Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868E HAZEL TON 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 16327 DIABLO COURT CITYtz P TRACY CA 95304 I^ <br /> CROSS STREET TSIRELAS DRIVE ApN 209-370-19 PARCEL SIZE 2.07 b <br /> p0 <br /> OWNER NAME <br /> WARREN ERNST PHONE 925-872-1825 {'• <br /> 7f <br /> OWNER ADDRESS <br /> 16327 DIABLO COURT CITYISTATE/ZJP TRACY CA 95304 <br /> CONTRACTOR <br /> TERRACON CONSULTANTS INC. PHONE 209-367.3701 <br /> CONTRACTOR ADDRESS 9021NOUSTRLAL WAY CITY/STATE/b, LODI CA 95240 <br /> LICENSE i_.' C-42 ^1 -C•36 OTHER C_57 NUMBER 559004 ExP1RATION DATE 5131/19 <br /> WATER TABLE DEPTH: -t5 it GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> PERC TEST Y ' BUILDING PERMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION REPAIRIADDITION - ENGINEER DESIGNED/ALTERNATIVE <br /> REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION <br /> INSTALLATION WILL SERVE: D RESIDENCE C. COMMERCIAL LOTHER <br /> NUMBER OF UVING UNITS: NUMBER OF BEDROOMS. NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG _ CAPACITY gal #OF COMPARTMENTS <br /> ❑ GREASE TRAP TYPEIMFG __ CAPACrTY gal #OF COMPARTMENTS_ <br /> DISTANCE TO NEAREST. WELL _ If FOUNDATION _ ft PROPERTY LINE It <br /> O UFT STATION SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> O LEACH LINES LEACHING CHAMBERS NOF LINFS LENGTH OF LINES it <br /> DISTANCE TO NEAREST WELL fl FOUNDATION _h PROPERTY LINE it <br /> ❑ FILTER BED WIDTH It LENGTH it DEPTH _it <br /> DISTANCE TO NEAREST WELL ft FOUNDATION _R PROPERTY LINE ft <br /> ❑ MOUNDED WIDTH N LENGTH _ fl DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION it PROPERTY LINE ft <br /> ❑ SUMPS WIDTH it LENGTH A DEPTH ft <br /> DISTANCE TO NEAREST WELL fl FOUNDATION fl PROPERTY LINE it <br /> ❑ DISPOSAL PONDS WIDTH R LENGTH R DEPTH ft <br /> DISTANCE TO NEAREST WELL It FOUNDATION fl PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH fl DEPTH ft <br /> DISTANCE TO NEAREST WELL It FOUNDATION ft PROPERTY LINE if <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 46 HQ�g <br /> g NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 1209)953-769 <br /> SIGNED Woods,Tamara �^+ �•^�^� TITLE STAFF SCIENTIST DATE 0210112019 <br /> I � <br /> ------------- <br /> l:i.. <br /> 'l <br /> .S <br /> N <br /> L. <br /> A141 J q UltI TY <br /> N I NT <br /> PARTMQU�us Puy <br /> S o <br /> Application Accepted By Date Area _ Employee ID# <br /> Final Inspection By Date 7 SPECIkL PE MIT-Approved by <br /> Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: <br /> COMMENTS — <br /> PE SC Received Chscktt! Amount Permit/ Invoice N Permit IDN <br /> Code INFO Date Cash Remitted Service Request N <br /> u 2 v 4111q .Iq 019v <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> W14110 <br />