Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 468-3420 <br />NUN-KEFUNL iLE YEKMII GALL <br />JOB ADDRESS 4101 5. Airport Way <br />CROSS STREET Industrial Dr. <br />OWNER NAME Pacific Gas h Electric <br />OWNER ADDRESS 77 Beale Street o <br />CONTRACTOR ASIa Construction Co , Inc. <br />CONTRACTOR ADDRESS 1090 St, Francis Way <br />YOJ-/69/ FOR INSPECTIONS <br />CITY/ZIP Stockton 95206 <br />APN 177-280-310-000 PARCEL SIZE 24.83 acres <br />tXPIRES I YEAR FROM UATE ISSUEI <br />11114,1) wde P'IR <br />PHONE 926-872-2544 <br />CITY/STATE/ZIP San Francisco, CA 94105 <br />PHONE 707 249 3562 <br />CITY/STATE/ZIP Bio Vsla CA 94571-0758 <br />LICENSE C-42 C-36 OTHER A General Engineering NUMBER 247178 EXPIRATION DATE 2,28/22 <br />WATER TABLE DEPTH: It GEOGRAPHICAL INFORMATION: Coordinates X Y <br />PERC TEST # 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 COMMERCIAL OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK <br />TYPE/MFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />❑ GREASE TRAP <br />TYPE/MFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />WELL <br />DISTANCE TO NEAREST: WELL <br />ft FOUNDATION <br />ft PROPERTY LINE ft <br />❑ LIFT STATION <br />SIZE TYPE OF PUMP <br />❑ PKG TX PLANT <br />❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ LEACH LINES <br />LEACHING CHAMBERS <br />Check#/ <br />as <br /># OF LINES <br />Date Permit/ Invoice # Permit ID# <br />Service Request # <br />LENGTH OF LINES <br />7S <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />❑ FILTER BED <br />WIDTH <br />ft LENGTH <br />ft <br />DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />❑ MOUNDED <br />WIDTH <br />ft LENGTH <br />ft <br />DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />❑ SUMPS <br />WIDTH <br />ft LENGTH <br />ft <br />DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />❑ DISPOSAL PONDS <br />WIDTH <br />ft LENGTH <br />ft <br />DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <br />❑ SEEPAGE PITS <br />NUMBER <br />WIDTH <br />ft DEPTH <br />DISTANCE TO NEAREST <br />WELL <br />ft <br />FOUNDATION <br />ft PROPERTY LINE <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 <br />REGULATIONS OF SAN JOAQUIN <br />COUNTY. <br />IrIII�IIr Irl 'ry IIVVR n✓vn/1VL 111V II{rL RC VIRC✓ rVR IIr JI'CV I IVIYJ rLCFIJC {.rNLL LV7 .Y JqJ'/O.Y// <br />SIGNED 1 �� TITLE Sr, rT t L'fil�`�'� DATE <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />ft <br />J , DEPARTMENTUSE ONLY <br />Application Accepted By L L� _ Date Xld t '7 Area I S r" k Employee ID#__ <br />Final Inspection By Date I C� <br />-zSPECIAL PERMIT -Approved by <br />Character of Soil to Depth of 3 Ft: PiU ump Soil Character: <br />COMMENTS <br />PE <br />Code <br />Sc Received <br />INFO <br />Check#/ <br />as <br />Amount <br />Remitted <br />Date Permit/ Invoice # Permit ID# <br />Service Request # <br />7S <br />So _2 <br />4� / 3CJ� � ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/1411l4/ 18 <br />