />DEPARTMENT E NLY <br />Date 12 <br />• <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZEIJON AVENUE - STOCKTON CA 95205 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL (209)953-7697 For? INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />JOB ADDRESS 6631 South Jack Tone Road crrozip Stockton 95215 <br />CROSS STREET Mariposa Road ApN 181-080-170-000 <br />PARCEL SIZE 1'193 acres <br />OWNER NAME Dennis E Feist TR PHONE (209) 942-1360 <br />OWNER ADDRESS PO Box 1592 <br />Cm/STATE/ZIP Linden, CA 95236 <br />CONTRACTOR AdvancedGeo, Inc. PHONE 800 511-9300 <br />CONTRACTOR ADDRESS 837 North Shaw Road Ciri/STATFJZiP Stockton, CA 95215 <br />LICENSE :C-42 02C-36 OTHER CA Professional Geo Brian Millman <br />NUMBER 8574 EXPIRATION DATE 1/31/23 <br />WATER TABLE DEM 100-110: ft GEOGRAPHICAL INFORMATION: Coordinates X <br />TYPE OF WORK: 0 NEW INSTALLATION <br /> <br />0 REPAIR/ADDITION <br /> 17 ENGINEER DESIGNED /ALTERNATIVE <br />Li REPLACEMENT II OUT-OF-SERVICE SEPTIC SYSTEM <br /> <br />Fl DESTRUCTION <br /> <br />INSTALLATION WILL SERVE: 0 RESIDENCE 0 COMMERCIAL <br /> <br />0 OTHER <br /> <br />NUMBER OF LIVING UNITS: <br />NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />SEPTIC TANK <br />TYPE/MFG <br /> <br />CAPACITY gal # OF COMPARTMENTS <br />GREASE TRAP <br /> <br />TYPE/MFG <br /> <br />CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL ft FOUNDATION <br />ft PROPERTY LINE ft <br />LIFT STATION <br />SIZE TYPE OF PUMP 1:1 PKG TX PLANT <br /> <br />0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />LEACH LINES LEACHING CHAMBERS <br /> <br /># OF LINES LENGTH OF LINES ft <br />DISTANCE TO NEAREST WELL <br /> <br />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 <br /> <br />ft FOUNDATION ft PROPERTY LINE ft <br />SUMPS WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />SEEPAGE PITS NUMBER <br /> <br />WIDTH ft DEPTH ft <br />DISTANCE TO NEAREST WELL ft FOUNDATION 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 />MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209)953-7697 <br />SIGNED Brian Millman TITLE CA Professional Geologist No. 8574 DATE 30 December 2020 <br />A <br /> <br />A