My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SR0081112
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
L
>
LEADSTONE
>
24405
>
4200/4300 - Liquid Waste/Water Well Permits
>
SR0081112
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
9/19/2019 7:02:09 PM
Creation date
9/19/2019 2:09:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0081112
PE
4211
FACILITY_NAME
24405 N LEADSTONE DR
STREET_NUMBER
24405
Direction
N
STREET_NAME
LEADSTONE
STREET_TYPE
DR
City
ACAMPO
Zip
95220
APN
00536003
ENTERED_DATE
9/4/2019 12:00:00 AM
SITE_LOCATION
24405 N LEADSTONE DR
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
4
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 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 <br /> _NON-REFUNDABLE PERMIT CALL(209)953-7697 FOR INSPECTIONS EXPIRES 11 YEAR FROM DATE ISSUED <br /> JOB ADDRESS Z��O; 1e- /�py�,-- J�� CITY/ZIP �AG�Y�Cb /�Zo! a <br /> CROSS STREET e!5 = e ,pJL APN_101.7�� PARCEL SIZE <br /> d <br /> v <br /> z <br /> OWNER NAME ZSf9- �'i�e �U/Ull/ _PHONE <br /> OWNER ADDRESS /� ^� /1 __/T✓�� / CITY/STATE/ZIP <br /> CONTRACTORCPHONE <br /> CONTRACTOR ADDRESS <br /> J / <br /> CITY/STATE/ZIP �1aCaiw <br /> LICENSE 00C-42 _Ii iC-36 OTHER NUMBER yO�/S EXPIRATION DATE_ <br /> WATER TABLE DEPTH: E/(/ L ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ❑ PERC TEST # BUILDING PERMIT# ZCAND USE APPLICATION# <br /> TYPE OF WORK: §C NEW INSTALLATION I I REPAIR/ADDITION I1 ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT Il OUT-OF-SERVICE SEPTIC SYSTEM ❑ DESTRUCTION _ <br /> INSTALLATION WILL SERVE: RESIDENCE ❑ COMMERCIAL ❑ OTHER <br /> NUMBER OF LIVING UNITS: I NUMBER OF BEDROOMS: 3 NUMBER OF EMPLOYEES: <br /> SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> CP- <br /> C3 GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL1ft FOUNDATION ft PROPERTY LINE SO" ft <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 5 ft <br /> DISTANCE TO NEAREST WELL JS6 ft FOUNDATION 76 ft PROPERTY LINE SZ 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 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 /> �, <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> 0/SEEPAGE PITS NUMBER WIDTH ft DEPTH � ft <br /> DISTANCE TO NEAREST WELL /5-0' ft FOUNDATION ft PROPERTY LINE 1�70 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 TITLE DATE <br /> FAAE <br /> E <br /> s o_Q— <br /> O M N <br /> T E T 1H <br /> EPA RTMENT SE NLY <br /> Application Accepted B Date Area Employee ID#� <br /> Final Inspection By-7 fDate _�G� P SPECIAL PERMIT-Approved by <br /> Character of Soil to Depth of 3 Ft:- PI /Sump Soil Character: <br /> COMMENTS �-IJN 7 _0o 2jf iP 144WWA <br /> PE SC Received Che Amount Permit/ <br /> Code INFO B Cash Remitted Date Service Request# Invoice# Permit ID# <br /> �-3 Ga MIMI2 <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />
The URL can be used to link to this page
Your browser does not support the video tag.