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SR0082794
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082794
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Last modified
12/9/2020 3:45:48 PM
Creation date
12/9/2020 3:36:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082794
PE
4216
FACILITY_NAME
5298 BRUNSWICK ROAD
STREET_NUMBER
5298
Direction
E
STREET_NAME
BRUNSWICK
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
19704006
ENTERED_DATE
10/28/2020 12:00:00 AM
SITE_LOCATION
5298 E BRUNSWICK RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HE.ALTH DEPARTMENT 1868 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)468-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 5298 Brunsvdda Road CITY/ZIP Manteca,95336 m <br /> CROSS STREET 99 Frontage Road APN. Iq 7O q O 0b PARCEL SIZE I Y <br /> OWNER NAME <br /> San Joaquin Delta Community PHONE College 209-954-5052 7: <br /> U <br /> OWNERADDRESS 5151Padfc Avenue CITY/STATE/ZIP Stockton,CA 95207 <br /> CONTRACTOR (Genera)CNW Construction/(Subcontractor)Allen A Waggoner Consuuclion Inc. PHONE(General)916-297-2446/(Subcontractor)209-599-8788 <br /> CONTRACTOR ADDRESS (Subcontractor)1012SAmcla Avenue CrTY/STATE2IP Ripon.CA95366 <br /> LICENSE ❑7C-42 0-C-36 OTHER AA NUMBER 6053)8 EXPIRATION DATE 10/312022 <br /> WATER TABLE DEPTH: See T,—n Report .S4 It GEOGRAPHICAL INF(R,ATION: Coordinates X Y <br /> ❑ PERC TEST # BUILDING PERMIT# @ LAND USE APPLICATION# <br /> TYPE OF WORK: NEW INSTALLATION C REPAIR/ADDITION C ENGINEER DESIGNED/ALTERNATIVE <br /> ❑ REPLACEMENT I OUT-OF-SERVICE SEPTIC SYSTEM C DESTRUCTION <br /> INSTALLATION WILL SERVE: ❑ RESIDENCE )k COMMERCIAL ❑ OTHER Ed—lonrGavanmenl <br /> NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES:'-'*- S Cyt <br /> SEPTIC TANK TYPEIMFG PBL Concrete Products CAPACITY 1500 gal #OF COMPARTMENTS 02 <br /> O GREASF TRAP TYPE/MFG A CAPACITY_ gal #OF COMPARTMENTS <br /> Tubi Ic 0el l DISTANCE TO NEAREST: WELL 179 It FOUNDATION S � ft PROPERTY LINE S�jt <br /> O LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT 13 SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> 0 LEACH LINES -1 LEACHING CHAMBERS y #OF LINES 4 LENGTH OF LINES 100 ft <br /> P,)61;(.Well DISTANCE TO NEAREST WELL r It FOUNDATION !D ft PROPERTY LINE <br /> ft <br /> O FILTER BED WIDTH ft LENGTH ft DEPTH It <br /> DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE It <br /> O MOUNDED WIDTH it LENGTH it DEPTH ft <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE It <br /> (3 SUMPS WIDTH it LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION ft PROPERTY LINE It <br /> O DISPOSAL PONDS WIDTH it LENGTH It DEPTH It <br /> DISTANCE TO NEAREST WELL It FOUNDATION it PROPERTYLINE It <br /> O SEEPAGE PITS NUMBER WIDTH ft DEPTH fl <br /> DISTANCE TO NEAREST WELL It FOUNDATION it PROPERTY LINE ft <br /> 1 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 HO )R INSPECTIONS-PLEASE CALL(209)953-7697 <br /> SIGNED Colin Culver l CNW Construc _ 'ITLE Project Manager DATE 10/122020 <br /> F YMENT <br /> ,1 t CT 28 201 <br /> R QUI O <br /> ONMENT�NTy <br /> H DEMN7A NT <br /> e / <br /> DEPARTMENT U E O LY <br /> Application Accepted Datei10 Area� Employee ID# <br /> Final Inspection By Date SPECIAL PERMIT-Approved by <br /> Character of Soil t Depth of 3 Ft: Pit/ Ump Soil Ch racter: <br /> CO[v1MENTS Ohl mf�la,r ' -gym w — O h. <br /> fh— <br /> PE SC Received Check#/ Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO B sh Remitted ervice Re uest# <br /> Or <br /> 42-01 ///•1 �fj ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> ems_ <br /> 4/14/18 `/ ffffff /1S 77/ / 31 <br />
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