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SR0081127
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081127
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Entry Properties
Last modified
9/24/2019 1:55:55 PM
Creation date
9/24/2019 11:31:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0081127
PE
4222
FACILITY_NAME
1350 REPORT AVE
STREET_NUMBER
1350
Direction
N
STREET_NAME
REPORT
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
14315015
ENTERED_DATE
9/6/2019 12:00:00 AM
SITE_LOCATION
1350 N REPORT AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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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 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 1350 Report Ave CITY/ZIP Stockton,95205 <br /> m <br /> CROSS STREET East Harding Way APN 143-150-150-000 PARCEL SIZE 1.850 e <br /> 0 <br /> OWNER NAME Chea Investments LLC PHONE 209 603-2045 y <br /> OWNER ADDRESS 4522 Spyglass Drive CITY/STATE/ZIP Stockton,CA,95219 <br /> CONTRACTOR Advanced GeoEnvironmental,Inc.(AGE) PHONE(800)511-9300 <br /> CONTRACTOR ADDRESS 837 N Shaw Road CITY/STATE/ZIP Stockton,CA,95215 <br /> LICENSE I C-42 I C-36 OTHER C-57/A-HaZ NUMBER 680227 EXPIRATION DATE 11/30/19 <br /> WATER TABLE DEPTH:–40 ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> PERC TEST # BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: I RESIDENCE I COMMERCIAL I OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES 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 ft <br /> DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL It 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 It FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH It DEPTH ft <br /> DISTANCE TO NEAREST WELL R 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!2091953-7697 <br /> SIGNED / \I,- <br /> TITLE Senior Geologist DATE 04 September 2019 <br /> PAYMENT11 N <br /> EIVED <br /> ij <br /> 0 6 2019 <br /> UIN COUNTY <br /> ONMENTAL <br /> rDiAfftt DEPARTMENT <br /> D PARTME E N <br /> Application Accepted Date Area Employee ID# <br /> Final Inspection By Date L SPE AL PERMIT-Approved by <br /> Character of Soil to epth of 3 Ft: P' ump oil CVaracter, <br /> COMMENTS PRY—Co I a IOfn I�9- fl�)A/! 4 1^L . <br /> PE SC Re eiv d Check#/ Amount PermiU <br /> Code INFO ash emitted Date ervice Re est# Invoice# Permit ID# <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />
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