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SR0083187
EnvironmentalHealth
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4200 – Liquid Waste Program
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SR0083187
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Entry Properties
Last modified
6/14/2021 4:57:19 PM
Creation date
6/14/2021 4:54:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
SR0083187
PE
4221
STREET_NUMBER
2754
STREET_NAME
COUNTRY CLUB
STREET_TYPE
CT
City
STOCKTON
Zip
95204
APN
12106004
ENTERED_DATE
1/21/2021 12:00:00 AM
SITE_LOCATION
2754 COUNTRY CLUB CT
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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Tags
EHD - Public
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ft DEPTH ft <br />ft FOUNDATION <br /> <br />ft PROPERTY LINE ft <br /> <br />ft DEPTH ft <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - Srocicrom CA 95205- (299)403S-3420 <br />NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />Joe AGGRESS 2754 Country Club Court Dryizip Stockton, CA <br /> <br />CROSS STREET Country Club Blvd. ApN 121-06-004 PARCEL SCrE •30 <br /> <br />OWNER NAmEAronna Aaron 13,40NE21,79-11132-21X33 <br /> <br />owNER ADDRERR 2754 Country Club Court CITY/STATE/ZIP Stockton, Ca <br /> <br />CONTRACTOR Haley Contracting <br /> <br />pHopiE 209-463-2517 <br /> <br />CONTRACTOR ADDRESS 4228 Newton Road <br /> <br />erryisTATEar Eitockban, CA 95205 <br />LICENSE 01_ 0-42 XC-36 OTHER , NUMBER 580907 <br /> <br />EXPIRATION DATE 11/30/2023 <br /> <br />WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X <br />Buusgue.Pumg* LAND UBE APP'. [CATION.* GraliCaTaia d <br />TYPE OF WORK H NEW INSTALLATION <br /> <br />RePAIRIAcomori ENGINEER DESIGNED /ALTERNATIVE <br />OUT-OF-SERVICE SEPTIC SYSTEM X DESTRUCTION Abend." (E ) 5.0k El REPLACEMENT <br /> <br />INSTALLATION WILL SERVE: 0 RESIDENCE <br /> <br />NUMBER OF LIVING Werra: I <br />TYPE/MEG \,)3 °MIS <br />TYPE/MFG <br />DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft <br />UFT STATION <br /> SIZE TYPE OF PUMP Cl PKG TX PLANT CI SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />T7 COMMERCIAL <br />NUMBER OF BEDROOMS: 3 <br />0 OTHER <br />NUMBER OF EMPLOYEES: <br />SEPTIC TANK <br />GREASE TRAP <br />CAPACITY Sn <br />gal # OF COMPARTMENTS I <br />CAPACITY gal # OF COMPARTMENTS <br />LENGTH OF LINES ft <br />ft PROPERTY LINE ft <br />ft DEPTH ft <br />ft PROPERTY k.it(E ft <br />ft DEPTH ft <br />LEACH UNES 1: LEACHING CHAMBERS #OFLJNES <br />DISTANCE TO NEAREST WELL ft FOUNDATION <br />FILTER BED Wore ft LENGTH <br />MUNK§ TQ NPABIT WELL FRUNDATION <br />MOUNDED WIDTH ft LENGTH <br />DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br />ft LENGTH <br />DISTANCE TO NEAREST WELL <br />DISPOSAL PONDS Worn ft LENGTI-1 <br />DISTANCE TO NEAREST WELL <br />SEEPAGE PITS NUMBER Warm <br />SUMPS 'Nero( <br />ft PROPERTY LINE ft ft FOUNDATION <br /> ft DEPTH ft <br />DISTANCE TO NEAREST WELL It FOUNDATION <br /> <br />ft PROPERTY LINE <br /> <br />ft <br /> <br />HEREBY CERTIFY THAT I HAVE PREPARED THIS APPUCATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOACTUN COUNTY ORDINANCES, <br />ATE LAWS AND RULES AM REGULATIONS OF SAN JCIAMIN COUNTY. <br />E REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />I. <br />SIGN TITLE President DATE 1-21 2021 <br />f <br />. , I • • • • I • J I 0 • f • Jr•P r I <br />EXISTING SEPT IC TANK IS LOCATED I N <br />BACK YARD, TANK WILL BE FILLED WITH <br />SANG PLUMB ING WILL BE REROUTED <br />TO THE FRONT OF THE RESIDENCE AND <br />CONNECTED TO CITY OF STOCKTON <br />V / I • I F P 0 1 V F IV II i t w1100 15 IP <br />SEWER . SEE ATTACHED DRAWING <br />441 <br />I <br />Application Accepted B Date i 721 /21 Area <br />Final Inspection By ,q,s7-1-- Date / Urell--V%--/ 0 SPECIAL PERMIT - Approved by <br />,I2SPARTMENT USE 9N4Y <br />Employee ID9 <br />PB/Surn! 7,,ellersctsr: Character of Soil to pth of 3 Ft: <br />CrOMMEN-Tc7' C1044ecier 6,7"zi : Vei-rh <br />ofri <br />PE <br />Code <br />SC <br />INFO <br />ReceivedAssh <br />By <br />ev.....)•ddIf Amount <br />,RemItted Date PermIt/ <br />Service Rueseqt i Invoice* Permit IDS <br />V2( CIS 4kti 1(4)1 491 C1/6-2-- 11 2+7- _, <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />P44 If, <br />144101/7-Cote <br />JAIN e <br />YJoil 202, ivvocskimi <br />CO p DE.4;414 r UN Ty <br />'IR 74 r <br />4/14/18
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