SR0081388 - Laserfiche WebLink

Home Browse Search

ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED JOB ADDRESS 19012 South Calla Drive CITY/ZIP Manteca,95336 _ m CROSS STREET Graves Road APN 28 Z-' L PARCEL SIZE 60.0 Acres o 0 OWNER NAME David and Anne Maria Boersma PHONE 209 823-2607 OWNER ADDRESS 19012 South Calla Drive CITY/STATE/ZIP Manteca,CA,95336 CONTRACTOR Advanced GeoEnvironmental,Inc.(AGE) PHONE(800)511-9300 CONTRACTOR ADDRESS 837 N Shaw Road CITY/STATE/ZIP Stockton,CA,95215 LICENSE 11C-42 0__C-36 OTHER C-57/A-HaZ NUMBER 680227 EXPIRATION DATE 11/30/19 WATER TABLE DEPTH:—35-40 ft GEOGRAPHICAL INFORMATION: Coordinates X Y X PERC TEST #I BUILDING PERMIT# LAND USE APPLICATION# TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED/ALTERNATIVE REPLACEMENT OUT-OF-SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: L RESIDENCE I COMMERCIAL OTHER NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: ❑ SEPTIC TANK TYPE/MFG CAPACITY gal #OF COMPARTMENTS ❑ GREASE TRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR(ENCLOSED SYSTEM) ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ FILTER BED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL fl FOUNDATION ft PROPERTY LINE ft ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ SUMPS WIDTH ft LENGTH ft DEPTH It DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ DISPOSAL PONDS WIDTH fl LENGTH It DEPTH It DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE ft ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft DISTANCE To NEAREST WELL It FOUNDATION It PROPERTY LINE ft 1 HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIMUM 48 d0bVADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 SIGNED TITLE Senior Geologist DATE 11 Nov.2019 11 I-FlIqU DEPARTMENT SE O LY v Application Accepted By Date L Area � J Employee ID# � Final Inspection By t (G�� Date 2 SPE AL PERMIT-Approved by Character of Soil to Depth of 3 Ft: Pitdump Soil Character: COMMENTS 'c� -z---7' S "� C-e- ��i+L PE SC ReceivedChec Amount Date Permit/ Invoice# PermitID# Code INFO 8 Cash Remitted Service a uest# 2, 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14/18