SR0085067 - Laserfiche WebLink

Home Browse Search

Date Area Employee ID# D PARTMENT USE O-NLY s 0 SPECIAL PERMIT - Approved by mp Soil Character: v 419 711111w.1111W Yr' Application Accepted By Final Inspection By Character of Soil to COMMENTS d th of 3 Ft: / 4 Date ONSITE WASTEWATER TREATMENT SYSTEM PERMIT SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209)468-3420 NON-REFUNDABLE PERMIT CALL (209) 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED 8 12,oc APN 2-50 PARCEL SIZE r 5 3 PHONE 0-6ei 40 Ltb— 9 LIL25 p;ci Rocyl cAnk CONTRACTOR P\ Se_Akt CONTRACTOR ADDRESS \JONA\ Dv- SL. LICENSE El 0C-42 00C-36 OTHER NUMBER 1 1:3 0 •c3,1-; EXPIRATION DATE 11 -S C) WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X EI PERO TEST # BUILDING PERMIT It. LAND USE APPLICATION # TYPE OF WORK: O NEW INSTALLATION D REPLACEMENT INSTALLATION WILL SERVE: E RESIDENCE SEPTIC TANK TYPE/MFG NUMBER OF LIVING UNITS: NUIMAER OF BEDROOMS: NUMBER OF EMPLOYEES: ‘ik CAPACITY gal # OF COMPARTMENTS GREASE TRAP TYPE/MFG CAPACITY gal # OF COMPARTMENTS ft FOUNDATION ft PROPERTY LINE ft DISTANCE TO NEAREST: WELL LIFT STATION SIZE TYPE OF PUMP CI PKG TX PLANT 0 SAND OIL SEPARATOR (ENCLOSED SYSTEM) # OF LINES ) LENGTH OF LiNEs 50 ft DISTANCE TO NEAREST WELL I j 9 ft FOUNDATION 1 5 ft PROPERTY LINE ( 7 ft WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ft LENGTH ft DEPTH ft WELL ft FOUNDATION ft PROPERTY LINE ft ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft DISPOSAL PONDS WIDTH ft LENGTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft ij SEEPAGE PITS NUMBER WIDTH ft DEPTH ft DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE 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. SIGNED MINIMUM 48 HOUR ANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 TITLE r \nine_ v DATE d-5 III. NAM to_ I , MI, I I fl 111111111 2 • PE Code '-f, SC INFO l Received By, (Check:IP -- - Amount Remitted - a v - Permit/ Service Request # Invoice # Permit ID# t,as 8 gfrs" 4 te --72,2___49eon 0 (0-7 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT 4/14/18 JOB ADDRESS CROSS STREET St-prvey \ OWNER NAME 4-rY/ZiP OWNER ADDRESS cmasTATE0, --ryckci GI 5 3 6 Lk PHONE i4-nq -bi1 1,(A-1 9 CITY/STATE/ZIP 14\teAes\--() (Pc q S 3S REPAIR/ADDITION 0 ENGINEER DESIGNED /ALTERNATIVE OUT-OF-SERVICE SEPTIC SYSTEM 0 DESTRUCTION COMMERCIAL OTHER ki) LEACH LINES 0 LEACHING CHAMBERS FILTER BED MOUNDED WIDTH DISTANCE TO NEAREST SUMPS WIDTH