SR0083587 - 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 JOB ADDRESS 5224 CROSS STREET Bennett Dr. OWNER NAME Shana Etal Ln. Q CITy/Zip StocktRon, CA 95212 PARCEL SIZE OWNER ADDRESS 5224 Shippee Ln CIN/STATE/ZIP $tOCktOn3 CA 95212 CONTRACTOR Carnahan CODStrUCtlOn PHONE 209-581-8090 CONTRACTOR ADDRESS 5750 W. F St. CITY/STATE21P Banta CA 953004 LICENSE ❑❑C-42 ❑❑C-36 OTHER B NUMBER 1035870 EXPIRATION DATE / d o �? WATER TABLE DEPTH: n GEOGRAPHICAL INFORMATION: COOrdinateS X ❑ PERC TEST # BUILDING PERMIT# LAND USE APPLICATION # INSTALLATION WILL SERVE: � RESIDENCE ❑ COMMERCIAL NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: 3 SEPTIC TANK O GREASETRAP O LIFT STATION Y ❑ ENGINEER DESIGNED / LTERNATIVE I DESTRUCTION t4YI ❑ OTHER NUMBER OF EMPLOYEES: TYPE/MFG Concrete CAPACITY 1900 gal # OF COMPARTMENTS 2 TYPE/MFG '/e If CAPACITY gal #OFCOMPARTMENTS� DISTANCE TO NEAREST: WELL /V ft FOUNDATION � n PROPERTY LINE 4 ft SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR (ENCLOSED SYSTEM) O LEACH LINES NEW INSTALLATION #OF LINES LENGTH OF LINES ❑ REPAIR/ADDITION TYPE OF WORK: ❑ DL REPLACEMENT Tank ❑ OUT -OF -SERVICE SEPTIC SYSTEM INSTALLATION WILL SERVE: � RESIDENCE ❑ COMMERCIAL NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: 3 SEPTIC TANK O GREASETRAP O LIFT STATION Y ❑ ENGINEER DESIGNED / LTERNATIVE I DESTRUCTION t4YI ❑ OTHER NUMBER OF EMPLOYEES: TYPE/MFG Concrete CAPACITY 1900 gal # OF COMPARTMENTS 2 TYPE/MFG '/e If CAPACITY gal #OFCOMPARTMENTS� DISTANCE TO NEAREST: WELL /V ft FOUNDATION � n PROPERTY LINE 4 ft SIZE TYPE OF PUMP O PKG TX PLANT O SAND OIL SEPARATOR (ENCLOSED SYSTEM) O LEACH LINES ❑ LEACHING CHAMBERS 2 #OF LINES LENGTH OF LINES Amount Remitted DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTYLIN O FILTER BED WIDTH Check#I Cas Amount Remitted ft LENGTH Invoice # Permit ID# ft DEPTH n 3�0 DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft O MOUNDED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTYLINE ft O SUMPS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTYLINE ft O DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft O SEEPAGEPITS NUMBER WIDTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION n PROPERTY LINE ft I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAOUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAOUIN COUNTY. 0 0 y l DEPARTMENT USE�ONLY u G Application Accepted By G—� Lr � Date ri0 Area l � -I Employee ID#� Final Inspection By /�}-6�lei.4-/Q-�1N'ra ' Date u.,Z('_ �' � ❑ SPECIAL PERMIT -Approved by Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: COMMENTS On R Ublic 0-m r "t) Wel s PE Code 42_01 SC INFO Received B Check#I Cas Amount Remitted Date Permit/ ervice Re uest # Invoice # Permit ID# Waw Its 3�0 b g2-�3 4/14/1 S ONSITE WASTEWATER TRTMNT SYSTEM PERMIT