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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 166E E. HAZELTON AVENUE - STOCKTON CA 95205. (208) 468-3420 <br />nUN-KEFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUE. <br />JOB ADDRESS 12958/12970 E Jahant Road CrrT21P Acamoo, 95220 <br />CROSS STREET North Graham Road APN 007-270-22 PARCEL SIZE 4.59 acres <br />OWNER NAME Baltazar MOrones ' <br />PRONE <br />OWNER ADDRESS Same as above Po R ao) CITY/STATEILP (IVw G le �} -/ 5Qa <br />CONTRACTOR Petralogix Engineering PHONE 209-770-0731 <br />CONTRACTOR ADDRESS 26675 Bruella Road CRY/STATE/ZIP Galt. CA 95632 <br />LK:ENSE C-42 11 'C-36 OTHER PG NUMBER 8657 EXPIRATION DATE4/30/2023 <br />Daniel Kramer <br />WATER TABLE DEPTH: <br />X PERC TEST # <br />TYPE OF WORK: <br />6 GEOGRAPHICAL INFORMATION: Coordinates X -121.159122 W y 38.204143- <br />2 BUILDING PERMIT # LAND USE APPLICATION # <br />NEW INSTALLATION REPAIRIADDmoN ENGINEER DESIGNED IALTERNATNE <br />REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION <br />INSTALLATION WILL SERVE: L RESIDENCE <br />I COMMERCIAL <br />7 OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES: <br />❑ <br />SEPTIC TANK <br />TYPEJMFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />❑ <br />GREASETRAP <br />TYPEIMFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL <br />It FOUNDATION <br />H PROPERTY LINE ft <br />❑ <br />UFT STATION <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 R <br />DISTANCE TO NEAREST WELL <br />It FOUNDATION <br />It PROPERTY LINE ft <br />❑ <br />FILTER BED <br />WIDTH ft LENGTH <br />It DEPTH It <br />DISTANCE TO NEAREST WELL <br />fl FOUNDATION <br />ft PROPERTY LINE It <br />❑ <br />MOUNDED <br />WIDTH II LENGTH <br />ft DEPTH It <br />DISTANCE TO NEAREST WELL <br />It FOUNDATION <br />R PROPERTY LINE It <br />❑ <br />SUMPS <br />WIDTH It LENGTH <br />ft DEPTH It <br />DISTANCE TO NEAREST WELL <br />ft FOUNDATION <br />It PROPERTY LINE fl <br />❑ <br />DISPOSALPONDS WIDTH It LENGTH <br />ft DEPTH ft <br />DISTANCE TO NEAREST WELL <br />It FOUNDATION <br />ft PROPERTY LINE fl <br />❑ <br />SEEPAGE PITS <br />NUMBER WIDTH <br />It DEPTH ft <br />DISTANCE To NEAREST WELL <br />It FOUNDATION _ <br />— ft PROPERTY LINE fl <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 />�t <br />O <br />O <br />b <br />r <br />PARTM T US LY /w <br />Application Accepted By _ F— {� Date Area y f %� Employee ID#ER <br />Final Inspection By Date SPECIAL PERMIT -Approved by <br />Character of Soil to Depth of 3 Ft: PiUSump Soil Character: <br />COMMENTS <br />Code I INFO 8v / 1 Vt7Bfh. RomiHnA Date InvoIce # I Permit ID# <br />42-0 <br />K24±,Y <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />