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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1668 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 468-3420 NON-REFUNDABLE PERMIT GALL JOB ADDRESS 10800 E West Ripon Road CROSS STREET Austin Road J9J-/OJ/ FOR INSPECTIONS LXPIRES 1 YEAR FROM UATE ISSL CITy/ZIp Ripon, 95366 APN 257-240-620-000 PARCEL SIZE 2.090 Acres OWNER NAME Marsha & Jerry Jenkins PHONE 209-630-5358 OWNER ADDRESS (209) 230-3314 Cm/STATE/ZIP Stockton, CA, 95215 CONTRACTOR AdvancedGeo, Inc. PHONE(800)511-9300 CONTRACTOR ADDRESS 837 North Shaw Road CITY/STATE2IP Stockton, CA, 95215 Supervised by CA Pro. 6e LICENSE C-42 ❑-C-36 OTHER GEO NUMBER _a`^'_ EXPIRATION DATE January 2023 ❑ LEACH LINES i LEACHING CHAMBERS 50-60 feet LENGTH OF LINES ft DISTANCE TO NEAREST WATER TABLE DEPTH: It GEOGRAPHICAL INFORMATION: Coordinates X Y PERC TEST #-' BUILDING PERMIT # ft LENGTH LAND USE APPLICATION # TYPE OF WORK: - NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED /ALTERNATIVE ft PROPERTY LINE ft REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: ❑ RESIDENCE 1 COMMERCIAL _ OTHER NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: ❑ SEPTIC TANK TYPE/MFG CAPACITY gal # OF COMPARTMENTS ❑ GREASETRAP TYPE/MFG CAPACITY gal #OFCOMPARTMENTS ❑ DISPOSAL PONDS WIDTH DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE fl ❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT ❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) ❑ LEACH LINES i LEACHING CHAMBERS # OF LINES LENGTH OF LINES ft DISTANCE TO NEAREST WELL It FOUNDATION it PROPERTY LINE ft ❑ FILTER BED WIDTH ft LENGTH it DEPTH ft DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ MOUNDED WIDTH It LENGTH it DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION it PROPERTY LINE It ❑ SUMPS WIDTH it LENGTH 0 DEPTH ft DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft ❑ DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH It DISTANCE TO NEAREST WELL ft FOUNDATION it PROPERTY LINE ft ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIMUM 48 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 SIGNED (--":5 TITLE Staff Geologist DATE 03/14/2022 DEPARTMENT USF ONLY Application Accepted By Date 3417a7ce� Area i Employee ID#—A("7 Final Inspection By Date ❑ SPECIAL PERMIT - Approved by Character of Soil to Depth of 3 Ft: Sw j Pit/Sump Soil Character: COMMENTS 4 011ie- I ,, a L i: PE I SC I Received I Check#/ I AmountPermiU ... Date. _ _ Invoice # Permit ID# n- 42-01 4214, 4/14/18 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT cNT AFD 9?? 4L )ENT