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SR0082541
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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33 (STATE ROUTE 33)
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31396
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082541
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Entry Properties
Last modified
11/20/2024 8:59:33 AM
Creation date
3/3/2021 2:46:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082541
PE
4222
STREET_NUMBER
31396
Direction
S
STREET_NAME
STATE ROUTE 33
City
TRACY
Zip
95304
APN
25531022
ENTERED_DATE
9/2/2020 12:00:00 AM
SITE_LOCATION
31396 S HWY 33
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1888 E.HAZELTON AVENUE-STOCKTON CA 95205-(209)488-3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 31390 #-31 -51L, s'. 5-17. l2 T• 33 CITY/ZIP ( 9-A C 13 l q 4 <br /> CROSS STREET ^IVU�"r,f)Yyk f ,fy�'�`"7 APN ZS� �3i 0% ' ZZ `pP�A�"RCEL SIZE �`t'�" ' " ° p <br /> OWNER NAME ✓ j"^)�t w n,.T� PHONE 1(P W() lo&v 3t _-I S"n <br /> OWNER ADDRESS I `� `��' - CITY/STATE21P/ �C l.� t i0% <br /> �O Y-- <br /> CONTRACTOR LOU Q P`I•� C�G�'>�N V(2L;i�I�'�'Y�L- PHONE 3yci-C3-i'1 <br /> CONTRACTOR ADDRESS T-'•1 L�, L ^ CITY/STATE/ZIP L-C'01 C <br /> LICENSE L_ C-42 0I.:C36 OTHER <br /> NUMBER Z1 1 E%PIRATION DATE T- 3L <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> PERC TEST # I 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 J COMMERCIAL 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 ❑ 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 /> (3 FILTER BED WIDTH ft LENGTH R DEPTH it <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 it <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 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 /> L9AAaUQVRAQ VANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL 2 7 <br /> SIGNED �� TITLE r Q'�J' n`' DATE <br /> EFNr <br /> IVEt) <br /> A �2 2020 <br /> Application Accepted .�j2 L L DEPARTMENT Date3U J ONLY Area 5 C��% Employee ID E I R�NMENTq��' <br /> Final Inspection By Date SPECIAL PERMIT-Approved by gRTMEIyT <br /> Character of Soil to Depth of 3 Ft: Pi mp Soil Character: <br /> COMMENTS <br /> PE SC Received ec Amount Date Permit/ Invoice# Permit ID# <br /> Code INFO B Cash Remitted ServiceRe uest# <br /> 'iaaa Sd3 #.Ise . <br /> Ly <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 4/14/18 <br />
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