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SR0085034
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0085034
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Entry Properties
Last modified
10/4/2022 4:05:31 PM
Creation date
10/4/2022 2:39:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0085034
PE
4221
FACILITY_NAME
2165 N UNION RD
STREET_NUMBER
2165
Direction
N
STREET_NAME
UNION
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
20410056
ENTERED_DATE
3/21/2022 12:00:00 AM
SITE_LOCATION
2165 N UNION RD
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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Tags
EHD - Public
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0 <br />d) G' ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E. HAZELTON AVENUE - STOCKTON CA 95205 - (209) 46"20 <br />NUN-Kt1-UNUABLt YtKMI I <br />JOB ADDRESS 2j6S N Union Road <br />CROSS STREET W Lathrop Road <br />OWNER NAME Nunes Family Properties, LP <br />OWNER ADDRESS 1463 Moffat Blvd Suite 5 <br />V0J-/0J/ I -UK INSYtGIIUNS GAI•IKt:b 13 tAK 1-KUMUA I t I,DUlz <br />J CITY/ZIP Manteca 95336 <br />�J <br />_ APN L^ 1' `J PARCEL SIZE ' L <br />PHONE 209-471-4495 <br />CITY/STATE/ZIP Manteca, Ce 95336 <br />CONTRACTOR Modesto Sand and Gravel, Inc. PHONE 209-545-4425 <br />CONTRACTOR ADDRESS 6137 Hammett Ct Cm/STATE/LP Modesto, Ca 95358 <br />LICENSE C _ C-42 11C-36 OTHER C-12 C-21 NUMBER 271166 EXPIRATION DATE 02/28/2023 <br />WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y— <br />C PERC TEST # BUILDING PERMIT # LAND USE APPLICATION # <br />TYPE OF WORK: _ NEW INSTALLATION REPAIR/ADDITION ENGINEER DESIGNED /ALTERNATIVE <br />REPLACEMENT _ OUT-OFSERVICE SEPTIC SYSTEM X DESTRUCTION Septic Tank <br />INSTALLATION WILL SERVE: C RESIDENCE CCOMMERCIAL G OTHER <br />NUMBER OF LIVING UNITS: NUMBER OF BEDROOMS: NUMBER OF EMPLOYEES: <br />❑ SEPTIC TANK TYPE/MFG <br />❑ GREASE TRAP TYPE/MFG <br />CAPACITY <br />CAPACITY <br />DISTANCE TO NEAREST: WELL ft FOUNDATION _ <br />❑ LIFT STATION SIZE TYPE OF PUMP O PKG TX PLANT <br />J <br />gal *OF COMPARTMENTS <br />gal # OF COMPARTMENTS <br />ft PROPERTY LINE ft <br />O SAND OIL SEPARATOR (ENCLOSED SYSTEM) <br />❑ LEACH LINES <br />C LEACHING CHAMBERS <br /># OF LINES <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />❑ FILTER BED <br />WIDTH <br />ft LENGTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />❑ MOUNDED <br />WIDTH <br />ft LENGTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />❑ SUMPS <br />WIDTH <br />ft LENGTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />❑ DISPOSAL PONDS WIDTH <br />ft LENGTH <br />ft <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />❑ SEEPAGE PITS <br />NUMBER <br />WIDTH <br />DISTANCE TO NEAREST <br />WELL <br />ft FOUNDATION <br />LENGTH OF LINES ft <br />ft PROPERTY LINE ft <br />DEPTH ft <br />ft PROPERTY LINE ft <br />DEPTH ft <br />ft PROPERTY LINE It <br />DEPTH ft <br />ft PROPERTY LINE ft <br />DEPTH ft <br />ft PROPERTY LINE ft <br />DEPTH ft <br />ft PROPERTY LINE ft <br />1 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 />DEPARTMENT USE -ONLY <br />LL // <br />Application Accepted B �— — Date ri / r: Area Ir Teczr4 Employee ID# A6 <br />Final Inspection By ateM j4 L SPECIAL PERMIT - Approved by <br />Character of Soil to Depth of 3 Ft: �^ Pit/Sump Soil Character: <br />COMMENTS 7eMr) <br />PE SC Received hoc Amount Date Permit/ Invoice # Permit ID# <br />Code INFO ash- Remitted Service Request# <br />IWO P5'-2 <br />42-01 <br />4/14/18 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />
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