Laserfiche WebLink
1 <br />ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 -(209) 468-3420 <br />NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />26603 S. Hansen Road <br />CrrIZIP Tracy, 95377 <br />JOB ADDRESS <br />West Schulte Road APN 209-110-04 PARCEL SIZE 2.53 <br />ft <br />CROSS STREET <br />(209)833-7107 <br />WELL <br />OWNER NAME Arron Fountain <br />PHONE <br />it PROPERTY LINE <br />OWNER ADDRESS 26603S. Hansen Road <br />CnvISTATEIZIP Tracy, CA 95377 <br />WIDTH <br />Terracon Consultants Inc./ Aaron Mejorado <br />PHONE (209)367-3701 <br />ft <br />CONTRACTOR <br />ft <br />CONTRACTOR ADDRESS 902 Industrial Way <br />CITYISTATEIZIP Lodi, CA 95240 <br />ft FOUNDATION <br />PE <br />72446 EXPIRATION DATE 06/30/2922 1024 <br />ft <br />LICENSE I C-42 . I C-36 OTHER NUMBER <br />CII <br />ft LENGTH <br />WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br />XI PERC TEST # 3 BUILDING PERMIT # <br />LAND USE APPLICATION # <br />TYPE OF WORK: NEW INSTALLATION <br />REPAWADDITION ENGINEER DESIGNED /ALTERNATIVE <br />REPLACEMENT <br />OUT -OF -SERVICE SEPTIC SYSTEM DESTRUCTION <br />INSTALLATION WILL SERVE: _' RESIDENCE <br />COMMERCIAL OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK TYPE/MFG <br />CAPACITY gal # OF COMPARTMENTS <br />❑ GREASE TRAP TYPE/MFG <br />CAPACITY gal # OF COMPARTMENTS <br />DISTANCE TO NEAREST: WELL <br />It FOUNDATION ft PROPERTY LINE it <br />❑ LIFT STATION SIZE TYPE OF PUMP <br />❑ PKG TX PLANT ❑ SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ LEACH LINES <br />LEACHING CHAMBERS <br /># OF LINES <br />LENGTH OF LINES <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />it PROPERTY LINE <br />ft <br />❑ FILTER BED <br />WIDTH <br />it LENGTH <br />ft <br />DEPTH <br />ft <br />DISTANCE To NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ MOUNDED <br />WIDTH <br />ft LENGTH <br />ft <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />It PROPERTY LINE <br />it <br />❑ SUMPS <br />WIDTH <br />It LENGTH <br />it <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ DISPOSAL PONDS <br />WIDTH <br />ft LENGTH <br />it <br />DEPTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />ft PROPERTY LINE <br />ft <br />❑ SEEPAGE PITS <br />NUMBER <br />WIDTH <br />ft DEPTH <br />It <br />DISTANCE TO NEAREST <br />WELL <br />It FOUNDATION <br />ft PROPERTY LINE <br />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 />u'llil115L•JuL!%l:Nl•1:I:19%Jil97�Ce1/L7��13�1�JG1y7i %��6[v�ti7•L n�rar��r�c�-�z��+wci.•ocr.•�•� <br />• �IField Geologist (CA only) 05/27/2022 <br />Application Accepted By <br />Final Inspection By C. <br />Character of Soil to Depth of 3 <br />COMMENTS PI <br />Area 5 Employee ID# JAS <br />SPECIAL PERMIT - Approved by <br />PE SC Received eck# Amount ate PermiU Invoice # Permit IO# <br />Code INFO B Remitted Service Request# . <br />J;ta;) it <br />42.01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />4/14/18 <br />