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SR0082477
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082477
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Entry Properties
Last modified
9/17/2020 2:22:16 PM
Creation date
9/17/2020 12:53:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082477
PE
4222
STREET_NUMBER
14110
Direction
S
STREET_NAME
CAMPBELL
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
20731009
ENTERED_DATE
8/19/2020 12:00:00 AM
SITE_LOCATION
14110 S CAMPBELL AVE
P_LOCATION
99
P_DISTRICT
004
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.HA2ELTON 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 14110 Campbell Avenue CITY/ZIP Escalon,95320 �n <br /> M <br /> M <br /> CROSS STREET Sorrenti Lane APN 207-310-090-000 PARCEL SIZE 8 acres C <br /> 0 <br /> OWNER NAME Doug and Cathy D011arhide PHONE(209)605-2403 y <br /> OWNER ADDRESS 14108 Campbell Avenue CITYISTATE21P Escalon,CA 95320 <br /> CONTRACTOR AdvancedGeo,Inc. PHONE 800 511-9300 <br /> CONTRACTOR ADDRESS 837 North Shaw Road CITY/STATE/ZIP Stockton,CA 95215 <br /> LICENSE C C-42 ❑ C-36XOTHEI, Pr NUMBER $S7EXPIRATION DAIc -�� d <br /> WATER TABLE DEPTH: 90-100 fi GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> x PERC TEST # t _ 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: ❑ RESIDENCE -1 COMMERCIAL OTHER <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br /> ❑ SEPTIC TANK TYPE/MFG CAPACITY gal 4 O COMPARTMENTS <br /> ❑ GREASETRAP TYPE/MFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL ft FOUNDATION_,--- _ ft PROPERTY LINE ft <br /> ❑ LIFT STATION SIZE TYPE OF PUMP O PKGTXPLANT LI SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ❑ LEACH LINES LEACHING CHAMBERS #OF LINES LENGTH OF LINES ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTYLINE 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 /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> ❑ SEEPAGE PITS NUMBER WIDTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION it 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(209)953-7697 <br /> SIGNED Brian Millman TITLE Senoir Geologist _ DATE 13 August 2020 <br /> ENT <br /> VED <br /> 2020 <br /> COUNTY <br /> LL L=EALT NTAL <br /> RTMENT <br /> DEPARTMENTUSE ONLY C <br /> Application Accepted 161L�A-1,�L Date 001'0 Area `1 7� Employee ID#� <br /> Final Inspection ByKAAn2t _ Date 611112C2-0 ❑ SPECIAL PERMIT-Approved by <br /> Character of Soil to pth of 3 Ft: F it/Sump Soil Character: <br /> COMMENTS <br /> PE SC Received Check#/ Amount PermiU <br /> Code Date INFO B Cash Remitted Service Request# Invoice N. Permit ID# <br /> y ►sa ) -15z) 17 q <br /> 4 11;-60,S-K-27 <br /> l�60, U�!!!� ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 41141114/18 <br />
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