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 />CALL <br />JOB ADDRESS 14300 N DeVries Road <br />CROSSSTREET Kingdon <br />OWNER NAME Susan Ripken Lambie <br />OWNER ADDRESS Same <br />CONTRACTOR DR Jolly <br />953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DA <br />CITY/Z1P Lodi 95242 <br />APN 055-240-050-000 PARCEL SIZE 23 Acres <br />P.— 209.327.2262 <br />PHONE 209.334.1395 <br />CONTRACTOR ADDRESS 261 S Stratford Lane CITYISTATElZIP Lodi <br />I 95242 <br />C-2 , C-36 ONUMBER EXPIRATIONDATE 1213 ' /2 <br />02-2LICENSE 442555 <br />WATER TABLE DEPTH: <br />ft GEOGRAPHICAL INFORMATION: Coordinates X <br />Y <br />PERC TEST # <br />BUILDING PERMIT # <br />LAND USE APPLICATION # <br />TYPE OF WORK: <br />NEW INSTALLATION <br />REPAIRIADDITION <br />ENGINEER DESIGNED/ALTERNATIVE <br />WIDTH <br />REPLACEMENT <br />OUT -0F -SERVICE SEPTIC SYSTEM <br />IK DESTRUCTION <br />INSTALLATION WILL SERVE: I RESIDENCE <br />COMMERCIAL <br />I OTHER <br />7 NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK <br />TYPEIMFG <br />CAPACITY _ <br />gal # OF COMPARTMENTS <br />❑ GREASE TRAP <br />TYPE/MFG <br />CAPACITY <br />gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL <br />ft FOUNDATION <br />_ _ R 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 />#OF LINES <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION_ <br />❑ FILTER BED <br />WIDTH <br />ft <br />LENGTH <br />DISTANCE TO NEAREST <br />WELL <br />it FOUNDATION <br />❑ MOUNDED <br />WIDTH <br />It <br />LENGTH <br />_ <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION _ <br />❑ SUMPS <br />WIDTH <br />ft <br />LENGTH <br />_ _ <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION _ <br />❑ DISPOSAL PONDS WIDTH <br />ft <br />LENGTH <br />_ <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />❑ SEEPAGE PITS <br />NUMBER <br />WIDTH <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION <br />LENGTH OF LINES ft <br />R PROPERTY LINE ft <br />DEPTI- ft <br />ft PROPERTY LINE _ ft <br />DEPT• It <br />ft PROPERTY LINE It <br />DEPTF <br />ft PROPERTY LINE R <br />DEPTH ft <br />ft PROPERTY LINE ft <br />DEPTH ft <br />fl PROPERTY LINE ft <br />EPARTMENTUSEONLY <br />Application Accepted By � _ _ Date �'- J � Area Ci G L% i Employee ID# <br />Final Inspection By-/Y��=n _ Data �' Y' _ SPECIAL PERMIT -Approved by <br />Character of Soil to Depth of 3 Ft: 4 PWSump Soil Character. <br />42-01 /Z ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4114118 <br />q �'M <br />0,92 <br />021 92021 <br />V/N <br />pgENo uNTY <br />R T MENTI <br />