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SR0082890
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082890
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Last modified
4/14/2021 9:51:47 AM
Creation date
4/14/2021 9:22:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082890
PE
4213
FACILITY_NAME
12455 N CURRY AVE
STREET_NUMBER
12455
Direction
N
STREET_NAME
CURRY
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
06114083
ENTERED_DATE
11/16/2020 12:00:00 AM
SITE_LOCATION
12455 N CURRY AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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FILTER BED WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL <br />— LEACHING CHAMBERS Infiltrator Ea 38 # OF LINES 3 LENGTH OF LINES 65' ft <br />ft FOUNDATION SE' ft PROPERTY LINE 60' ft <br />ft DEPTH ft <br />ft FOUNDATION ft PROPERTY LINE ft <br />ft DEPTH ft <br />ft PROPERTY LINE ft <br />ft DEPTH ft <br /> ft PROPERTY LINE ft <br /> ft DEPTH ft <br />42-01 <br />4/14/18 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />DISTANCE TO NEAREST WELL 193. <br />TYPE OF WORK: )(' NEW INSTALLATION <br />1:1 REPLACEMENT <br />)r. RESIDENCE Li COMMERCIAL <br />NUMBER OF BEDROOMS: <br />'1 1 ENGINEER DESIGNED /ALTERNATIVE <br />0 DESTRUCTION <br />CI OTHER <br />NUMBER OF EMPLOYEES: <br />REPAIFt/ADOMON <br />OUT-OF-SERVICE SEPTIC SYSTEM <br />INSTALLATION WILL SERVE: <br />NUMBER OF LIVING UNITS: <br />LIFT STATION 0 PKG TX PLANT CI SAND OIL SEPARATOR (ENCLOSED SYSTEM) SIZE TYPE OF PUMP <br />CAPACITY 1500 gal # OF COMPARTMENTS 2 <br /># OF COMPARTMENTS <br />ft PROPERTY LINE 266 <br /> CAPACITY gal <br />ft FOUNDATION Z 1- <br />ti SEPTIC TANK TypENFG P and L Concrete <br />GREASE TRAP TYPE/MFG <br />t50 DISTANCE TO NEAREST: WELL ft <br />ft LENGTH <br />WELL ft FOUNDATION <br />ft LENGTH <br />WELL ft FOUNDATION <br />ft FOUNDATION <br />Wen, 42" <br />ft FOUNDATION 1°Cr ft PROPERTY LINE 50' ft <br />ft <br />ft <br />)1 LEACH LINES <br />MOUNDED WIDTH <br />DISTANCE TO NEAREST <br />SUMPS WIDTH <br />DISTANCE TO NEAREST <br />DISPOSAL PONDS WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL ft PROPERTY LINE <br />ft DEPTH 23' SEEPAGE PITS NUMBER 3 <br />DISTANCE TO NEAREST WELL 250' <br />I HEREBY CERTIFY THAT I HAVE PR ARED 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 />,21 tAt <br />arI N E NOTICE REQUIRED FOR iNSUEGertiticA2E CALL 20 9 7 7 7( <br /> TITLE it DATE t1EN Cb <br />•• <br />SIGNED <br />1E00 <br />To,ok 05t -LIAM <br /> <br />4\ki <br />DEPARTMENT USE ONLY <br />_L----- Z--Z-- Date Ii P.V., ., <br />Final Inspection By aatrijt.. ..0 'CUS1440,0., Date C/ S I 1.1, 1 -vbi-t Li SPECIAL PERMIT - Approved by <br />Character of Soil to Depth of 3 Ft: Pit/Sump S0II Character: F--/..)V• 4,X.,./.30 i <br />COMMENTS Amy,/ sHz. -r e f _ /\it, vie ilS i..1 ,H,,,i4 s-t-* 46 i per- r/r)or -- <br />recorOk• <br />PE <br />Code <br />SC <br />INFO <br />Received <br />By <br />Check/N <br />Cash <br />Amount <br />Remitted Date , <br />Permit/ <br />Regiusst A Invoice # Permit ID# <br />9a 13 11 -7 (.49, 11 6149 f• s i'Ll \111.1,0 , tZrOt`gV`610 <br />Application Accepted By Are. tjJ4q Employee ID#
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