My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SR0066652
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
T
>
13TH
>
1934
>
4200/4300 - Liquid Waste/Water Well Permits
>
SR0066652
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
10/23/2019 3:30:33 PM
Creation date
12/2/2017 12:48:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0066652
PE
4221
FACILITY_ID
FA0017836
FACILITY_NAME
AVINA, MIGUEL F SR
STREET_NUMBER
1934
Direction
E
STREET_NAME
13TH
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
17118038
ENTERED_DATE
2/22/2013 12:00:00 AM
SITE_LOCATION
1934 E 13TH ST
QC Status
Approved
Scanner
SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\T\THIRTEENTH\1934\SR0066652.PDF
QuestysFileName
SR0066652
QuestysRecordID
1945098
QuestysRecordType
12
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
Page 1 of 1
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue-STOCKTON CA 95205-6232-(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 9.53-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS ! /CITY ZlP ^� <br /> CRO55 STREET <br /> APN / 4 �r lPARCEL SIZE 0 �' — <br /> OWNER NAME `^ a7 <br /> lJr�� !— L.�V �� PHONE <br /> IIt�� � <br /> OWNER ADDRESS _ CITYISTATEIZIP _ <br /> qvLCONTRACTOR Lf _ __ PHONE <br /> CONTRACTOR ADDRESS C(oLJ I _�` �� �v( CITY/STATE/ZIP <br /> LICENSE UC42 17C-36 OTHER � —� � NUMBER %�EXPIRATION DATE <br /> WATER TABLE DEPTH: _ ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ❑ PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: ❑ NEW INSTALLATION L REPAIR/ADDITION L ENGINEER DESIGNED/ALTERNATIVE <br /> LI REPLACEMENT DESTRUCTION L-- <br /> INSTALLATION WILL SERVE: E RESIDENCE ❑ COMMERCIAL �NOIM�IEROF <br /> �- <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: MPLOYEES: <br /> ❑ SEPTIC TANK TYPEIMFG CAPACITY gal #OF COMPARTMENTS <br /> ❑I GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL It FOUNDATION ft PROPERTY LINE ft <br /> ❑ `LIFT STATION SIZE — TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES E 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 It <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 ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE It <br /> ❑ DISPOSAL PONDS WIDTH - ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE It <br /> ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft <br /> DISTANCE To NEAREST W€LL ft FOUNDATION ft PROPERTY LINE ft <br /> I HEREBYCERTIFY T HAVE PREP ED 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 /> UR ADVANCE NOTICE REQUIRED FOR INSPEC IONS,-/PL,EASE CALL(209)953-7697 <br /> SIGNED TITLE DATE DATE 2 <br /> ti w <br /> � S <br /> T <br /> �1 <br /> T <br /> • DEPARTMENT LIV ONLY <br /> Application Accepted3 Date Area Employee ID#, ���7 <br /> Final Inspection By Cp Date a 26 ❑ SPECIAL PERMIT-Approved by <br /> Character of Soil to D pth of 3 Ft: PiVSump Soil Cha aeter: <br /> COMMENTS 0 --Lk-El I:3 *4e- dervlwtiSkJ-(4s jk9k- <br /> - P Y1 Ld5+- -f DL.60—L.60— ed 61-1� <br /> r <br /> PE SC Received liec Amount Permit! <br /> Code INFO B sh Remitted Date Service Request# Invoice# Permit ID# <br /> dZ-)L- <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 10!4/07 <br />
The URL can be used to link to this page
Your browser does not support the video tag.