SR0084469 - Laserfiche WebLink

Home Browse Search

ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 4683420 I'ERMII tXPIRES l TLAK t -RUM IJAIt 155UED JOB ADDRESS I L1r->r.) C t-7.'ek ACI it IC-- ,/� CITY/ZIP ]] CROSS STREET %LESC IS JC-C� APN; V I I ✓` V` OWNER NAME �c(1"�-1 GFJ�C Q/_nL 1 i41G1 ShG;nDiy1 PHONE OWNERADDRESS SSeAr"e. CITYISTATE/ZIP CONTRACTOR Septic Services Group PHONE 916-203-6259 CONTRACTOR ADDRESS PO BOX 569 CITY/STATE/ZIP Wilton, CA -95693 PARCEL SIZE 1-76 LICENSE i C42 _I C-36 OTHER A NUMBER 1068208 EXPIRATION DATE 8-31-2022 ❑ LEACH LINES I 0 # OF LINES WATER TABLE DEPTH: t V_ �+ ft GEOGRAPHICAL INFORMATION: Coordinates X Y PERC TEST # BUILDING PERMIT # LAND USE APPLICATION # TYPE OF WORK: NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED /ALTERNATIVE REPLACEMENT OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION INSTALLATION WILL SERVE: RESIDENCE IJ COMMERCIAL OTHER 2 NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: `J NUMBER OF EMPLOYEES: ❑ SEPTIC TANK TYPE/MFG CAPACITY gal # OF COMPARTMENTS ❑ GREASE TRAP TYPEIMFG CAPACITY gal # OF COMPARTMENTS WELL DISTANCE TO NEAREST: WELL ft FOUNDATION ft PROPERTY LINE ft ❑ LIFT STATION SIZE TYPE OF PUMP 0 PKG TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) ❑ LEACH LINES LEACHING CHAMBERS # OF LINES I LENGTH OF LINES 65 ft B Cash DISTANCE TO NEAREST WELL ft FOUNDATION kF;OV It PROPERTY LINE ft ❑ FILTER BED WIDTH ft LENGTH it DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ MOUNDED WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ SUMPS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ❑ DISPOSAL PONDS WIDTH ft LENGTH It DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE ft SEEPAGE PITS NUMBER I WIDTH 5 It DEPTH Z 157- ft DISTANCE TO NEAREST WELL ZfXi t ft FOUNDATION l (JU i.- ft PROPERTY LINE /cAr. ft I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. MINIMUM 48 HOU DVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL 209 1953-7697 rl Yen— SIGNED It=TITLE �y/ �-� DATE Application Accepted By 'Y-/ t— Date i a Area 14 lq4q Employee ID# Final Inspection By e-9-09^- Date&- -?i SPECIAL PERMIT -Approved by Character of Soil to Depth of 3 Ft: Pit/Sump Soil Character: COMMENTS FLj j 1 jj15)14e . C"'tIstlh <" IhPs 'I`o rerrie k PE Received Check #/ Amount Permit/Invoice Code B Cash Remitted Date # Permit ID# Service Request # LI�10 kF;OV 300 •I •71 9 07 '-I 42-01 C� / 1. 1 1461 I /t ��I ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4114/18 �/ • Vj`\J1 , V- f v(