Laserfiche WebLink
iv kaei <br />y 3,s ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 7868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (2091468-3420 <br />Y <br />nUN-T(tFUIVDABLE PERMIT <br />CALL (209) 953-7697 FOR INSPECTIONS <br />EXPIRES 1 YEAR FROM DATE ISSU' <br />JOB ADDRESS <br />6011 East Pinc Street <br />CITY/ZIP <br />Lodi, CA 95240 <br />CROSS STREET <br />Guild AVC. <br />APN 049-120-65 <br />PARCEL SIZE 16.82 <br />OWNER NAME <br />Rivermade- <br />pdG EijPHONE <br />209-369-3586 <br />OWNER ADDRESS <br />6155 East Pine Street% <br />NUMBER OF BEDROOMS: <br />Lodi, CA 95240 <br />CONTRACTOR <br />Haley Contracting <br />CITYISTATEZP <br />1 i IS 209-463-2517 <br />gal # OF COMPARTMENTS <br />❑ <br />PHONE <br />_ CAPAC7'TY <br />CONTRACTOR ADDRESS 4228 Newton Road CITYISTATE721P Stockton , CA 9525 <br />LICENSE C-42 "JC"..0-36 OTHER A, B, C-16 NUMBER 580907EXPIRATIONDATE 11/30/2017 <br />WATER TABLE DEPTH:? f1 it <br />GEOGRAPHICAL INFORMATION: COOrdIRetB3 X <br />y <br />€ <br />PERC TEST # BUILDING PERMIT # LAND USE APPLICATION # <br />TYPE <br />OF WORK: NEW INSTALLATION <br />X REPAIR/ADDITION <br />ENGINEER DESIGNED /ALTERNATIVE <br />REPLACEMENT <br />OUT -OF -SERVICE SEPTIC SYSTEM <br />DESTRUCTION <br />WILL SERVE: RESIDENCE X. COMMERCIAL <br />OTHER <br />LINSTALLATION <br />NUMBER OF LIVING UNITS: <br />NUMBER OF BEDROOMS: <br />NUMBER OF EMPLOYEES: 300 <br />❑ <br />SEPTIC TANK TYPE/MFG Existing <br />CAPACITY _ <br />gal # OF COMPARTMENTS <br />❑ <br />GREASE TRAP TYPE/MFG <br />_ CAPAC7'TY <br />gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL_ It FOUNDATION <br />It PROPER'Y LME h <br />❑ <br />LIFTSTATION SITE TYPE OF PUMP O PKG TX PLANT ❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ <br />LEACH LINES LEACHING CHAMBERS # of LINES <br />LENGTH OF LINES ft <br />DISTANCE TO NEAREST <br />WELL It <br />h PROPERTY UNE it <br />IN <br />FILTER BED WIDTH _ 40 <br />�FO.,UNNDATION <br />it LENGTH 5-r ft <br />DEPTH Y -O" It <br />DISTANCE TO NEAREST <br />WELL _ It FOUNDATION _ft <br />PROPERTY LINE it <br />❑ <br />MOUNDED WIDTH <br />ft LENGTH H <br />DEPTH ft <br />DISTANCE TO NEAREST <br />WELL It FOUNDATION <br />ft PROPERTY LINE ft <br />❑ <br />SUMPS WIDTH ,4 <br />ft LENGTH �^ ft <br />DEPTH ft <br />DISTANCE TO NEAREST <br />WELL It FOUNDATION <br />R PROPERTY LINE ft <br />❑ <br />DISPOSAL PONDS WIDTH ___ <br />it LENGTH it <br />DEPTH - ft <br />DISTANCE TO NEAREST <br />WELL.___ It FOUNDATION <br />R PROPERTY LINE ft <br />® <br />SEEPAGE PITS NumuER 4 <br />WIDTH3�-O" It <br />DEPTH 25.'.-O" tt <br />DISTANCE To NEAREST <br />WELLCjtY Water ft FOUNDATION 40'..0" <br />It PROPERTY LINE 71-0' ft <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 REGULATIONS OF SAN JOAQUIN COUNTY. <br />SIGNED <br />Application Accept <br />spection <br />Final In! <br />Character of Soil to <br />COMMENTS <br />of 3 Ft: <br />f L 2 <br />E President <br />a -3a O�, <br />=ofte <br />Area 1 "i <br />SPECIAL <br />PIUSump Soil Character: _ <br />DATE lune 13, 2017 <br />au? <br />4u"N cou <br />fV1l'' <br />Employee lD# I <br />Approved by <br />42.01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4,24112 <br />V(1-MCNT <br />}D�0.- <br />A <br />--)-5----- <br />Area 1 "i <br />SPECIAL <br />PIUSump Soil Character: _ <br />DATE lune 13, 2017 <br />au? <br />4u"N cou <br />fV1l'' <br />Employee lD# I <br />Approved by <br />42.01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4,24112 <br />V(1-MCNT <br />