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SR0084765
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4200/4300 - Liquid Waste/Water Well Permits
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SR0084765
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Entry Properties
Last modified
3/4/2022 4:09:18 PM
Creation date
3/4/2022 2:57:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0084765
PE
4218
STREET_NUMBER
1362
Direction
N
STREET_NAME
SHAW
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
14326006
ENTERED_DATE
1/25/2022 12:00:00 AM
SITE_LOCATION
1362 N SHAW RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 468-3420 <br />NON-KEFUNDABLE PERMIT GALL (LUB) 1003-/D8/ FOR INSPECTIONS tXPIRE5 T TEAR FROM LJAIt 155Ut <br />JOB ADDRESS 1362 N. SHAW RD CITY/ZIP STOCKTON/95215 <br />CROSS STREET E. FREMONT ST APN 14326006 PARCEL SIZE 228 AC <br />OWNER NAME EAGLES NEST HARLEY DAVIDSON PHONE 209-438-13624050 <br />OWNER ADDRESS 1362 N. SHAW RD. CITY/STATE/ZIP STOCKTON <br />CONTRACTOR HALEY CONTRACTING PHONE 209-463-2517 <br />CONTRACTOR ADDRESS 4228 NEWTON RD. CITY/STATE/ZIP STOCKTON / CA / 95205 <br />LICENSE _l C-42 \. C-36 OTHER A, B, C16 NUMBER 580907 EXPIRATION DATE 11-30-23 <br />WATER TABLE DEPTH: 9 V _ f7 0 ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br />PERC TEST # I I BUILDING PERMIT # 9 109 Ovi 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: -1 RESIDENCE COMMERCIAL ] OTHER Q j <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: QVA <br />s� <br />0 SEPTIC TANK TYPE/MFG P&L CONCRETE CAPACITY 1,500 gal # OF COMPARTMENTS 2 <br />❑ GREASE TRAP TYPE/MFG CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL �J b I I O It FOUNDATION ft PROPERTY LINE fl <br />❑ LIFT STATION SIZE TYPE OF PUMP ❑ PKG TX PLANT ❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />O <br />LEACH LINES <br />LEACHING CHAMBERS <br />INFILTRATOR E4 A # OF LINES <br />3 LENGTH OF LINES %4, " ft <br />Date L;?.) <br />Area Employee ID# YA <br />DISTANCE TO NEAREST <br />WELL <br />N/A <br />ft FOUNDATION 15 <br />ft PROPERTY LINE 70 fl <br />Pit/Sump OilChar cter: <br />❑ <br />FILTER BED <br />WIDTH <br />ft <br />LENGTH <br />L lfi< <br />It DEPTH ft <br />t Pc` 1►rlt'S <br />�/ <br />ockr 'll li 1 <br />f <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />It PROPERTY LINE ft <br />❑ <br />MOUNDED <br />WIDTH <br />ft <br />LENGTH <br />(n Sb <br />ft DEPTH <br />Y/y <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE <br />❑ <br />SUMPS <br />WIDTH <br />It <br />LENGTH <br />ft DEPTH <br />, IAA <br />DISTANCE TO NEAREST <br />WELL <br />fl FOUNDATION <br />ft PROPERTY LINE ft <br />`a <br />❑ <br />DISPOSAL PONDS WIDTH <br />It <br />LENGTH <br />ft DEPTH J4 <br />2 <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE fl <br />5 /Q ' <br />SEEPAGE PITS <br />NUMBER 3WIDTH <br />36 <br />ft DEPTH 25 <br />DISTANCE TO NEAREST <br />WELL <br />N/A <br />It FOUNDATION 40 <br />ft PROPERTY LINE 70 <br />vIN L'OI , T' <br />lv <br />I HEREBY <br />CERTIFY THAT <br />I HAVE PREP D <br />ICATION <br />AND <br />THE WORK WILL BE IJIACCORDANCE <br />WITH SAN JOAQUIN COUNTY ORDINANC ,H D <br />PgRrI�JN�I <br />ATE LAWSHIS <br />AND <br />RULES AND REGULATIONS OF SANONE <br />OAQUIN COUNTY. <br />MI <br />H E NOTICAREQUIRED <br />FOR INSPECTIONS <br />- PLEASE CALL 2 7 <br />SIGNED <br />- <br />TITLE PROJECTMANAGER DATE 1-25-22 <br />ko <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18 <br />DEPARTMENTU <br />fi L <br />EONLY <br />f ✓l <br />Application Accepted By <br />Date L;?.) <br />Area Employee ID# YA <br />Final Inspection By / > • J <br />yG '" Date <br />-1 SPECIAL PERMIT - Approved by <br />Character of Soil to epth of 3 Ft: <br />Pit/Sump OilChar cter: <br />COMMENTS cwJ cora M(ye,�, <br />SYS e. c1bjF�L <br />0ci erSiZF / �5P 011 <br />L lfi< <br />M I <br />t Pc` 1►rlt'S <br />�/ <br />ockr 'll li 1 <br />f <br />'m C - � � <br />PE SC Received Check Amount Date <br />Permit/ Invoice # Permit ID# <br />Code INFO B <br />Remitted <br />Service Re st# <br />4a) <br />(n Sb <br />42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18 <br />
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